title: Estimated cumulative radiation dose from PET/CT in children with malignancies: a 5-year retrospective review.
abstract: BACKGROUND
  The increasing use of serial PET/CT scans in the management of pediatric malignancies raises the important consideration of radiation exposure in children.
  
  
  OBJECTIVE
  To estimate the cumulative radiation dose from PET/CT studies to children with malignancy and to compare with the data in literature.
  
  
  METHODS
  Two hundred forty-eight clinical PET/CT studies performed on 78 patients (50 boys/28 girls, 1.3 to 18 years old from December 2002 to October 2007) were retrospectively reviewed under IRB approval. The whole-body effective dose (ED) estimates for each child were obtained by estimating the effective dose from each PET/CT exam performed using the ImPACT Patient Dosimetry Calculator for CT and OLINDA for PET.
  
  
  RESULTS
  The average number of PET/CT studies was 3.2 per child (range: 1 to 14 studies). The average ED of an individual CT study was 20.3 mSv (range: 2.7 to 54.2), of PET study was 4.6 mSv (range: 0.4 to 7.7) and of PET/CT study was 24.8 mSv (range: 6.2 to 60.7). The average cumulative radiation dose per patient from CT studies was 64.4 mSv (range: 2.7 to 326), from PET studies was 14.5 mSv (range: 2.8 to 73) and from PET/CT studies was 78.9 mSv (range: 6.2 to 399).
  
  
  CONCLUSIONS
  The radiation exposure from serial PET/CT studies performed in pediatric malignancies was considerable; however, lower doses can be used for both PET and CT studies. The ALARA principle must be applied without sacrificing diagnostic information.
authors.affiliation: Department of Radiology, Olive View-UCLA Medical Center, 14445 Olive View Drive, 2 D115, Sylmar, CA, USA. chawlasoni@gmail.com
authors.forename: Soni C
authors.initials: SC
authors.lastname: Chawla
authors.forename: Noah
authors.initials: N
authors.lastname: Federman
authors.forename: Di
authors.initials: D
authors.lastname: Zhang
authors.forename: Kristen
authors.initials: K
authors.lastname: Nagata
authors.forename: Soujanya
authors.initials: S
authors.lastname: Nuthakki
authors.forename: Michael
authors.initials: M
authors.lastname: McNitt-Gray
authors.forename: M Ines
authors.initials: MI
authors.lastname: Boechat
mesh_terms: D001822:Body Burden; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D015995:Prevalence; D011829:Radiation Dosage; D011874:Radiometry / Q000706:statistics & numerical data*; D012062:Relative Biological Effectiveness; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*