Estimated cumulative radiation dose from PET/CT in children with malignancies: a 5-year retrospective review.
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.
Chawla
Soni C
SC
Department of Radiology, Olive View-UCLA Medical Center, 14445 Olive View Drive, 2 D115, Sylmar, CA, USA. chawlasoni@gmail.com
Federman
Noah
N
Zhang
Di
D
Nagata
Kristen
K
Nuthakki
Soujanya
S
McNitt-Gray
Michael
M
Boechat
M Ines
MI
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*