title: Imaging trends and radiation exposure in pediatric inflammatory bowel disease at an academic children's hospital.
abstract: OBJECTIVE
  The purpose of this study was to retrospectively evaluate diagnostic imaging trends and radiation exposure in pediatric inflammatory bowel disease (IBD) at a U.S. academic children's hospital between 2001 and 2010.
  
  
  METHODS
  Pediatric IBD patients within our health system during the 2001, 2006, and 2010 calendar years were identified. The number of abdominopelvic radiologic and endoscopic examinations (total and by modality) performed during each 1-year-period was recorded for each subject. Means were compared using the Wilcoxon rank sum test. The cumulative lifetime number of diagnostic examinations by modality and estimated effective radiation dose (using Monte Carlo simulation software and CT dose-length product values) was calculated for the 2010 IBD subject cohort.
  
  
  RESULTS
  There was a 53% increase in the average number of abdominopelvic diagnostic examinations obtained per pediatric IBD patient comparing 2001 with 2010 (1.29 ± 2.19 vs 1.98 ± 3.46, p = 0.004). Abdominal radiography (p = 0.02), MRI (p < 0.0001), and esophagogastroduodenoscopy (EGD) (p = 0.01) showed significantly increased use. The increase in use of CT and ileocolonoscopy was not significant (p > 0.05). There was significantly reduced use of contrast enema, small-bowel follow-through (SBFT), and upper gastrointestinal (UGI) series (all, p < 0.0001). The average pediatric IBD patient seen in 2010 (mean age, 13.9 years) had undergone 1.08 CT, 0.82 MRI, 1.36 abdominal radiographic, 0.14 contrast enema, 0.52 SBFT, 0.54 UGI, 1.00 ileocolonoscopy, and 0.72 EGD examinations during his or her lifetime, with an average cumulative lifetime estimated effective radiation dose of 4.6 mSv.
  
  
  CONCLUSIONS
  Although the number of yearly diagnostic examinations performed for pediatric IBD patients increased significantly between 2001 and 2010, the cumulative lifetime estimated effective radiation dose is relatively low in most of these patients.
authors.affiliation: Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, C.S. Mott Children's Hospital, 1540 E Hospital Dr, Rm 3-226, Ann Arbor, MI 48109-4252, USA. dominaj@med.umich.edu
authors.forename: Jason G
authors.initials: JG
authors.lastname: Domina
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Dillman
authors.forename: Jeremy
authors.initials: J
authors.lastname: Adler
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Christodoulou
authors.forename: Shokoufeh
authors.initials: S
authors.lastname: Khalatbari
authors.forename: Adam L
authors.initials: AL
authors.lastname: Dorfman
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Strouse
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D002648:Child; D003113:Colonoscopy; D003287:Contrast Media; D004733:Enema; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000000981:diagnostic imaging*; D008297:Male; D009010:Monte Carlo Method; D011829:Radiation Dosage; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media