title: Retrospective study of cumulative diagnostic radiation exposure during childhood in patients with spina bifida.
abstract: BACKGROUND
  The Biological Effects of Ionizing Radiation Committee of the National Academy of Sciences in 2005 and other expert panels have warned that risk of cancer increases with higher doses of radiation. Children with spina bifida and hydrocephalus have far greater exposure to radiation than the average person, starting almost directly after birth and continuing throughout their lifetimes.
  
  
  OBJECTIVE
  The purpose of this study was to estimate the amount of ionizing radiation that patients with spina bifida and hydrocephalus are exposed to during childhood from diagnostic imaging.
  
  
  METHODS
  Thirty patients, ages 18 years or older, with spina bifida and hydrocephalus were randomly selected from a spina bifida clinic and their radiology records were reviewed. Descriptive analyses were conducted. The total radiation exposure was then calculated for the study group, and the mean effective dose per patient was determined.
  
  
  RESULTS
  In the study group, during their first 18 years, each patient had a mean of 55.1 studies and a median of 45 radiologic studies, a mean of 9.6 brain CT scans, and a mean cumulative effective dose of 81.9 mSv (2.6 mSv/patient/year over 18 years) and a median cumulative effective dose of 77.2 mSV of accumulated radiation exposure (4.5 mSv/patient/year over 18 years).
  
  
  CONCLUSIONS
  Clinicians should recognize that increased radiation exposure puts patients with spina bifida and hydrocephalus at higher risk for cancer. The population of children and adults with spina bifida and hydrocephalus should be surveyed for incidence of cancer.
authors.affiliation: Children's Hospital Los Angeles, Department of Pediatrics, Los Angeles, CA, USA; USC Keck School of Medicine, Los Angeles, CA, USA; USC Center for Excellence in Developmental Disabilities, Los Angeles, CA, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Smookler
authors.affiliation: Children's Hospital Los Angeles, Department of Pediatrics, Los Angeles, CA, USA; USC Keck School of Medicine, Los Angeles, CA, USA; USC Center for Excellence in Developmental Disabilities, Los Angeles, CA, USA. Electronic address: adeavenportsaman@chla.usc.edu.
authors.forename: Alexis
authors.initials: A
authors.lastname: Deavenport-Saman
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003952:Diagnostic Imaging / Q000009:adverse effects / Q000379:methods*; D006233:Persons with Disabilities; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging*; D009369:Neoplasms / Q000209:etiology; D000069079:Radiation Exposure / Q000009:adverse effects / Q000032:analysis*; D011859:Radiography; D012189:Retrospective Studies; D016135:Spinal Dysraphism / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Cancer; Childhood; Cumulative effective radiation dose; Hydrocephalus; Spina bifida