title: Multimodality Imaging in Pediatric Osteosarcoma in the Era of Image Gently and Image Wisely Campaign With a Close Look at the CT Scan Radiation Dose.
abstract: The increasing use of serial multimodality imaging in the management of pediatric osteosarcoma raises concern of over exposure to ionizing radiation in children, especially from repeated computed tomographic (CT) scans. This study reviews the utilization of multimodality imaging in patients with osteosarcoma at our institution and analyzes any potential radiation-related complications. Twenty-eight patients were identified. Three patients developed late complications-acute myeloid leukemia, myelodysplastic syndrome, and early menopause. Using the patient's age and body part imaged, CT dose length product and effective dose was estimated with the use of a conversion factor for 19 patients. The effective doses were higher in the 3 patients with late complications than the other patients in the cohort (P=0.018). These results suggest an increased risk for adverse effects with higher CT exposures and effective doses. On the basis of our data and published data, methods to decrease the doses of radiation from medical imaging need to be explored. The number of CT scans may be limited. Implementing the Image Gently concept to decrease radiation exposure can be beneficial in modification of CT acquisition parameters.
authors.affiliation: Departments of *Radiology and Nuclear Medicine †Pediatrics, Pediatric Hematology-Oncology ∥Surgery and Orthopedics #Radiation Oncology §Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS ‡Department of Radiology, Brigham and Women's Hospital, Boston, MA ¶Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, LA.
authors.forename: Vani
authors.initials: V
authors.lastname: Vijayakumar
authors.forename: Anderson B
authors.initials: AB
authors.lastname: Collier
authors.forename: Chun
authors.initials: C
authors.lastname: Ruan
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
authors.forename: Rachel
authors.initials: R
authors.lastname: Lowery
authors.forename: Jennifer
authors.initials: J
authors.lastname: Barr
authors.forename: Chindo
authors.initials: C
authors.lastname: Hicks
authors.forename: Gail
authors.initials: G
authors.lastname: Megason
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Vijayakumar
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D064847:Multimodal Imaging / Q000009:adverse effects / Q000379:methods; D012516:Osteosarcoma / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000009:adverse effects*; D055815:Young Adult