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Review
. 2010 May;40(5):681-6.
doi: 10.1007/s00247-009-1434-z. Epub 2009 Dec 5.

Estimated cumulative radiation dose from PET/CT in children with malignancies: a 5-year retrospective review

Soni C Chawla  1 , Noah Federman, Di Zhang, Kristen Nagata, Soujanya Nuthakki, Michael McNitt-Gray, M Ines Boechat
Affiliations
Review

Estimated cumulative radiation dose from PET/CT in children with malignancies: a 5-year retrospective review

Soni C Chawla et al. Pediatr Radiol. 2010 May.

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.

Materials and 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).

Conclusion: 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.

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Figures

Fig. 1
Fig. 1
Age distribution
Fig. 2
Fig. 2
Study distribution
Fig. 3
Fig. 3
Effective dose (mSv) of an individual CT study
Fig. 4
Fig. 4
Effective dose (mSv) of an individual PET study
Fig. 5
Fig. 5
Effective dose (mSv) of an individual PET/CT study
Fig. 6
Fig. 6
Cumulative dose (mSv) per patient from CT studies
Fig. 7
Fig. 7
Cumulative dose (mSv) per patient from PET studies
Fig. 8
Fig. 8
Cumulative dose (mSv) per patient from PET/CT studies
Fig. 9
Fig. 9
Individual PET-CT dose (mSv) as function of age
Fig. 10
Fig. 10
Cumulative PET-CT dose (mSv) as function of age
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