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Review
. 2025 Nov;55(12):2508-2517.
doi: 10.1007/s00247-025-06371-7. Epub 2025 Aug 15.

A systematic review of radiation dose to the eye lens from pediatric brain computed tomography scans

Amanda Alison Perdomo  1   2 , Jake Cameron Forster  3   4 , Mohamed Khaldoun Badawy  5   6
Affiliations
Review

A systematic review of radiation dose to the eye lens from pediatric brain computed tomography scans

Amanda Alison Perdomo et al. Pediatr Radiol. 2025 Nov.

Abstract

Background: With the increasing use of pediatric brain computed tomography (CT) and the International Commission on Radiological Protection's revised threshold for radiation-induced lens opacities, concerns have grown regarding cumulative radiation exposure to the eye lens.

Objective: This review examines the magnitude of lens doses reported in pediatric brain CT and the methodologies used to estimate these doses.

Methods: A systematic literature search of MedLine, Embase, and PubMed (2012-2024) identified 18 eligible studies, including direct patient measurements, phantom-based experiments, and computational modeling.

Results: Reported lens doses varied widely across studies. Software-based tools generally estimate higher doses than those measured directly on patients or phantoms. Multiple dose-reduction strategies such as gantry tilting, organ-based tube current modulation, and protocol optimization were effective in significantly lowering lens exposure without compromising diagnostic quality.

Conclusion: In all cases, individual scan doses remain below the cataractogenic threshold. However, children undergoing repeated imaging may exceed this limit over time. Cumulative lens dose tracking and routine implementation of orbit-sparing techniques are recommended to reduce long-term radiation risk in vulnerable pediatric populations.

Keywords: Cataract; Computed tomography; Eye lens; Pediatrics; Radiation dose; Systematic review.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram outlining the article selection process for studies included in this review
Fig. 2
Fig. 2
Reported mean lens doses according to age from retrospective and prospective patient brain CT studies using software-based dose estimation tools [13, 16, 18, 23, 26, 28, 29]. Certain series were excluded from the “average” series – see the main text for details. mGy milligray
Fig. 3
Fig. 3
Mean lens dose per displayed computed tomography dose index volume (CTDIvol) from retrospective patient cohort studies that calculated lens doses using software-based dose estimation tools [16, 18, 23]. mGy milligray
Fig. 4
Fig. 4
Lens dose per milliampere-seconds (mAs) from retrospective patient cohort studies that calculated lens doses using software-based dose estimation tools [13, 16, 23, 28]. mGy milligray
See this image and copyright information in PMC

References

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