Risk of Brain Tumor Induction from Pediatric Head CT Procedures: A Systematic Literature Review
Open accessAbstract
Head computed tomography (CT) is instrumental for managing patients of all ages. However, its low dose radiation may pose a low but non-zero risk of tumor induction in pediatric patients. Here, we present a systematic literature review on the estimated incidence of brain tumor induction from head CT exams performed on children and adolescents. MEDLINE was searched using an electronic protocol and bibliographic searches to identify articles related to CT, cancer, and epidemiology or risk assessment. Sixteen studies that predicted or measured head CT-related neoplasm incidence or mortality were identified and reviewed. Epidemiological studies consistently cited increased tumor incidence in pediatric patients (ages 0-18) exposed to head CTs. Excess relative risk of new brain tumor averaged 1.29 (95% confidence interval, 0.66-1.93) for pediatric patients exposed to one or more head CTs. Tumor incidence increased with number of pediatric head CTs in a dose-dependent manner, with measurable excess incidence even after a single scan. Converging evidence from epidemiological studies supported a small excess risk of brain tumor incidence after even a single CT exam in pediatric patients. However, refined epidemiological methods are needed to control for confounding variables that may contribute to reverse causation, such as patients with pre-existing cancer or cancer susceptibility. CT remains an invaluable technology that should be utilized so long as there is clinical indication for the study and the radiation dose is as small as reasonably achievable.
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Pearce et al. and Sheppard et al. showed an increased risk of leukaemia and brain tumours from CT applications with a cumulative dose of 50-60 mGy.
“Studies by Pearce et al. [67] and Sheppard et al. [68] showed the increased risk of leukaemia and brain tumuors from CT applications with a cumulative dose of 50–60 mGy.”
From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [68]
The Results section reports increased brain-tumor incidence after pediatric CT exposure. It does not report an increased leukaemia risk; the 60 mGy figure is an assumed dose for a single head CT scan, while the reported average cumulative brain dose is 41±9 mGy. (LLM, conf=0.88)
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References 52 · Cited by 90
- Authors
- Sheppard, J. P., Nguyen, T., Alkhalid, Y., Beckett, J. S., Salamon, N., & Yang, I.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Yang, Isaac
- Venue
- Brain Tumor Research and Treatment
- Published
- 2018
- Volume
- 6
- Issue
- 1
- Pages
- 1
- ISSN
- 2288-2405 (ISSN-L)
- 2288-2413
- PMC
- PMC5932294
- OpenAlex
- W2801052754
- Cited by
- 90
- References
- 52
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 7 · 2023: 12 · 2022: 9 · 2021: 13 · 2020: 18 · 2019: 17 · 2018: 1
- FWCI
- 1.91
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Brain Tumor Research and Treatment (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc)
- Funders
- Tina and Fred Segal Benign Brain Tumor and Skull Base Research Fellowship
- David Geffen Medical Scholarship
- UCLA Visionary Ball Fund
- Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research UCLA Scholars
- Jason Dessel Memorial Seed Grant
- UCLA Honberger Endowment Brain Tumor Research Seed Grant
- Stop Cancer (US) Research Career Development Award
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Effects of Radiation Exposure
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
- Keywords
- pediatric head CT, radiation-induced cancer, low-dose radiation, excess relative risk, dose-response relationship, adolescents, radiation dose optimization
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