Dose Estimation for the European Epidemiological Study on Pediatric Computed Tomography (EPI-CT)
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Within the European Epidemiological Study to Quantify Risks for Paediatric Computerized Tomography (EPI-CT study), a cohort was assembled comprising nearly one million children, adolescents and young adults who received over 1.4 million computed tomography (CT) examinations before 22 years of age in nine European countries from the late 1970s to 2014. Here we describe the methods used for, and the results of, organ dose estimations from CT scanning for the EPI-CT cohort members. Data on CT machine settings were obtained from national surveys, questionnaire data, and the Digital Imaging and Communications in Medicine (DICOM) headers of 437,249 individual CT scans. Exposure characteristics were reconstructed for patients within specific age groups who received scans of the same body region, based on categories of machines with common technology used over the time period in each of the 276 participating hospitals. A carefully designed method for assessing uncertainty combined with the National Cancer Institute Dosimetry System for CT (NCICT, a CT organ dose calculator), was employed to estimate absorbed dose to individual organs for each CT scan received. The two-dimensional Monte Carlo sampling method, which maintains a separation of shared and unshared error, allowed us to characterize uncertainty both on individual doses as well as for the entire cohort dose distribution. Provided here are summaries of estimated doses from CT imaging per scan and per examination, as well as the overall distribution of estimated doses in the cohort. Doses are provided for five selected tissues (active bone marrow, brain, eye lens, thyroid and female breasts), by body region (i.e., head, chest, abdomen/pelvis), patient age, and time period (1977-1990, 1991-2000, 2001-2014). Relatively high doses were received by the brain from head CTs in the early 1990s, with individual mean doses (mean of 200 simulated values) of up to 66 mGy per scan. Optimization strategies implemented since the late 1990s have resulted in an overall decrease in doses over time, especially at young ages. In chest CTs, active bone marrow doses dropped from over 15 mGy prior to 1991 to approximately 5 mGy per scan after 2001. Our findings illustrate patterns of age-specific doses and their temporal changes, and provide suitable dose estimates for radiation-induced risk estimation in epidemiological studies.
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Uncertainties in individual doses are not negligible (geometric s.d. of the order of 2 on average), particularly in early years, and could not be fully integrated in the risk analyses.
“While the EPI-CT dose reconstruction is based on sophisticated modeling of doses and associated shared and unshared uncertainties, uncertainties in individual doses are not negligible (geometric s.d. of the order of 2 on average7), particularly in early years, and could not be fully integrated in the risk analyses.”
From Risk of hematological malignancies from CT radiation exposure in children, adolescents and young adults (2023) · cites this paper as [7]
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Un enjeu majeur de radioprotection en imagerie médicale
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- Authors
- Thierry-Chef, I., Ferro, G., Le Cornet, L., Dabin, J., Istad, T. S., Jahnen, A., Lee, C., Maccia, C., Malchair, F., Olerud, H. M., Harbron, R. W., Figuerola, J., Hermen, J., Moissonnier, M., Bernier, M.-O., de Basea, M. B., Byrnes, G., Cardis, E., Hauptmann, M., Journy, N., Kesminiene, A., Meulepas, J. M., Pokora, R., & Simon, S. L.
- Affiliations
- Universitat Pompeu Fabra (ES)
- Centre international de recherche sur le cancer (FR)
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany
- Belgian Nuclear Research Centre (BE)
- Norwegian Radiation and Nuclear Safety Authority (NO)
- Luxembourg Institute of Science and Technology, Esch-sur-Alzette, Luxembourg
- Division of Cancer Epidemiology and Genetics (US)
- CAATS, Sèvres, France
- University of South-Eastern Norway (NO)
- Luxembourg Institute of Science and Technology (LU)
- Institut de Radioprotection et de Sûreté Nucléaire (FR)
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- The Netherlands Cancer Institute (NL)
- University Medical Center of the Johannes Gutenberg University Mainz (DE)
- Corresponding author
- Thierry-Chef, Isabelle
- ORCID
- Venue
- Radiation Research
- Publisher
- Radiation Research Society
- Published
- 2021-04-28
- Volume
- 196
- Issue
- 1
- Pages
- 74-99
- ISSN
- 0033-7587 (ISSN-L)
- 1938-5404
- OpenAlex
- W3157149673
- Cited by
- 31
- References
- 69
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 6 · 2023: 10 · 2022: 2 · 2021: 3 · 2020: 1
- FWCI
- 2.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Radiation Research (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- World Health Organization
- National Institute for Health Research Health Protection Research Unit
- Cancer Research UK (C22891/A16015)
- National Institute for Health and Care Research (RRX119)
- Newcastle University
- Public Health England
- Helse Nord-Trøndelag
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
- Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Digital Radiography and Breast Imaging
- Keywords
- pediatric computed tomography, organ dose estimation, DICOM header, Monte Carlo uncertainty analysis, head CT, chest CT, brain dose, lens dose, thyroid dose, breast dose, radiation-induced cancer risk, children and adolescents
- MeSH terms
- Adolescent, Child, Child, Preschool, Europe, Female, Humans, Infant, Infant, Newborn, Male, Radiation Dosage, Tomography, X-Ray Computed, Cohort Studies, Phantoms, Imaging
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