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Cited by 3,222Radiation Dose and ImagingEffects of Radiation ExposureAdvanced Radiotherapy Techniques

Estimated Risks of Radiation-Induced Fatal Cancer from Pediatric CT

Brenner, David J., Elliston, Carl D., Hall, Eric J., Berdon, Walter E.·2001·American Journal of Roentgenology
DOI 10.2214/ajr.176.2.1760289
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Abstract

OBJECTIVE: In light of the rapidly increasing frequency of pediatric CT examinations, the purpose of our study was to assess the lifetime cancer mortality risks attributable to radiation from pediatric CT. MATERIALS AND METHODS: Organ doses as a function of age-at-diagnosis were estimated for common CT examinations, and estimated attributable lifetime cancer mortality risks (per unit dose) for different organ sites were applied. Standard models that assume a linear extrapolation of risks from intermediate to low doses were applied. On the basis of current standard practice, the same exposures (milliampere-seconds) were assumed, independent of age. RESULTS: The larger doses and increased lifetime radiation risks in children produce a sharp increase, relative to adults, in estimated risk from CT. Estimated lifetime cancer mortality risks attributable to the radiation exposure from a CT in a 1-year-old are 0.18% (abdominal) and 0.07% (head)-an order of magnitude higher than for adults-although those figures still represent a small increase in cancer mortality over the natrual background rate. In the United States, of approximately 600,000 abdominal and head CT examinations annually performed in children under the age of 15 years, a rough estimate is that 500 of these individuals might ultimately die from cancer attributable to the CT radiation. CONCLUSION: The best available risk estimates suggest that pediatric CT will result in significantly increased lifetime radiation risk over adult CT, both because of the increased dose per milliampere-second, and the increased lifetime risk per unit dose. Lower milliampere-second settings can be used for children without significant loss of information. Although the risk-benefit balance is still strongly tilted toward benefit, because the frequency of pediatric CT examinations is rapidly increasing, estimates that quantitative lifetime radiation risks for children undergoing CT are not negligible may stimulate more active reduction of CT exposure settings in pediatric patients.

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Authors
Brenner, D. J., Elliston, C. D., Hall, E. J., & Berdon, W. E.
Affiliations
  • Columbia University (US)
  • Columbia University Irving Medical Center (US)
ORCID
Venue
American Journal of Roentgenology
Publisher
American Roentgen Ray Society
Published
2001-02
Volume
176
Issue
2
Pages
289-296
ISSN
  • 0002-9580 (ISSN-L)
  • 0361-803X
  • 1546-3141
DOI
10.2214/ajr.176.2.1760289
OpenAlex
W2138025351
Cited by
3,222
References
79
Citations by year
2026: 44 · 2025: 92 · 2024: 78 · 2023: 115 · 2022: 116 · 2021: 134 · 2020: 148 · 2019: 137 · 2018: 124 · 2017: 141 · 2016: 190 · 2015: 186 · 2014: 179 · 2013: 176 · 2012: 213
FWCI
60.27
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Roentgenology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01ca077285-03)
  • National Cancer Institute (CA77285)
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
  • Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
Keywords
pediatric computed tomography, radiation-induced cancer, age at diagnosis, linear no-threshold model, low-dose radiation risk, abdominal CT, head CT, benefits and risks
MeSH terms
Adolescent, Cause of Death, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Neoplasms, Radiation-Induced, Tomography, X-Ray Computed, Risk Assessment

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