Radiation exposure and estimated risk of radiation-induced cancer from thoracic and abdominal radiographs in 1307 neonates

• Published in: European radiology Vol. 35; no. 1; pp. 297 - 308
• Main Authors: Weiß, Deliah, Beeres, Martin, Rochwalsky, Ulrich, Vogl, Thomas J., Schlößer, Rolf
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2025; Springer Nature B.V
• Subjects: Abdomen; Birth weight; Cancer; Diagnostic Radiology; Female; Hospitals; Humans; Imaging; Infant, Newborn; Infant, Premature; Internal Medicine; Interventional Radiology; Leukemia; Male; Medicine; Medicine & Public Health; Neonates; Neoplasms, Radiation-Induced - etiology; Neuroradiology; Newborn babies; Paediatric; Patients; Pediatrics; Radiation; Radiation Dosage; Radiation effects; Radiation Exposure - adverse effects; Radiography, Abdominal - methods; Radiography, Thoracic - adverse effects; Radiology; Respiratory distress syndrome; Retrospective Studies; Risk; Risk Assessment; Software; Thorax; Ultrasound; X ray imagery; X-rays; United States > US; Infant; Intensive care; Diagnostic imaging; Newborn; Radiation
• ISSN: 1432-1084; 0938-7994; 1432-1084
• DOI: 10.1007/s00330-024-10942-x

Objective This study examined radiation exposure and the possible risk of radiation-induced cancer in a large sample of newborn and premature patients. Material and methods In this retrospective study, we included all hospitalised neonates treated at our university hospital who received at least one X-ray examination from 1 January 2013 to 31 December 2018. We evaluated the dose area product (DAP), effective dose (ED), and estimated risk. The International Commission on Radiological Protection Publication 60 defines values (2.8–13 × 10 −2  Sv −1 ) to calculate the estimated risk in relation to the ED. Results Of the 3843 patients (aged 241.1 ± 35.45 days) treated in the neonatal care unit, 1307 (34%) received at least one X-ray. The mean number of X-ray examinations per patient was 3.19 and correlated negatively with birth weight. The mean cumulative DAP was 5.9 mGy*cm 2 , and the cumulative ED was 23.7 µSv per hospital stay. Patients with a birth weight of < 1000 g showed the highest cumulative ED and DAP ( p  < 0.001). Patients with a birth weight of < 2500 g had the highest ED and DAP per image ( p  < 0.001). The highest radiation exposure (ED/DAP) occurred for thoracic/abdominal examinations, especially for neonates < 500 g ( p  < 0.001). Conclusion There is a strong correlation between immaturity, the number of X-ray examinations, and radiation exposure. The total exposure was minimal, and the number of X-rays per patient has been decreasing in recent years. Clinical relevance Possible risks to newborns and premature infants caused by ionising X-rays are often the subject of scientific and clinical discussion. Nevertheless, conventional X-ray imaging remains a frequently used tool, and total exposure remains at a very low level. Key Points The number of X-rays per patient has been decreasing in a large university hospital . Half of all patients received only one X-ray; most had a birth weight over 1500   g . This radiation risk can be classified as ‘minimal’ for patients with a birth weight of <   500   g and as ‘negligible’ for others .