Cumulative radiation exposure from medical imaging and associated lifetime cancer risk in children with osteogenesis imperfecta.

Thorby-Lister, Amy, Högler, Wolfgang, Hodgson, Kirsten, Crabtree, Nicola, Nightingale, Peter, Shaw, Nick and Saraff, Vrinda (2018) Cumulative radiation exposure from medical imaging and associated lifetime cancer risk in children with osteogenesis imperfecta. Bone, 114. pp. 252-256. ISSN 1873-2763. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

Full text not available from this repository.
Official URL: https://www.sciencedirect.com/science/article/abs/...

Abstract

OBJECTIVES

To estimate the cumulative effective dose of radiation (E) and additional lifetime attributable risk (LAR) of cancer from ionizing radiation in children with osteogenesis imperfecta (OI), who require frequent imaging for fractures and bone densitometry (DXA) surveillance. Also, to evaluate the pattern of long bone fractures.

METHODS

We reviewed all imaging (x-rays, DXA and computed tomography [CT]) conducted in a cohort of children with OI with a minimum observation period of 5 years. For each image, E was estimated using age-dependent local data, and LAR of cancer was extrapolated. LAR and fracture data were compared among children with mild, moderate and severe OI. LAR was allocated to cancer risk categories, and the moderate risk group (1 in 1000 to 1 in 100) was evaluated further.

RESULTS

Results from 106 children with OI (50% females, 5747 images) are presented, with a median (range) observation period of 11.7 (5.2-15.6) years. CT accounted for 0.8% of total imaging procedures but contributed to 66% of total E. The overall LAR of cancer was minimal, averaging an additional 8.8 cases per 100,000 exposed patients (0.8-403). LAR was significantly lower in children with mild OI compared to those with moderate (p = 0.006) and severe OI (p = 0.001). All patients with a moderate LAR of cancer (n = 8) had undergone CT scans and 88% had scoliosis or vertebral fractures. The cohort experienced 412 long bone fractures, with the most common site being the femur (26.5%). OI severity correlated positively with long bone fracture rates (p < 0.001).

CONCLUSIONS

When compared to baseline LAR of cancer (50%) the additional cancer risk from ionizing radiation imaging in our paediatric OI cohort was small (0.0088%). To reduce additional cancer risk, we recommend replacing spinal x-rays with vertebral fracture assessments on DXA and exercising caution with CT imaging.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: QZ Pathology. Oncology
WN Medical imaging. Radiology
WS Paediatrics. Child health
Divisions: Planned IP Care > Oncology and Clinical Haematology
Clinical Support > Radiology
Womens and Childrens > Paediatrics
Related URLs:
Depositing User: Beth Connors
Date Deposited: 02 Aug 2019 09:24
Last Modified: 02 Aug 2019 09:24
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2266

Actions (login required)

View Item View Item