Estimated Risks of Radiation-Induced Fatal Cancer from Pediatric CT
David J. Brenner1,
Carl D. Elliston1,
Eric J. Hall1 and
Walter E. Berdon2
1
Center for Radiological Research, Columbia University, 630 W. 168th St., New
York, NY 10032.
2
Department of Radiology, Division of Pediatric Radiology,
Columbia-Presbyterian Medical Center, 630 W. 168th St., New York, NY
10032.
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Fig. 1. —Graph shows proportion of total number of CT examinations
performed on individuals younger than a given age. Data are from 1989 British
study by Shrimpton et al. [5].
Ordinate on right shows estimated absolute numbers of CT examinations now
performed annually in United States on patients younger than a given age
(based on proportions from Shrimpton et al.
[5], an overall annual
frequency of CT examinations in the United States of 91/1000
[3], and current United States
population of 274,000,000).
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Fig. 2. —Bar graph shows annual number of abdominal and pelvic CT
examinations performed at St. Louis Children's Hospital (Mallinckrodt
Institute of Radiology, St. Louis, MO) on patients younger than a given age,
for years 1996-1999 (bars left to right in each group) (McAlister WH,
personal communication). Number of pediatric CT examinations almost doubled
between 1996 and 1999.
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Fig. 3. —Graph shows lifetime attributable cancer mortality risks per
unit dose as a function of age at a single acute exposure as estimated by
National Academy of Sciences BEIR V (Biological Effects of lonizing
Radiations) committee (solid line)
[12] and in ICRP
(International Commission on Radiological Protection) report 60 (dotted
line) [13]. Note rapid
increase in lifetime risk with decreasing age at exposure.
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Fig. 4A. —Breakdown by cancer type. Graphs show breakdown by cancer
type of risk per unit dose for females (A) and males (B) of
lifetime attributable cancer mortality risks as a function of age at a single
acute exposure as estimated by the National Academy of Sciences BEIR V
(Biological Effects of lonizing Radiations) committee
[12].
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Fig. 4B. —Breakdown by cancer type. Graphs show breakdown by cancer
type of risk per unit dose for females (A) and males (B) of
lifetime attributable cancer mortality risks as a function of age at a single
acute exposure as estimated by the National Academy of Sciences BEIR V
(Biological Effects of lonizing Radiations) committee
[12].
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Fig. 5A. —Estimated age-dependent CT doses to various organs. Graphs
show estimated age-dependent doses to various organs that contribute
significantly to overall estimated risk for typical single CT examination of
head (A) and of abdomen (B). Note different scales for the two
graphs. As discussed in text, the same exposure techniques
(milliampere-seconds) for all ages are assumed here. For both types of
examinations, doses increase markedly with decreasing age.
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Fig. 5B. —Estimated age-dependent CT doses to various organs. Graphs
show estimated age-dependent doses to various organs that contribute
significantly to overall estimated risk for typical single CT examination of
head (A) and of abdomen (B). Note different scales for the two
graphs. As discussed in text, the same exposure techniques
(milliampere-seconds) for all ages are assumed here. For both types of
examinations, doses increase markedly with decreasing age.
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Fig. 6. —Graph shows estimated lifetime attributable cancer mortality
risk as a function of age at examination for a single typical CT examination
of head (broken dotted line) and of abdomen (broken solid
line). Note rapid increase in risk with decreasing age.
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Fig. 7A. —Breakdown by cancer type of estimated lifetime
CT-attributable cancer mortality risks as a function of age. Graphs show
breakdown by cancer type of estimated lifetime attributable cancer mortality
risks in females and males as a function of age at CT examination for a
typical single CT examination of head (A, B) and of abdomen
(C, D). Note different scales for head and for abdominal data.
For all sites, risk rapidly increases with decreasing age.
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Fig. 7B. —Breakdown by cancer type of estimated lifetime
CT-attributable cancer mortality risks as a function of age. Graphs show
breakdown by cancer type of estimated lifetime attributable cancer mortality
risks in females and males as a function of age at CT examination for a
typical single CT examination of head (A, B) and of abdomen
(C, D). Note different scales for head and for abdominal data.
For all sites, risk rapidly increases with decreasing age.
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Fig. 7C. —Breakdown by cancer type of estimated lifetime
CT-attributable cancer mortality risks as a function of age. Graphs show
breakdown by cancer type of estimated lifetime attributable cancer mortality
risks in females and males as a function of age at CT examination for a
typical single CT examination of head (A, B) and of abdomen
(C, D). Note different scales for head and for abdominal data.
For all sites, risk rapidly increases with decreasing age.
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Fig. 7D. —Breakdown by cancer type of estimated lifetime
CT-attributable cancer mortality risks as a function of age. Graphs show
breakdown by cancer type of estimated lifetime attributable cancer mortality
risks in females and males as a function of age at CT examination for a
typical single CT examination of head (A, B) and of abdomen
(C, D). Note different scales for head and for abdominal data.
For all sites, risk rapidly increases with decreasing age.
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Fig. 8. —Graph shows estimated relative risk and standard errors for
solid cancer mortality among Japanese atomic bomb survivors of all ages
[11]. Only very low-dose data
points are shown. At doses of relevance to CT examinations, these data do not
suggest any threshold in dose below which no excess risk exists.
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Copyright © 2001 by the American Roentgen Ray Society.
