Over-scanning in pediatric head CT: prevalence, dosimetric impact, and associated cancer risks

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-10-17 DOI:10.1016/j.ejrad.2025.112471

Parvane Tayeb Zadeh , Farshid Mahmoudi , Abbas Rezaeian , Mehrdad Gholami

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引用次数: 0

Abstract

Background

Pediatric head CT is a common diagnostic tool that exposes radiosensitive organs to ionizing radiation. Children’s developing tissues are more vulnerable to radiation-induced harm, making accurate dose and cancer risk estimation essential.

Objective

To quantify organ-specific radiation doses and lifetime attributable cancer risk (LAR) in pediatric head CT, with a focus on the impact of over-scanning.

Methods

This retrospective study analyzed 102 pediatric head CT scans performed at three hospitals. Organ doses were estimated using size-specific dose estimates and Monte Carlo simulations. LARs were calculated based on age- and sex-specific risk models. The prevalence and extent of over-scanning were assessed, and their effects on organ doses and cancer risk were analyzed.

Results

The highest doses were delivered to the brain, eye lenses, oral mucosa, salivary glands, red bone marrow, and thyroid. LARs were highest for thyroid cancer, leukemia, lung, and breast cancer. Risk estimates were inversely associated with age and consistently higher in females. Over-scanning was observed in 77.5 % of cases. Importantly, it occurred exclusively in the caudal direction and significantly increased radiation to non-target organs, especially the lungs, thyroid, salivary glands, and oral mucosa. This led to substantial rises in cancer risk, particularly for thyroid cancer in females (254 %) and in children aged 5–10 years (824 %).

Conclusion

Over-scanning is a prevalent and preventable source of excess radiation in pediatric head CT. It significantly elevates organ doses and cancer risks, especially in young children, underscoring the need for optimized scan protocols and technologist training.

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儿童头部CT过度扫描：患病率、剂量学影响和相关癌症风险

儿童头部CT是一种常见的诊断工具，可将放射敏感器官暴露于电离辐射中。儿童正在发育的组织更容易受到辐射引起的伤害，因此准确的剂量和癌症风险评估至关重要。目的量化儿童头部CT的器官特异性辐射剂量和终身归因癌风险（LAR），重点研究过度扫描的影响。方法回顾性分析三家医院102例儿童头部CT扫描。使用尺寸特异性剂量估计值和蒙特卡罗模拟来估计器官剂量。LARs是根据年龄和性别特异性风险模型计算的。评估了过度扫描的患病率和程度，并分析了其对器官剂量和癌症风险的影响。结果大鼠脑、眼晶状体、口腔黏膜、唾液腺、红骨髓、甲状腺等部位给药剂量最高。甲状腺癌、白血病、肺癌和乳腺癌的发病率最高。风险估计值与年龄呈负相关，女性的风险估计值始终较高。77.5%的病例出现过扫。重要的是，它只发生在尾侧，对非靶器官的辐射明显增加，尤其是肺、甲状腺、唾液腺和口腔粘膜。这导致癌症风险大幅上升，特别是女性（254%）和5-10岁儿童（824%）患甲状腺癌的风险大幅上升。结论儿童头部CT过度扫描是一种常见的可预防的过量辐射源。它显著提高了器官剂量和癌症风险，特别是在幼儿中，强调了优化扫描方案和技术人员培训的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.