X-ray and more x-rays in preterm neonates: are we doing the right thing?

Congress:

EuroSafe Imaging 2020

Poster Number:

ESI-13422

Type:

EuroSafe Imaging

Keywords:

Performed at one institution, Observational, Retrospective, Dosimetric comparison, Radiation safety, Fluoroscopy, Digital radiography, CT, Radioprotection / Radiation dose, Paediatric, Action 7 - Radiation protection of children

Authors:

A. Urtasun, F. N. Diaz, M. A. D. C. Marquez Bravo, N. G. Racioppo, S. R. Garcia Lopez, M. Ulla

DOI:

10.26044/esi2020/ESI-13422

DOI-Link:

https://dx.doi.org/10.26044/esi2020/ESI-13422

Fig. 5: Graphic representation of x-rays/day index per PN patient showing the average...

Fig. 3: Teaching file of suboptimal collimation (full image) with 291.41 cm2 of...

Fig. 1: Coverpage

Fig. 2: Methods

Background/introduction

Continued improvement of medical care has decreased the mortality of very premature births. The higher number of preterm neonates (PN) results in higher acuity patients and extended hospital stays, and a consequence needs for diagnostic exams. As tissue radiosensitivity is inversely related to age, it becomes particularly crucial in this group of patients with yet rapidly proliferating and differentiating cells to keep radiation exposure as low as reasonably achievable (ALARA). The aim of this study is to establish an analytic baseline of radiation exposure of...

Description of activity and work performed

We perform a retrospective analysis for a six months period, including preterm neonates admitted to the NICU with a gestational age between 24 and 34 weeks (included) ( Fig. 2). We analyze the number and type of radiological studies looking for x-rays, fluoroscopy, and CT scans, and estimate the cumulative effective radiation dose (ERD) using a reference table (Table 1). Also, we classify the x-ray as optimal or suboptimal collimation of the x-ray beam according to a certified board radiology qualitative observation ( Fig. 3)....

Conclusion and recommendations

A total of 23 PN were included and analyzed. The mean age of the patients was 31.61 gestational age birth,with a meantime of NICU stay of 30.83 days ( Fig. 4). The average of x-rays was 10.17/patient, only one head CT scan was performed, and the cumulative ERD was 0.21 mSv/patient (range 0-1.82 mSv). From 234 x-rays, 214 were classified as suboptimal collimated (91.45%). The x-rays/day index results in 0.33 x-rays/day (or one x-ray every three days). Only one patient exceeds the upper control limit...

Personal/organisational information

A. Urtasun; Buenos Aires, BU/AR - nothing to disclose F. N. Diaz; Buenos Aires, BA/AR - nothing to disclose M. Ulla; Pilar- Buenos Aires/AR - nothing to disclose M. A. D. C. Marquez Bravo; Buenos Aires/AR - nothing to disclose N. G. Racioppo; Buenos Aires/AR - nothing to disclose S. R. Garcia Lopez; Buenos Aires/AR - nothing to disclose

References

Patel RM, Kandefer S, Walsh MC, et al (2015) Causes and timing of death in extremely premature infants from 2000 through 2011. N Engl J Med 372:331–340. Wallingford K, Rubarth LB (2017) Development and Evaluation of a Radiation Safety Program in the NICU. Neonatal Netw 36:306–312. Glass HC, Costarino AT, Stayer SA, et al (2015) Outcomes for Extremely Premature Infants. Survey of Anesthesiology 59:272–273. Cohen MD (2015) ALARA, image gently and CT-induced cancer. Pediatr Radiol 45:465–470. Jeetoo SD, Smith J, Pitcher RD (2019) Radiological Studies...