Congress:
EuroSafe Imaging 2020
Keywords:
Multicentre study, Not applicable, Prospective, Dosimetric comparison, Comparative studies, CT, Radioprotection / Radiation dose, Paediatric
Authors:
K. Khasanova, I. E. Tyurin
DOI:
10.26044/esi2020/ESI-14903
Background/introduction
Currently, medical exposure for diagnostic purposes is the main dose-generating factor with has a significant reduction potential. In some countries doses received from radiation diagnostic manipulations have overtaken the naturally-occurring background radiation and have further increasing tendency. This situation is associated with increasing frequency of diagnostic procedures and with spreading of high-dose research methods. The problem of excessive radiation exposure among pediatric patients is especially acute. It’s associated with:
- a high susceptibility of children to ionizing radiation
- a high proliferative activity of the body
- longer life expectancy compared to adults
All this factors create a cumulative effect and increases the risk of developing stochastic effects.
According to generally accepted clinical guidelines for the treatment of children with Hodgkin’s lymphoma (HL), the main diagnostic method for initial staging and treatment assessment is computed tomography (CT). Children with HL are forced to undergo multiple repetitive studies, so more than 7 computed tomography scans can be performed on a child within a year. At present, children with HL occupy the second place (after patients with neuroblastomas), among patients receiving the highest radiation doses from X-ray and radionuclide methods and the first place in the development of long-term secondary complications.
The total annual effective dose (ED) received by a child with lymphoma (mainly in the first year of treatment and with a relapse of the disease) is from 60 to 160 mSv, which is a significant risk factor and, in some cases, can lead to iatrogenic radiation-induced distant complications.
The best visualization of mediastinal structures is achieved by performing multiphase contrast enhancement (CE) CT. The number of technical errors and artifacts during CE CT in children may be high. During the arterial phase the artifacts from contrast agent in magistral veins complicate an objective assessment of pathology when it is located in the chest.
Unfortunately, these aspects are not always taken into account by radiologists in everyday practice, which leads to an increase in radiation exposure to children.
Based on the foregoing, it should be concluded that the radiation on children with HL is a significant impact factor and can affect the prognosis of long-term consequences.