Anil Rao MD, Presenter: Nothing to Disclose

Wenjun He, Abstract Co-Author: Nothing to Disclose

Eugene Mah, Abstract Co-Author: Nothing to Disclose

Walter Huda PhD, Abstract Co-Author: Research support, Siemens AG

Cephus E. Simmons RRA, Abstract Co-Author: Nothing to Disclose

Hai Yao PhD, Abstract Co-Author: Nothing to Disclose

To quantify absorbed radiation doses and calculate radiation risks to pediatric patients having UGI studies for symptoms other than bilious vomiting.

We recorded the Kerma Area Product (KAP in Gy-cm2) for 47 consecutive patients undergoing UGI studies on our digital fluoroscopic equipment. KAP values were converted into corresponding effective doses (E) using E/KAP (mSv/ Gy-cm2) conversion factors published by the National Radiological Protection Board in Report R-279. These E/KAP conversion factors took into account x-ray beam quality (kV and filtration), x-ray beam projection (PA or lateral) and patient age. E-values were converted into risks using age dependent risks of radiation induced cancer published in BEIR-VII report. For each parameter, we computed the median value (with the 10th and 90th percentiles in parenthesis). The final impression and technique of obtaining the images such as "last image save" on the fluoroscopic monitor (no added radiation dose to the patient) was also recorded.

The median patient age was 12 months (0.8 months; 118 months). The median KAP value was 0.12 Gy-cm2 (0.04 Gy-cm2; 0.79 Gy-cm2). The median E value was 0.11 mSv (0.04 mSv; 0.38 mSv). The median radiation risk of cancer induction by this radiation exposure was 3.7 per 100,000 patients (1.1 per 100,000; 10.1 per 100,000). There were no trends in cancer radiation risks with patient age. 1 patient had possible intestinal malrotation. 2 patients had incidental aberrant right subclavian artery. The remaining 44 patients (93.6%) had normal anatomy.11 patients (23%) had gastroesophageal reflux. 41 patients had almost all the images acquired using the last image saving technique except for the preliminary scout abdomen/ KUB radiograph. This reduced the radiation dose without compromising the anatomical information.

Radiation induced cancer risks to pediatric patients undergoing UGI studies are very low (<<0.01%). Radiation risks vary by up to an order of magnitude primarily because of differences in examination complexity, and are independent of patient age. Images obtained by using "last image save" do not affect diagnostic information.  

UGI studies done using DPF and images acquired by using the "last image save" technique is strongly recommended. This decreases radiation doses and risks without compromising the study.

Rao, A, He, W, Mah, E, Huda, W, Simmons, C, Yao, H, Radiation Doses and Risks to Pediatric Patients during Upper Gastrointestinal (UGI) Studies Using Digital Pulse Fluoroscopy (DPF).  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8012192.html