1. Dose Estimation for the European Epidemiological Study on Pediatric Computed Tomography (EPI-CT)
- Author
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Choonsik Lee, Jérémie Dabin, Johannes Hermen, Steven L. Simon, Marie-Odile Bernier, Jordi Figuerola, Magda Bosch de Basea, Hilde Merete Olerud, Roman Pokora, Andreas Jahnen, Elisabeth Cardis, Carlo Maccia, Graham Byrnes, Neige Journy, Johanna M. Meulepas, Isabelle Thierry-Chef, Tore S. Istad, Ausrele Kesminiene, Françoise Malchair, Lucian Le Cornet, Gilles Ferro, Richard W Harbron, Monika Moissonnier, Michael Hauptmann, ATHENA, Irsn, Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), International Agency for Research on Cancer (IARC), German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), SCK CEN, Norwegian Radiation Protection Authority, Luxembourg Institute of Science and Technology (LIST), Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), Centre d'Assurance qualité des Applications Technologiques dans le domaine de la Santé (CAATS), CAATS, Newcastle University, Barcelona Institute for Global Health (ISGlobal), Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Radiation Programme, Institute of Biometry and Registry Research, Brandenburg Medical School Theodor Fontane, U1018, INSERM (INSERM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, The Netherlands Cancer Institute [Amsterdam, The Netherlands], Mainz University, and National Cancer Institute - NCI
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Male ,medicine.medical_specialty ,Adolescent ,[SDV]Life Sciences [q-bio] ,Biophysics ,Radiation Dosage ,030218 nuclear medicine & medical imaging ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,medicine ,Dosimetry ,Humans ,Radiology, Nuclear Medicine and imaging ,Young adult ,Child ,Radiation ,business.industry ,Phantoms, Imaging ,Infant, Newborn ,Infant ,[SDV] Life Sciences [q-bio] ,Europe ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Absorbed dose ,Child, Preschool ,Cohort ,Abdomen ,Body region ,Female ,Tomography ,business ,Nuclear medicine ,Tomography, X-Ray Computed - Abstract
International audience; Within the European Epidemiological Study to Quantify Risks for Paediatric Computerized Tomography (EPI-CT study), a cohort was assembled comprising nearly one million children, adolescents and young adults who received over 1.4 million computed tomography (CT) examinations before 22 years of age in nine European countries from the late 1970s to 2014. Here we describe the methods used for, and the results of, organ dose estimations from CT scanning for the EPI-CT cohort members. Data on CT machine settings were obtained from national surveys, questionnaire data, and the Digital Imaging and Communications in Medicine (DICOM) headers of 437,249 individual CT scans. Exposure characteristics were reconstructed for patients within specific age groups who received scans of the same body region, based on categories of machines with common technology used over the time period in each of the 276 participating hospitals. A carefully designed method for assessing uncertainty combined with the National Cancer Institute Dosimetry System for CT (NCICT, a CT organ dose calculator), was employed to estimate absorbed dose to individual organs for each CT scan received. The two-dimensional Monte Carlo sampling method, which maintains a separation of shared and unshared error, allowed us to characterize uncertainty both on individual doses as well as for the entire cohort dose distribution. Provided here are summaries of estimated doses from CT imaging per scan and per examination, as well as the overall distribution of estimated doses in the cohort. Doses are provided for five selected tissues (active bone marrow, brain, eye lens, thyroid and female breasts), by body region (i.e., head, chest, abdomen/pelvis), patient age, and time period (1977-1990, 1991-2000, 2001-2014). Relatively high doses were received by the brain from head CTs in the early 1990s, with individual mean doses (mean of 200 simulated values) of up to 66 mGy per scan. Optimization strategies implemented since the late 1990s have resulted in an overall decrease in doses over time, especially at young ages. In chest CTs, active bone marrow doses dropped from over 15 mGy prior to 1991 to approximately 5 mGy per scan after 2001. Our findings illustrate patterns of age-specific doses and their temporal changes, and provide suitable dose estimates for radiation-induced risk estimation in epidemiological studies.
- Published
- 2020
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