2021, Number 3
<< Back Next >>
Rev Mex Pediatr 2021; 88 (3)
Measurement of intentional exposure to ionizing radiation in a neonatal intensive care unit
Arízaga-Ballesteros V, Garza-Castillo R, Franco-Cabrera MC, Estrada-Hernández C, Lara-Díaz VJ, Alcorta-García MR
Language: Spanish
References: 25
Page: 96-100
PDF size: 222.42 Kb.
ABSTRACT
Introduction: Chest X-rays are one of the most common procedures used in neonatal intensive care units (NICU). The objective of this study was to determine the X-ray radiation dose received by hospitalized patients by means of incident air kerma (Ki), a measure of the skin entry dose.
Material and methods: Observational, prospective, longitudinal and descriptive study. We included patients treated at the NICU of the Hospital Materno Infantil, Nuevo León, Mexico, who had one or more thoraco-abdominal (portable) radiographs taken during their stay. Ki was measured according to the International Atomic Energy Agency for the dosimetry of pediatric patients in plain radiography.
Results: Sixty-six patients were analyzed. In total, 416 radiographs were taken; the median number of radiographs per patient was 13 (IQR 2-26). The Ki was 140 (IQR 80-450) μGy by radiography. In 75% of the exposures, the median Ki was 195 μGy.
Conclusions: In newborns cared for in the NICU, the radiation doses from thoraco-abdominal radiographs are higher than international recommendations.
REFERENCES
Hinojosa-Armendáriz VI, Mejía-Rosales SJ, Franco-Cabrera MC. Optimization of radiation dose and image quality in mobile neonatal chest radiography. Radiography. 2018; 24(2): 104-109.
Scott MV, Fujii AM, Behrman RH, Dillon JE. Diagnostic ionizing radiation exposure in premature patients. J Perinatol. 2014; 34(5): 392-395.
da Costa Pinto F, Rocha G, Flor-de-Lima F, Soares H, Ramos I, Guimaraes H. Radiation exposure in very low birth weight infants. Minerva Pediatr. 2019; 71(3): 247-252
Kartikeswar GAP, Parikh TB, Pandya D, Pandit A. Ionizing radiation exposure in NICU. Indian J Pediatr [Internet]. 2020; 87(2): 158-160.
Furlow B. Radiation protection in pediatric imaging. Radiol Technol. 2011; 82(5): 421-439.
Toma P, Bartoloni A, Salerno S, Granata C, Cannatà V, Magistrelli A et al. Protecting sensitive patient groups from imaging using ionizing radiation: effects during pregnancy, in fetal life and childhood. Radiol Med. 2019; 124(8): 736-744.
Don S. Radiosensitivity of children: potential for overexposure in CR and DR and magnitude of doses in ordinary radiographic examinations. Pediatr Radiol. 2004; 34(S3): S167-S172.
Paniagua Muños RP. Estimación de dosis en exámenes de rayos X para neonatos en el Hospital Nacional Dos de Mayo [Tesis]. Perú: Universidad Nacional del Callao; 2013. Disponible en: http://repositorio.unac.edu.pe/bitstream/handle/UNAC/142/RolinsonPaul_Tesis_tituloprofesional_2013.pdf?sequence=3&isAllowed=y
Frayre AS, Torres P, Gaona E, Rivera T, Franco J, Molina N. Radiation dose reduction in a neonatal intensive care unit in computed radiography. Appl Radiat Isot. 2012; 71 Suppl: 57-60.
Directorate-General XII: Science R and D, A. European Guidelines on Quality Criteria for Diagnostic Radiographic Images [Internet]. 1996. p. 88. Available in: https://www.sprmn.pt/pdf/EuropeanGuidelineseur16260.pdf
Huda W. Kerma-area product in diagnostic radiology. Am J Roentgenol. 2014; 203(6): W565-W569.
International Atomic Energy Agency (IAEA). Radiation protection in Paediatric Radiology, Safety reports series no. 71, IAEA, Vienna. IAEA Saf Reports Ser. 2012; 71: 128.
Willis CE, Slovis TL. The ALARA concept in pediatric CR and DR: Dose reduction in pediatric radiographic exams - A white paper conference Executive Summary. Pediatr Radiol. 2004; 34 (suppl. 3): 2004-2005.
Kurepa D, Zaghloul N, WatKins L, Liu J. Neonatal lung ultrasound exam guidelines. J Perinatol . 2018; 38(1): 11-22.
Fletcher EWL, Baum JD, Draper G. The risk of diagnostic radiation of the newborn. Br J Radiol. 1986; 59(698): 165-170.
Sharma J, Sarma J, Agarwal S. Assessment of diagnostic reference level in radiography of neonatal chest anteroposterior examination: a hospital-based study. J Med Phys. 2018; 43(3): 200-203.
Vassileva J, Rehani MM, Applegate K, Ahmed NA, Al-Dhuhli H, Al-Naemi HM. IAEA survey of paediatric computed tomography practice in 40 countries in Asia, Europe, Latin America and Africa: procedures and protocols. Eur Radiol. 2013; 23(3): 623-631.
Aramesh M, Zanganeh KA, Dehdashtian M, MaleKian A, Fatahiasl J. Evaluation of radiation dose received by premature neonates admitted to neonatal intensive care unit. J Clin Med Res. 2017; 9(2): 124-129.
Chawla SC, Federman N, Zhang D, Nagata K, NuthakKi S, McNitt-Gray M et al. Estimated cumulative radiation dose from PET/CT in children with malignancies: a 5-year retrospective review. Pediatr Radiol. 2010; 40(5): 681-686.
Amis ES, Butler PF, Applegate KE, Birnbaum SB, Brateman LF, Hevezi JM et al. American College of Radiology white paper on radiation dose in medicine. J Am Coll Radiol [Internet]. 2007; 4(5): 272-2784.
Yu CC. Radiation safety in the Neonatal Intensive Care Unit: too little or too much concern? Pediatr Neonatol. 2010; 51(6): 311-319.
Gordon PV, Swanson JR. A simple step to reduce radiation exposure in the NICU. J Perinatol. 2014; 34(5): 331-332.
Seibert JA, Morin RL. The standardized exposure index for digital radiography: An opportunity for optimization of radiation dose to the pediatric population. Pediatr Radiol. 2011; 41(5): 573-581.
Makri T, YakoumaKis E, Papadopoulou D, Gialousis G, Theodoropoulos V, Sandilos P et al. Radiation risk assessment in neonatal radiographic examinations of the chest and abdomen: a clinical and Monte Carlo dosimetry study. Phys Med Biol. 2006; 51(19): 5023-5033.
Risk of ionizing radiation exposure to children: a subject review. American Academy of Pediatrics. Committee on Environmental Health. Pediatrics. 1998; 101(4 Pt 1): 717-719.