Literature DB >> 18368400

CT versus plain radiographs for evaluation of c-spine injury in young children: do benefits outweigh risks?

Ricardo R Jimenez1, Michael A Deguzman, Shelly Shiran, Andrew Karrellas, Robert L Lorenzo.   

Abstract

BACKGROUND: Various reports support the use of cervical spine (c-spine) CT over conventional radiography in screening of c-spine injury. Interest now exists in diagnostic radiation-induced morbidity.
OBJECTIVE: To estimate excess relative risk for developing cancer from c-spine high-resolution CT radiation exposure.
MATERIALS AND METHODS: We conducted a retrospective review of children evaluated for c-spine injury using CT. The study population was divided into three age groups, 0-4 years (group 1), 5-8 years (group 2), and older than 8 years (group 3). Anthropomorphic 1-year-old and 5-year-old phantoms were used to measure radiation at the thyroid during radiography and CT. Excess relative risk for thyroid cancer was estimated using these measurements.
RESULTS: A total of 557 patients were evaluated with CT. The radiographic method most commonly used was head CT/c-spine CT in 363 (65%). Only 179 children (32%) had any type of prior radiography. The use of c-spine CT exposes the thyroid to 90-200 times more radiation than multiple conventional radiographs. The mean excess relative risk for thyroid cancer after CT was 2.0 for group 1 and 0.6 for group 2. There were no comparison data for group 3.
CONCLUSION: C-spine CT is associated with a significant exposure to ionizing radiation and increases excess relative risk for thyroid cancer in young children.

Entities:  

Mesh:

Year:  2008        PMID: 18368400     DOI: 10.1007/s00247-007-0728-2

Source DB:  PubMed          Journal:  Pediatr Radiol        ISSN: 0301-0449


  25 in total

1.  Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative.

Authors:  David J Brenner
Journal:  Pediatr Radiol       Date:  2002-03-07

2.  Current adult and pediatric CT doses.

Authors:  Edward Nickoloff
Journal:  Pediatr Radiol       Date:  2002-03-07

Review 3.  The pediatric cervical spine: developmental anatomy and clinical aspects.

Authors:  F M Fesmire; R C Luten
Journal:  J Emerg Med       Date:  1989 Mar-Apr       Impact factor: 1.484

4.  The ALARA concept in pediatric CR and DR: dose reduction in pediatric radiographic exams--a white paper conference.

Authors:  Charles E Willis; Thomas L Slovis
Journal:  AJR Am J Roentgenol       Date:  2005-02       Impact factor: 3.959

5.  Let's not relive the past: a review of cancer risk after diagnostic or therapeutic irradiation.

Authors:  Elaine Ron
Journal:  Pediatr Radiol       Date:  2002-08-29

6.  The role of helical CT in the assessment of cervical spine injuries.

Authors:  D B Nuñez; R M Quencer
Journal:  AJR Am J Roentgenol       Date:  1998-10       Impact factor: 3.959

7.  Risk of ionizing radiation exposure to children: a subject review. American Academy of Pediatrics. Committee on Environmental Health.

Authors: 
Journal:  Pediatrics       Date:  1998-04       Impact factor: 7.124

8.  Estimated risks of radiation-induced fatal cancer from pediatric CT.

Authors:  D Brenner; C Elliston; E Hall; W Berdon
Journal:  AJR Am J Roentgenol       Date:  2001-02       Impact factor: 3.959

Review 9.  Pediatric spinal trauma: injuries in very young children.

Authors:  Charles d'Amato
Journal:  Clin Orthop Relat Res       Date:  2005-03       Impact factor: 4.176

Review 10.  Clearing the cervical spine of paediatric trauma patients.

Authors:  S E Slack; M J Clancy
Journal:  Emerg Med J       Date:  2004-03       Impact factor: 2.740

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  10 in total

Review 1.  Treatment of cervical subaxial injury in the very young child.

Authors:  Zühtü Özbek; Emre Özkara; Murat Vural; Ali Arslantaş
Journal:  Eur Spine J       Date:  2017-10-30       Impact factor: 3.134

2.  Utility of plain radiographs and MRI in cervical spine clearance in symptomatic non-obtunded pediatric patients without high-impact trauma.

Authors:  Justin M Moore; Jonathan Hall; Michael Ditchfield; Christopher Xenos; Andrew Danks
Journal:  Childs Nerv Syst       Date:  2016-12-06       Impact factor: 1.475

3.  X-ray vs. CT in identifying significant C-spine injuries in the pediatric population.

Authors:  Andrew T Hale; Abraham Alvarado; Amita K Bey; Sumit Pruthi; Gregory A Mencio; Christopher M Bonfield; Jeffrey E Martus; Robert P Naftel
Journal:  Childs Nerv Syst       Date:  2017-06-27       Impact factor: 1.475

Review 4.  Triage tools for detecting cervical spine injury in pediatric trauma patients.

Authors:  Annelie Slaar; M M Fockens; Junfeng Wang; Mario Maas; David J Wilson; J Carel Goslings; Niels Wl Schep; Rick R van Rijn
Journal:  Cochrane Database Syst Rev       Date:  2017-12-07

5.  A retrospective comparison of CT and MRI in detecting pediatric cervical spine injury.

Authors:  Mark Henry; Ron I Riesenburger; James Kryzanski; Andrew Jea; Steven W Hwang
Journal:  Childs Nerv Syst       Date:  2013-04-13       Impact factor: 1.475

Review 6.  Risk of malignancy associated with head and neck CT in children: a systematic review.

Authors:  Jenny X Chen; Bart Kachniarz; Sapideh Gilani; Jennifer J Shin
Journal:  Otolaryngol Head Neck Surg       Date:  2014-07-22       Impact factor: 3.497

7.  Variation in Computed Tomography Imaging for Pediatric Injury-Related Emergency Visits.

Authors:  Jennifer R Marin; Li Wang; Daniel G Winger; Rebekah C Mannix
Journal:  J Pediatr       Date:  2015-07-29       Impact factor: 4.406

Review 8.  Pediatric cervical spine trauma imaging: a practical approach.

Authors:  Alexia M Egloff; Nadja Kadom; Gilbert Vezina; Dorothy Bulas
Journal:  Pediatr Radiol       Date:  2008-11-12

9.  Cervical Spine Evaluation in Pediatric Trauma: A Review and an Update of Current Concepts.

Authors:  Nirmal Raj Gopinathan; Vibhu Krishnan Viswanathan; Alvin H Crawford
Journal:  Indian J Orthop       Date:  2018 Sep-Oct       Impact factor: 1.251

10.  A Knee Size-Independent Parameter for Malalignment of the Distal Patellofemoral Joint in Children.

Authors:  Ferdinand Wagner; Günther Maderbacher; Jan Matussek; Boris M Holzapfel; Birgit Kammer; Jochen Hubertus; Sven Anders; Sebastian Winkler; Joachim Grifka; Armin Keshmiri
Journal:  Adv Orthop       Date:  2019-09-15
  10 in total

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