Cumulative radiation dose estimates from medical imaging in paediatric patients with non-oncologic chronic illnesses. A systematic review.

Paediatric patients with non-oncologic chronic illnesses often require ongoing care that may result in repeated imaging and exposure to ionizing radiation from both diagnostic and interventional procedures. In this study the scientific literature on cumulative effective dose (CED) of radiation accrued from medical imaging among specific cohorts of paediatric, non-oncologic chronic patients (inflammatory bowel disease, cystic fibrosis, congenital heart disease, shunt-treated hydrocephalus, hemophilia, spinal dysraphism) was systematically reviewed. We conducted PubMed/Medline, Scopus and EMBASE searches of peer-reviewed papers on CED from diagnostic and therapeutic radiological examinations. No time restriction was introduced in the search. Only studies reporting CEDs accrued for a period >1 year were included. We found that the annual CED was relatively low (<3 mSv/year) in cystic fibrosis, congenital heart disease, patients with cerebrospinal fluid shunts and hemophilia, while being moderate (>3-20 mSv/year) in Crohn's patients. This extra yearly radiation exposure accrues over the lifetime and can reach high values (>100 mSv) in selected cohorts of paediatric chronic patients.