NDLI: Risk of radiation-induced malignancies from CT scanning in children who underwent shunt treatment before 6 years of age: a retrospective cohort study with a minimum 10-year follow-up.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	White, Ian K. Shaikh, Kashif A. Moore, Reilin J. Bullis, Carli L. Sami, Mairaj T. Gianaris, Thomas J. Fulkerson, Daniel H.
Spatial Coverage	Indiana
Description	Author Affiliation: White IK ( Department of Neurosurgery, Indiana University School of Medicine)
Abstract	OBJECT: A number of mathematical models predict the risk of future cancer from the ionizing radiation exposure of CT scanning. The predictions are alarming. Some models predict 29,000 future cancers and 14,500 deaths in the US will be directly caused by 1 year's worth of CT scanning. However, there are very few clinical data to justify or refute these claims. Young children are theoretically highly susceptible to the damaging effects of radiation. In this study, the authors examined children who underwent CSF shunt placement before 6 years of age. The authors chose to study shunt-treated patients with the assumption that these patients would undergo future imaging, facilitating surveillance. They chose a study period of 1991-2001 to allow more than 10 years of follow-up data. METHODS: The authors studied 104 consecutive children who underwent CSF shunt placement prior to 6 years of age and who had at least 10 years of follow-up data. Sixty-two of these patients underwent shunt placement prior to 1 year of age. The age at the initial scanning session, the number of future CT scanning sessions, diagnosis, and results of any future studies were recorded. The age-specific radiation dose was calculated for children younger than 1 year. Children younger than 1 year at the time of shunt placement were evaluated separately, based on the assumption that they represented the highest risk cohort. The authors examined all data for any evidence of future leukemia or head/neck tumor (benign or malignant). RESULTS: These children underwent a total of 1584 CT scanning sessions over a follow-up period of 1622 person-years. A total of 517 scanning sessions were performed prior to 6 years of age, including 260 in the 1st year of life. Children who underwent shunt placement before 1 year of age underwent an average of 16.3 ± 13.5 CT sessions (range 1-41). Children undergoing placement between 1 and 6 years of age received an average of 14.1 ± 12.5 CT studies (range 5-52). There were no subsequent tumors (benign or malignant) or leukemia detected. CONCLUSIONS: Previously published models predict a significant number of future cancers directly caused by CT scanning. However, there are very few published clinical data. In the authors' study, zero future radiation-induced malignancies were detected after routine CT scanning in a high-risk group. While the authors do not consider their single-institution study adequate to define the actual risk, their data suggest that the overall risk is low. The authors hope this study encourages future collaborative efforts to define the actual risk to patients.
File Format	HTM / HTML
ISSN	19330707
Issue Number	5
Volume Number	13
e-ISSN	19330715
Journal	Journal of Neurosurgery: Pediatrics
Language	English
Publisher	American Association of Neurological Surgeons
Publisher Date	2014-05-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Ventriculoperitoneal Shunt Hydrocephalus Neoplasms, Radiation-induced Age Factors Indiana Humans Child, Preschool Infant Male Epidemiology Journal Article Young Adult Etiology Surgery Female Retrospective Studies Child Adverse Effects Tomography, X-ray Computed Risk Factors Discipline Neurosurgery Radiation Dosage Discipline Pediatrics Confounding Factors (epidemiology) Sample Size Follow-up Studies Adolescent Methods
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Surgery Pediatrics, Perinatology and Child Health

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