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Cumulative radiation exposure and cancer risk estimation in children with heart disease.

Publication ,  Journal Article
Johnson, JN; Hornik, CP; Li, JS; Benjamin, DK; Yoshizumi, TT; Reiman, RE; Frush, DP; Hill, KD
Published in: Circulation
July 8, 2014

BACKGROUND: Children with heart disease are frequently exposed to imaging examinations that use ionizing radiation. Although radiation exposure is potentially carcinogenic, there are limited data on cumulative exposure and the associated cancer risk. We evaluated the cumulative effective dose of radiation from all radiation examinations to estimate the lifetime attributable risk of cancer in children with heart disease. METHODS AND RESULTS: Children ≤6 years of age who had previously undergone 1 of 7 primary surgical procedures for heart disease at a single institution between 2005 and 2010 were eligible for the study. Exposure to radiation-producing examinations was tabulated, and cumulative effective dose was calculated in millisieverts. These data were used to estimate lifetime attributable risk of cancer above baseline using the approach of the Committee on Biological Effects of Ionizing Radiation VII. The cohort included 337 children exposed to 13 932 radiation examinations. Conventional radiographs represented 92% of examinations, whereas cardiac catheterization and computed tomography accounted for 81% of cumulative exposure. Overall median cumulative effective dose was 2.7 mSv (range, 0.1-76.9 mSv), and the associated lifetime attributable risk of cancer was 0.07% (range, 0.001%-6.5%). Median lifetime attributable risk of cancer ranged widely depending on surgical complexity (0.006%-1.6% for the 7 surgical cohorts) and was twice as high in females per unit exposure (0.04% versus 0.02% per 1-mSv effective dose for females versus males, respectively; P<0.001). CONCLUSIONS: Overall radiation exposures in children with heart disease are relatively low; however, select cohorts receive significant exposure. Cancer risk estimation highlights the need to limit radiation dose, particularly for high-exposure modalities.

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Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

July 8, 2014

Volume

130

Issue

2

Start / End Page

161 / 167

Location

United States

Related Subject Headings

  • Risk Factors
  • Radiation Dosage
  • Neoplasms, Radiation-Induced
  • Male
  • Infant, Newborn
  • Infant
  • Humans
  • Heart Diseases
  • Female
  • Diagnostic Imaging
 

Citation

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Chicago
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Johnson, J. N., Hornik, C. P., Li, J. S., Benjamin, D. K., Yoshizumi, T. T., Reiman, R. E., … Hill, K. D. (2014). Cumulative radiation exposure and cancer risk estimation in children with heart disease. Circulation, 130(2), 161–167. https://doi.org/10.1161/CIRCULATIONAHA.113.005425
Johnson, Jason N., Christoph P. Hornik, Jennifer S. Li, Daniel K. Benjamin, Terry T. Yoshizumi, Robert E. Reiman, Donald P. Frush, and Kevin D. Hill. “Cumulative radiation exposure and cancer risk estimation in children with heart disease.Circulation 130, no. 2 (July 8, 2014): 161–67. https://doi.org/10.1161/CIRCULATIONAHA.113.005425.
Johnson JN, Hornik CP, Li JS, Benjamin DK, Yoshizumi TT, Reiman RE, et al. Cumulative radiation exposure and cancer risk estimation in children with heart disease. Circulation. 2014 Jul 8;130(2):161–7.
Johnson, Jason N., et al. “Cumulative radiation exposure and cancer risk estimation in children with heart disease.Circulation, vol. 130, no. 2, July 2014, pp. 161–67. Pubmed, doi:10.1161/CIRCULATIONAHA.113.005425.
Johnson JN, Hornik CP, Li JS, Benjamin DK, Yoshizumi TT, Reiman RE, Frush DP, Hill KD. Cumulative radiation exposure and cancer risk estimation in children with heart disease. Circulation. 2014 Jul 8;130(2):161–167.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

July 8, 2014

Volume

130

Issue

2

Start / End Page

161 / 167

Location

United States

Related Subject Headings

  • Risk Factors
  • Radiation Dosage
  • Neoplasms, Radiation-Induced
  • Male
  • Infant, Newborn
  • Infant
  • Humans
  • Heart Diseases
  • Female
  • Diagnostic Imaging