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Computed Tomography Associated Radiation Exposure in Children with Craniosynostosis

Madeleine K. Bruce, BA; Aditya M. Mittal, BS; Miles J. Pfaff, MD, MHS; Darunee S. Whitt, MS, DABR; Lynda L. Flom, MD; Joseph E. Losee, MD; Jesse A. Goldstein, MD
UPMC
2021-01-31

Presenter: Madeleine Bruce

Affidavit:
Vu Nguyen

Director Name: Vu Nguyen

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

Background:
Radiographic imaging is a critical component of the diagnosis and management of craniosynostosis (CS). The aim of this study was to quantify the cumulative medical radiation exposure from computed tomography (CT) in patients with CS with the Pittsburgh Craniofacial protocol.

Methods:
Medical records of nonsyndromic patients with CS were examined for demographic information, and the effective radiation dose (ERD) in mSv was calculated for each head CT. Two-tailed Student's t test was performed and a p ≤ 0.05 was considered statistically significant.

Results:
241 patients were included. Mean age at first head CT was 0.51 0.42 years. Mean number of CT scans obtained was 2.14 1.12, mean ERD of a single head CT was 4.27 1.65 mSv, mean total combined ERD was 9.11 4.77 mSv. There was an inverse square relationship between ERD and age at scan, with a 27.7% decrease from a scan obtained at 6 months versus 12 months (5.24 1.50 mSv vs. 3.78 1.35 mSv, respectively; p <0.001).

Conclusions:
Patients with CS on average undergo 2 CT scans related to their diagnosis, with a mean total ERD of 9.11 mSv; this is equivalent to 1.5 years of the average annual background radiation dose a person living in the US will encounter from environmental radiation, medical exposures and consumer products. A CT obtained at <6months is associated with a higher ERD, thus we recommend delaying imaging from the initial presentation to closer to the date of surgery when possible.

Author Contact Information:
Madeleine Bruce
4401 Penn Avenue
Pittsburgh, Pennsylvania
15224

4126925323
412-692-5323 (cell)

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