gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

KiCT: Cancer risk after exposure with computed tomographies in childhood: descriptive analysis of the feasibility study

Meeting Abstract

  • Lucian Krille - IMBEI Universitätsmedizin Mainz, Mainz
  • Peter Scholz - IMBEI Universitätsmedizin Mainz, Mainz
  • Gudrun Miritz - IMBEI Universitätsmedizin Mainz, Mainz
  • Steffen Müller - BIPS Uni Bremen, Bremen
  • Maria Blettner - IMBEI Universitätsmedizin Mainz, Mainz

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds313

doi: 10.3205/11gmds313, urn:nbn:de:0183-11gmds3131

Published: September 20, 2011

© 2011 Krille et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Background: Computed tomographies (CT) are indispensable diagnostic tools in modern medicine. Since their introduction, their usage rose worldwide steadily and now contributes a disproportional share to the collective medical radiation exposure per capita. Annually 30,000 paediatric CTs are performed in Germany (Galanski 2006). The immediate benefit is opposed by the risks to health due to the radiation burden. Children are particular affected in virtue of their increased radiation sensitivity and longer life span under risk. The cancer risk at low doses of exposure is not sufficiently quantified. Worldwide no study has been published concerning the cancer burden after exposure to paediatric CT. Apart from cancer risk estimation this study’s data allows analysing the long term patterns of paediatric CT usage, which will be presented today.

Methods: The study’s design and feasibility was already presented on the GMDS in 2010. From major university medical centres we abstracted data from the radiologic information system – the electronic patients and exams database. After on site clerical review we determined the distinct exams and their respective types. Their description allowed classification by and determination of exposed body regions. The dosimetric detail information is stored as meta-data in the picture archiving and communication system and is not accessible easily. Specialised software developed and to collect dosimetric detail information. Based on the physical parameters, the individual effective dose was calculated using a study server. The outcome, cancer development in childhood, was determined by stochastic linkage between the German childhood cancer registry’s database and the compiled cohort from the radiology department.

Results: Until now the assembled cohort undercuts by far the statistically relevant size. We will present observed and expected cancer cases in the cohort, in an explorative SIR analysis.

The long-term patterns of paediatric CT usage will be presented, revealing changes in sex, average age at exposure, and number of scans per capita by time and medical centre. The performed exams will be analysed descriptively concerning exposed body regions and individual effective doses over time – for those where dose information is available. The results will be compared with published national and international values, wherever possible.

Conclusion: The cohort assembled from the pilot study is too small to extract statically relevant results. The main study’s termination is envisaged for the year 2013. Until then, the pilot study will deliver the fist overview of the current and past paediatric CT usage practice in terms of a timeline.


References

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Brenner DJ, et al. Estimated Risks of Radiation-Induced Fatal Cancer from Pediatric CT. American Journal of Roentgenology. 2001;176(2):289-96.
2.
Galanski, M, Nagel, HD, and Stamm, G. Paediatrische CT-Expositionspraxis in der BRD: Ergebnisse 2005/06. Hannover: Medizinische Hochschule Hannover; 2006.
3.
Krille L, et al. Computed tomography in children: multicenter cohort study design for the evaluation of cancer risk. Eur J Epidemiol. 2011
4.
Prokop M. Strahlendosis in der Computertomographie. Der Radiologe. 2008;48(3):229-42.