Estimated cumulative radiation dose from PET/CT in children with malignancies: a 5-year retrospective review

Pediatr Radiol. 2010 May;40(5):681-6. doi: 10.1007/s00247-009-1434-z. Epub 2009 Dec 5.


Background: The increasing use of serial PET/CT scans in the management of pediatric malignancies raises the important consideration of radiation exposure in children.

Objective: To estimate the cumulative radiation dose from PET/CT studies to children with malignancy and to compare with the data in literature.

Materials and methods: Two hundred forty-eight clinical PET/CT studies performed on 78 patients (50 boys/28 girls, 1.3 to 18 years old from December 2002 to October 2007) were retrospectively reviewed under IRB approval. The whole-body effective dose (ED) estimates for each child were obtained by estimating the effective dose from each PET/CT exam performed using the ImPACT Patient Dosimetry Calculator for CT and OLINDA for PET.

Results: The average number of PET/CT studies was 3.2 per child (range: 1 to 14 studies). The average ED of an individual CT study was 20.3 mSv (range: 2.7 to 54.2), of PET study was 4.6 mSv (range: 0.4 to 7.7) and of PET/CT study was 24.8 mSv (range: 6.2 to 60.7). The average cumulative radiation dose per patient from CT studies was 64.4 mSv (range: 2.7 to 326), from PET studies was 14.5 mSv (range: 2.8 to 73) and from PET/CT studies was 78.9 mSv (range: 6.2 to 399).

Conclusion: The radiation exposure from serial PET/CT studies performed in pediatric malignancies was considerable; however, lower doses can be used for both PET and CT studies. The ALARA principle must be applied without sacrificing diagnostic information.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Body Burden*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Neoplasms / diagnosis*
  • Neoplasms / epidemiology*
  • Positron-Emission Tomography / statistics & numerical data*
  • Prevalence
  • Radiation Dosage*
  • Radiometry / statistics & numerical data*
  • Relative Biological Effectiveness
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Tomography, X-Ray Computed / statistics & numerical data*