Introduction
Materials and methods
Norwegian cohort and data source
Categorization of radiological procedures
Comparison of doses by modality
Data analysis
Results
Frequency and probability by modality
Age categorya | Number of patients examinedb (%) | Total number of examinations | ||||
---|---|---|---|---|---|---|
Conventional radiography | CT | Diagnostic fluoroscopy | NM | Noncardiac intervention | ||
0–3 m (newborn) (n =1,773) | 561 (31.6%) | 4,785 | 178 | 157 | 20 | 16 |
4–30 m (1 year) (n =2,111) | 1,240 (58.7%) | 9,539 | 293 | 410 | 86 | 29 |
31–90 m (5 years) (n =2,782) | 1,195 (43%) | 6,894 | 248 | 323 | 103 | 22 |
91–150 m (10 years) (n =3,100) | 830 (26.8%) | 4,715 | 292 | 204 | 119 | 7 |
151–210 m (15 years) (n =2,954) | 884 (29.9%) | 4,492 | 297 | 137 | 74 | 24 |
211–216 m (late adolescents) (n =2,473) | 163 (6.6%) | 267 | 22 | 4 | 10 | 1 |
Total | 30,692 | 1,330 | 1,235 | 412 | 99 |
Age category | Number of examinations | Proportion of patients | ||||
---|---|---|---|---|---|---|
Conventional radiography | CT | Diagnostic fluoroscopy | NM | Noncardiac intervention | ||
0–3 m (newborn) (n =1,773) | 0 | 69.1 | 92.4 | 96.0 | 99.0 | 99.2 |
1 | 5.4 | 5.8 | 1.8 | 0.9 | 0.8 | |
2–9 | 15.4 | 1.8 | 2.1 | 0.1 | 0.1 | |
≥ 10 | 10.1 | 0.0 | 0.1 | 0.0 | 0.0 | |
4–30 m (1 year) (n =2,111) | 0 | 41.9 | 92.3 | 91.0 | 97.5 | 99.1 |
1 | 7.9 | 4.6 | 4.8 | 1.4 | 0.6 | |
2–9 | 38.0 | 3.1 | 4.1 | 1.1 | 0.3 | |
≥ 10 | 12.2 | 0.0 | 0.1 | 0.0 | 0.0 | |
31–90 m (5 years) (n =2,782) | 0 | 58.1 | 94.6 | 94.0 | 97.6 | 99.4 |
1 | 8.2 | 3.7 | 3.9 | 1.6 | 0.5 | |
2–9 | 27.6 | 1.7 | 1.9 | 0.8 | 0.1 | |
≥ 10 | 6.1 | 0.0 | 0.1 | 0.0 | 0.0 | |
91–150 m (10 years) (n =3,100) | 0 | 74.1 | 94.9 | 96.7 | 97.6 | 99.8 |
1 | 6.7 | 3.0 | 1.9 | 1.5 | 0.2 | |
2–9 | 15.1 | 2.0 | 1.3 | 0.8 | 0.0 | |
≥ 10 | 4.1 | 0.0 | 0.1 | 0.0 | 0.0 | |
151–210 m (15 years) (n =2,954) | 0 | 71.3 | 93.6 | 97.1 | 98.1 | 99.5 |
1 | 7.4 | 4.6 | 2.0 | 1.4 | 0.3 | |
2–9 | 17.4 | 1.8 | 0.9 | 0.5 | 0.2 | |
≥ 10 | 4.0 | 0.0 | 0.0 | 0.0 | 0.0 | |
211–216 m (late adolescents) (n =2,473) | 0 | 93.9 | 99.2 | 99.8 | 99.7 | 99.96 |
1 | 4.1 | 0.7 | 0.2 | 0.2 | 0.04 | |
2–9 | 1.9 | 0.1 | 0.0 | 0.1 | 0.0 | |
≥ 10 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 |
Frequent examination types
Examination modality | Most frequent examinations | Number of examinations | Number of patients |
---|---|---|---|
Conventional radiography | AP and lateral thorax | 14,421 | 2,393 |
AP thorax | 12,416 | 958 | |
Scoliosis | 507 | 102 | |
Abdomen | 299 | 172 | |
CT | Thorax | 403 | 234 |
Head | 244 | 117 | |
Abdomen | 51 | 40 | |
Diagnostic fluoroscopy | Chest/thorax | 214 | 152 |
Esophagus | 170 | 92 | |
NM | Lung perfusion | 181 | 105 |
Myocardial perfusion | 59 | 38 | |
Noncardiac intervention | NA | - | - |
Age category | Number of examinations | Proportion of patients | |||
---|---|---|---|---|---|
X-ray thorax | CT thorax | Fluoroscopy thorax | NM lung perfusion | ||
0–3 m (newborn) (n =1,773) | 0 | 82.5 | 97.9 | 99.8 | 99.8 |
1 | 8.4 | 1.9 | 0.2 | 0.2 | |
2 | 4.8 | 0.2 | 0.1 | 0.1 | |
≥ 3–11 | 4.3 | 0.1 | 0.0 | 0.0 | |
4–30 m (1 year) (n =2,111) | 0 | 49.9 | 96.1 | 97.8 | 98.7 |
1 | 7.6 | 2.6 | 1.7 | 1.0 | |
2 | 13.8 | 0.6 | 0.4 | 0.2 | |
≥ 3–26 | 28.7 | 0.7 | 0.1 | 0.0 | |
31–90 m (5 years) (n =2,782) | 0 | 63.5 | 97.8 | 97.7 | 98.6 |
1 | 7.3 | 1.5 | 1.8 | 1.1 | |
2 | 9.5 | 0.4 | 0.4 | 0.2 | |
≥ 3–45 | 19.7 | 0.3 | 0.1 | 0.1 | |
91–150 m (10 years) (n =3,100) | 0 | 78.1 | 98.5 | 99.2 | 98.8 |
1 | 6.2 | 1.0 | 0.5 | 0.8 | |
2 | 4.0 | 0.4 | 0.2 | 0.2 | |
≥ 3–38 | 11.7 | 0.2 | 0.1 | 0.2 | |
151–210 m (15 years) (n =2,954) | 0 | 75.1 | 98.3 | 99.5 | 99.3 |
1 | 7.3 | 1.4 | 0.5 | 0.4 | |
2 | 5.4 | 0.3 | 0.0 | 0.2 | |
≥ 3–23 | 12.2 | 0.0 | 0.0 | 0.0 | |
211–216 m (late adolescents) (n =2,473) | 0 | 95.2 | 99.8 | 99.96 | 99.96 |
1 | 3.4 | 0.2 | 0.04 | 0.0 | |
2 | 0.9 | 0.0 | 0.0 | 0.04 | |
≥ 3–12 | 0.5 | 0.0 | 0.0 | 0.0 |
Effective dose by modality, body region and age category
Modality | Body Region | Age category | Number of examinations | Number of examinations with DAP/DLP | Median (IQR) DAP (Gycm2) | Median (IQR) DLP (mGycm) | Median (IQR) effective dose (mSv) |
---|---|---|---|---|---|---|---|
Conventional radiography | Thorax | 0–3 m (newborn) | 4,615 | 428 | 0.01 (0.004–0.01) | 0.012 (0.01–0.02) | |
4–30 m (1 year) | 9,322 | 2,376 | 0.01 (0.01–0.02) | 0.008 (0.005–0.01) | |||
31–90 m (5 years) | 6,567 | 2,780 | 0.02 (0.01–0.04) | 0.008 (0.004–0.02) | |||
91–150 m (10 years) | 4,216 | 1,910 | 0.05 (0.03–0.07) | 0.013 (0.01–0.02) | |||
151–210 m (15 years) | 3,840 | 1,323 | 0.08 (0.06–0.12) | 0.013 (0.01–0.02) | |||
211–216 m (late adolescents) | 177 | 19 | 0.13 (0.1–0.17) | 0.020 (0.02–0.03) | |||
CT | Thorax | 0–3 m (newborn) | 58 | 27 | 61.04 (43.1–65.65) | 2.38 (1.68–2.56) | |
4–30 m (1 year) | 138 | 51 | 54.00 (23–88.65) | 1.40 (0.59–2.30) | |||
31–90 m (5 years) | 104 | 48 | 42.30 (25.81–69.73) | 0.76 (0.46–1.26) | |||
91–150 m (10 years) | 94 | 44 | 72.14 (36.36–126.65) | 0.94 (0.47–1.65) | |||
151–210 m (15 years) | 75 | 41 | 169.65 (58–248.15) | 2.38 (0.81–3.47) | |||
211–216 m (late adolescents) | 6 | 2 | 247.50 (154–341) | 3.47 (2.16–4.77) | |||
Diagnostic fluoroscopy | Gastrointestinal tract (neck + chest + abdomen) | 0–3 m (newborn) | 91 | 74 | 0.15 (0.07–0.27) | 0.27 (0.12–0.48) | |
4–30 m (1 year) | 197 | 121 | 0.30 (0.15–0.50) | 0.23 (0.11–0.38) | |||
31–90 m (5 years) | 83 | 63 | 0.44 (0.19–0.78) | 0.22 (0.09–0.38) | |||
91–150 m (10 years) | 32 | 25 | 0.54 (0.18–0.99) | 0.18 (0.06–0.33) | |||
151–210 m (15 years) | 23 | 15 | 0.77 (0.28–1.24) | 0.17 (0.06–0.27) | |||
211–216 m (late adolescents) | 0 | 0 | - | - |
Examination | Age category | Radio-pharmaceutical | Weight range (kg) | Administered activity range (MBq) | Conversion factor-effective dose/administered activity (mSv/MBq)a | Effective dose range (mSv) |
---|---|---|---|---|---|---|
Lung perfusion | 0–3 m (newborn) | 99mTc-labeled MAA | 3.7–6.5 | 10 | NA | - |
4–30 m (1 year) | 6.5–12.6 | 10–17.6 | 0.063 | 0.63–1.11 | ||
31–90 m (5 years) | 12.6–24.4 | 17.6–31.9 | 0.034 | 0.60–1.09 | ||
91–150 m (10 years) | 24.4–42 | 31.9–51.2 | 0.023 | 0.74–1.18 | ||
151–210 m (15 years) | 42–69.1 | 51.2–78.4 | 0.016 | 0.82–1.25 | ||
211–216 m (late adolescents) | > 69.1 | ≥ 78.4 | 0.011 | ≥ 0.86 | ||
Lung ventilation | 0–3 m (newborn) | 99mTc-labeled technegas | 3.7–6.5 | 100 | NA | - |
4–30 m (1 year) | 6.5–12.6 | 100–153.9 | 0.087 | 8.70–13.39 | ||
31–90 m (5 years) | 12.6–24.4 | 153.9–279.8 | 0.047 | 7.23–13.15 | ||
91–150 m (10 years) | 24.4–42 | 279.8–447.9 | 0.031 | 8.67–13.88 | ||
151–210 m (15 years) | 42–69.1 | 447.9–686 | 0.022 | 9.85–15.09 | ||
211–216 m (late adolescents) | > 69.1 | ≥ 686 | 0.015 | ≥ 10.29 | ||
Myocardial scintigraphy, Stress | 0–3 m (newborn) | 99mTc-labeled sestamibi/tetrofosmin2 | 3.7–6.5 | 84–143.6 | NA | - |
4–30 m (1 year) | 6.5–12.6 | 143.6–263.8 | 0.045b | 6.46–11.86 | ||
31–90 m (5 years) | 12.6–24.4 | 263.8–479.6 | 0.023b | 6.06–11.03 | ||
91–150 m (10 years) | 24.4–42 | 479.6–767.8 | 0.016b | 7.67–12.28 | ||
151–210 m (15 years) | 42–69.1 | 767.8–1176 | 0.01b | 7.67–11.76 | ||
211–216 m (late adolescents) | > 69.1 | ≥ 1176 | 0.0079b | ≥ 9.29 | ||
Myocardial scintigraphy, Rest | 0–3 m (newborn) | 99mTc-labeled sestamibi/tetrofosmin2 | 3.7–6.5 | 80 | NA | - |
4–30 m (1 year) | 6.5–12.6 | 80–87.92 | 0.053b | 4.24–4.66 | ||
31–90 m (5 years) | 12.6–24.4 | 87.92–159.88 | 0.028b | 2.46–4.48 | ||
91–150 m (10 years) | 24.4–42 | 159.88–255.92 | 0.018b | 2.88–4.61 | ||
151–210 m (15 years) | 42–69.1 | 255.92–392 | 0.012b | 3.07–4.70 | ||
211–216 m (late adolescents) | > 69.1 | ≥ 392 | 0.009b | ≥ 3.53 | ||
Renography standard | 0–3 m (newborn) | 99mTc-labeled MAG3 (normal renal function, no accounting for emptying of bladder within 0.5–1 h post administration) | 3.7–6.5 | 15–17.5 | NA | - |
4–30 m (1 year) | 6.5–12.6 | 17.5–25.9 | 0.022 | 0.38–0.57 | ||
31–90 m (5 years) | 12.6–24.4 | 25.9–37.8 | 0.012 | 0.31–0.45 | ||
91–150 m (10 years) | 24.4–42 | 37.8–52.5 | 0.012 | 0.45–0.63 | ||
151–210 m (15 years) | 42–69.1 | 52.5–68.7 | 0.009 | 0.47–0.62 | ||
211–216 m (late adolescents) | > 69.1 | ≥ 68.7 | 0.007 | ≥ 0.48 | ||
Renal scintigraphy | 0–3 m (newborn) | 99mTc-labeled DMSA | 3.7–6.5 | 18.5 | NA | - |
4–30 m (1 year) | 6.5–12.6 | 18.5–21.3 | 0.037 | 0.68–0.79 | ||
31–90 m (5 years) | 12.6–24.4 | 21.3–38.8 | 0.021 | 0.45–0.82 | ||
91–150 m (10 years) | 24.4–42 | 38.8–62.1 | 0.015 | 0.58–0.93 | ||
151–210 m (15 years) | 42–69.1 | 62.1–95.2 | 0.011 | 0.68–1.05 | ||
211–216 m (late adolescents) | > 69.1 | ≥ 95.2 | 0.0088 | ≥ 0.84 |