UPMC Children’s Pediatric Urologist Rajeev Chaudhry, MD, Launched New Study to Clarify Radiation Entrance Skin Dose from Abdominal X-rays in Pediatric Patients

A new prospective study designed and led by Rajeev Chaudhry, MD, assistant professor of urology at UPMC Children’s Hospital of Pittsburgh, is working to better clarify the actual amount of radiation from abdominal X-rays absorbed at skin level in pediatric patients.

X-ray imaging is ubiquitous in the medical care of children and adults and has provided clinicians with valuable diagnostic insights into injury and illness for generations. While X-rays are generally viewed as safe, effective, and painless ways to image structures hidden inside the body, there is still a risk associated with exposure to ionizing radiation.

“Nevertheless,” says Dr. Chaudhry,” X-rays should still be used judiciously, and we ought to be certain about the exact amount of radiation being absorbed into the body in adults, and particularly in children who are still developing. However, we have only approximations of the dose based on what is emitted by the machine and subsequently captured on the imaging plate. But we don't have concrete values for what dose is absorbed into the patients at skin level. That's a problem, and our study is working to figure this out."

As Dr. Chaudhry explains, the effects of ionizing radiation on the body are stochastic. This means that "the effect occurs by chance, generally occurring without a threshold level of dose, whose probability is proportional to the dose and whose severity is independent of the dose."¹

"This is important because what it means is that while we know the more radiation you are exposed to, the worse the effects, we don't know for an individual what amount can cause cellular damage that could manifest years later as a malignancy or some kind of genetic change," says Dr. Chaudhry.

For the new study, Dr. Chaudry is enrolling pediatric patients to assess the entrance skin dose of radiation from abdominal X-ray using small but sensitive Landauer NanoDOT ™OSLD single point dosimeters placed on the skin.

The dosimeter will capture the radiation dose, and Dr. Chaudhry's team will then analyze the data and compare the values against the current approximation measures from the machine's settings and air kerma values.

“This study is the first of its kind in pediatric patients and should provide us with a more concrete understanding of the radiation patients absorb at skin level," says Dr. Chaudhry. "We'll also look at comparisons between children based on age, size, body mass index, and other factors to see if these have any statistically significant findings."

Clinically the study’s findings will be significant in that a more precise understanding of absorbed radiation dose will likely be obtained; but the findings, whatever they may be, will also help clinicians in their discussions with patients and families who want to and should know precisely how much radiation is entering the body.

"Think about the young patient who, perhaps because of their condition, may need repeat imaging over months or years. There is a risk to that, and we ought to know more about it. Right now, we have only estimates. They may be good estimates, but we can do better," says Dr. Chaudhry.  

Learn more about Dr. Chaudhry here.

Read findings from a prior study by Dr. Chaudhry on radiation exposure in pediatric patients through conventional fluoroscopic voiding cystourethrogram.

References

1. U. S. Nuclear Regulatory Commission. Reference Library.