SHOULD THE PELVIS BE INCLUDED IN ABDOMINAL COMPUTED TOMOGRAPHY SCANS OF CHILDREN WITH UPPER-ABDOMINAL PRIMARY MALIGNANT TUMORS?
INTRODUCTION: There is increasing awareness of the potential risk associated with ionizing radiation in pediatric radiology. Children with abdominal cancer undergo multiple computed tomography (CT) scans both at diagnosis and for follow-up.
OBJECTIVE: We sought to estimate the potential contribution of pelvis CT findings in the management of children with upper-abdominal tumors in correlation with the effective radiation dose.
METHODS: Three hundred forty-two children (aged 1 day to 16 years) with histologically proven upper-abdominal primary malignant tumors (children with lymphoma were not included) were examined during the last 15 years in our department. Their upper- and lower-abdominal CT scans were reviewed retrospectively for clinically significant pelvic abnormalities. The effective radiation dose for each abdominal area was calculated.
RESULTS: Nine children (2.63%) showed CT pelvic abnormalities that did not change clinical management, and 7 (2.04%) showed findings that affected tumor staging. Thirty-nine percent of the total effective radiation dose was from pelvic CT scans.
CONCLUSIONS: Our data indicate that clinically significant pelvic CT findings are rare in children with upper-abdominal primary malignant tumors. We suggest that the pelvis should not be routinely included in abdominal CT scans unless indicated by other clinical or laboratory findings, given the high level of effective radiation dose.
Submitted by Maria Zarifi
- Copyright © 2008 by the American Academy of Pediatrics