National guidelines for dental diagnostic imaging in the developmental age
This document aims to support the dental professional in choosing the adequate diagnostic technique, minimising the radiation dose in observance of the As Low As Reasonably Achievable (ALARA) principle (7). This principle states that the biological cost can only be justifed when the beneft, that is, the diagnosis, outweighs the risk related to radiation exposure. In this guideline paper, we report recommendations for radiologists, medical physicists, paediatrician, dentists and maxillofacial surgeons, with reference to the specifc felds.
Protecting sensitive patient groups from imaging using ionizing radiation: effects during pregnancy, in fetal life and childhood
The frequency of imaging examinations requiring radiation exposure in children (especially CT) is rapidly increasing. This paper reviews the current evidence in radiation protection in pediatric imaging, focusing on the recent knowledge of the biological risk related to low doses exposure. Even if there are no strictly defined limits for patient radiation exposure, it is recommended to try to keep doses as low as reasonably achievable (the ALARA principle). To achieve ALARA, several techniques to reduce the radiation dose in radiation-sensitive patients groups are reviewed. The most recent recommendations that provide guidance regarding imaging of pregnant women are also summarized, and the…
Up-to-date imaging review of paediatric soft tissue vascular masses, focusing on sonography
The purpose of this article is to provide an up-to-date overview on imaging of paediatric vascular soft tissue masses, including both neoplastic and non-neoplastic lesions. We describe the-often challenging-imaging diagnosis-mainly performed by ultrasound (and secondarily by MRI) and differential diagnosis of vascular soft tissue lesions in children. We underline how important it is to determine whether a vascular anomaly has a regional vascular origin, or if there are other entities, ranging from benign to malignant lesions, which have flow-signal or blood degradation products. Even though clinical examination and patient's history are the first and indispensable steps in the initial diagn…
Is MRI imaging in pediatric age totally safe? A critical reprisal.
Current radiological literature is strongly focussed on radiation imaging risks. Indeed, given there is a small but actual augment in cancer risk from exposure to ionizing radiation in children, it is important to understand what the risk of alternative techniques could be. We retrospectively review literature data concerning possible MR imaging risks, focussing on the biological effects of MR, sedation and gadolinium compound risks when dealing with infant patients. The main concerns can be summarized in: (1) Biological effects of non-ionizing electromagnetic fields (EMF) employed—whose mechanisms of interaction with human tissues are polarization, induced current, and thermal heating, res…
Adult exposures from MDCT including multiphase studies: first Italian nationwide survey.
To evaluate the radiation dose in routine multidetector computed tomography (MDCT) examinations in Italian population.This was a retrospective multicentre study included 5,668 patients from 65 radiology departments who had undergone common CT protocols: head, chest, abdomen, chest–abdomen–pelvis (CAP), spine and cardiac. Data included patient characteristics, CT parameters, volumetric CT dose index (CTDIvol) and dose length product (DLP) for each CT acquisition phase. Descriptive statistics were calculated, and a multi-regression analysis was used to outline the main factors affecting exposure.The 75th percentiles of CTDIvol (mGy) and DLP (mGy cm) for whole head were 69 mGy and 1,312 mGy cm…
Fibrous hamartoma of infancy: an Italian multi-institutional experience.
Fibrous hamartoma of infancy: an Italian multi-institutional experience. Carretto E, Dall'Igna P, Alaggio R, Siracusa F, Granata C, Ferrari A, Cecchetto G. Source Division of Paediatric Surgery, Department of Paediatrics, University of Padua, Padua, Italy. Abstract BACKGROUND: Fibrous hamartoma (FH) of infancy is a benign mesenchymal tumor, occurring as a superficial mass. Complete excision is curative. OBJECTIVE AND METHODS: The clinical features and treatment results of 18 children with FH are described. RESULTS: Local excision was the most common procedure. Surgery was radical in 10 patients, with microscopic residual disease in 6; all of them are alive with no evidence of disease 2 to 4…
Italian inter-society expert panel position on radiological exposure in Neonatal Intensive Care Units.
Abstract Background In the recent years, clinical progress and better medical assistance for pregnant women, together with the introduction of new complex technologies, has improved the survival of preterm infants. However, this result requires frequent radiological investigations mostly represented by thoracic and abdominal radiographs in incubators. This document was elaborated by an expert panel Italian inter-society working group (Radiologists, Paediatricians, Medical Physicists) with the aim to assist healthcare practitioners in taking choices involving radiation exposures of new-born infants and to provide practical recommendations about justification and optimization in Neonatal Inte…
Radiation dose from multidetector CT studies in children: results from the first Italian nationwide survey
Background Multidetector CT (MDCT) scanners have con- tributed to the widespread use of CT in paediatric imaging. However, concerns are raised for the associated radiation exposure. Very few surveys on radiation exposure from MDCT studies in children are available. Objective The aim of this study was to outline the status of radiation exposure in children from MDCT practice in Italy. Materials and methods In this retrospective multicentre study we asked Italian radiology units with an MDCT scanner with at least 16 slices to provide dosimetric and acquisition param- eters of CT examinations in three age groups (1–5, 6–10, 11– 15 years) for studies of head, chest and abdomen. The dosi- metric…