[Intl_DxMedPhys] Heads up on NEJM paper on radiation exposure in peds and hematologic cancer risk

[Mark Supanich]

Hi all,


Just a heads up that NEJM published a paper from Smith-Bindman et al this afternoon. https://urldefense.com/v3/__https://www.nejm.org/doi/full/10.1056/NEJMoa2502098?query=featured_home__;!!KGKeukY!1m_oRWHMFCepm1fT1RIhzq46cPRXjfbhAvYKAO_5iNUOWD5mqN0G-iBdtAZYZy1h5_JOVRouzbgwoLM5N75lJAFaFMiQA3UTRzxHR2RjJ7wH4P8$ 

It's an observational study of 3.5+ million peds looking at cumulative exposure to ionizing radiation, particularly focused on bone marrow dose, and increased risk of hematologic cancer incidence. Their results claim an increased incidence of cancer in patients with exposure to imaging, and demonstrate a cummulative dose effect. They claim their results are not likely due to reverse causation as they have reasons for exams and symptoms of these cancers were not common reasons for exams. They also note their results are inline with the EPI-CT study. Of note, it appears that they looked at imaging from 1996-2017 - so much of the imaging likely occurred on imaging equipment without many of the modern dose reduction features.

This is sure to get media play and parents will certainly have questions as the media coverage develops. Continuing to focus on the judicious use of imaging, the benefits of diagnostic imaging to answer clinical questions, and the fact that modern imaging equipment adapts to patient size and uses optimized radiation will be key talking points.

>From the paper: "By the end of follow-up, 7.5% (280,548 of 3,724,623) of all the children and 9.2% (272 of 2961) of those in whom a hematologic cancer developed had received a cumulative dose of at least 1 mGy."

[cid:image002.png at 01DC27F9.63B8FD00]

There is a lot to look at in this paper and the supplemental materials, so more information/analysis is sure to come.
--
Mark P. Supanich, Ph.D., DABR, FAAPM (he/him)
Director - Diagnostic Medical Physics
Rush University System for Health
Associate Professor & Vice Chair for Physics and Informatics
Rush Medical College Department of Diagnostic Radiology and Nuclear Medicine
[RUSH]

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