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Radiation risk and cost-benefit analysis of a paediatric radiology procedure: results from a national study

¹ Department of Radiation Physics, IMV and ² Department of Paediatrics, IMK, Faculty of Health Science, University of Linköping, S-581 85 Linköping, Sweden, ³ Department of Medical Physics, Örebro University Hospital, S-701 85 Örebro, Sweden and ⁴ Department of Statistics, University of Glasgow, Glasgow G12 8QW, UK

A national study was performed to investigate radiation doses and associated risks to patients during X-ray fluoroscopy-guided small intestinal biopsies in the investigation of coeliac disease. Thermoluminescent dosemeters (TLD) and questionnaires were sent to 42 of the 43 paediatric departments in Sweden performing these biopsies. During the study period (2 x 3 weeks) 257 biopsies were recorded, representing about 10% of annually performed paediatric investigations. The results show that the absorbed dose during biopsy ranged from 0.04 mGy to 23.8 mGy (mean 1.87 mGy). The fluoroscopy time ranged from 2 s to 663 s (mean 60 s). The collective dose from the procedure amounts to 4.7 manSv year^–1. Thus, the annual excess cancer mortality, including severe hereditary effects, can be estimated at 0.6–0.7 cases per year. However, significant dose saving can be obtained by proper choice of sedation and biopsy equipment.