ABSTRACT
The radiation exposures of children undergoing full spine radiography were investigated in two pediatric hospitals in Greece. Entrance surface kerma (Ka,e) was assessed by thermoluminescence dosimetry and patient's effective dose (E) was estimated by Monte Carlo simulation. All required information regarding patient age and sex, the irradiation geometry, the x-ray spectra, and other exposure parameters (tube voltage and current) were registered as well. Values of Ka,e were measured to range from 0.22 mGy to 2.12 mGy, while E was estimated to range from 0.03 mSv to 0.47 mSv. In general, all values were greater in one of the two hospitals, as higher tube currents and exposure times were used in the examinations because of the difference in radiographers' training and practice. Moreover, dose to red bone marrow was found to be between 0.01 to 0.23 mSv and dose to breast ranged between 0.02 and 1.05 mSv depending on the age, projection, and hospital. These values are comparable with literature sources.
Subject(s)
Computer Simulation , Hospitals, Pediatric , Monte Carlo Method , Radiation Dosage , Radiometry , Scoliosis/diagnostic imaging , X-Rays , Body Burden , Bone Marrow/diagnostic imaging , Breast/radiation effects , Child , Child, Preschool , Greece , Humans , Radiography , Radiometry/adverse effects , Radiometry/methods , Radiometry/statistics & numerical data , Risk AssessmentABSTRACT
It has been shown that intrathecal chemotherapy may cause brain damage, which can be depicted in neuroimaging studies. The aim of this work was to examine possible morphologic alterations in the brain of children with extracranial solid tumors, without CNS complications, treated with systemic chemotherapy. Brain CT images of 69 children with extracranial malignancies were reviewed and the extent of 12 CSF compartments was measured in 49 CT examinations performed during intravenously given chemotherapy and in 20 after therapy completion. Measurements were compared with corresponding normative data. About half of the children undergoing chemotherapy and half of the patients examined after treatment were found to have diffuse brain atrophy. Focal lesions that might be associated with therapy toxicity were not observed. Chemotherapy, even when administered via the systemic route, may cause brain damage, which is observed long after the end of treatment.
Subject(s)
Antineoplastic Agents/adverse effects , Brain/pathology , Adolescent , Atrophy , Brain/diagnostic imaging , Brain/drug effects , Child , Child, Preschool , Female , Humans , Infant , Male , Tomography, X-Ray ComputedABSTRACT
RATIONALE AND OBJECTIVES: The authors evaluate quantitatively brain atrophy induced by central nervous system prophylaxis in children treated for acute lymphoblastic leukemia during and after therapy completion. METHODS: Measurements of the width of the subarachnoid compartments were performed in 243 brain computed tomography (CT) examinations of 196 children examined during (125) and/or after (71) treatment for acute lymphoblastic leukemia without central nervous system involvement. Data were compared with normative data. RESULTS. Diffuse brain atrophy was observed in 74% and 65% of the CT examinations performed during and after cessation of treatment, respectively. The highest incidence of brain atrophy (78%) occurred during the administration of intrathecal chemotherapy. All children younger than 2 years of age exhibited brain atrophy. CONCLUSIONS: Brain atrophy is the principal CT finding in the majority of children treated for acute lymphoblastic leukemia and it can be attributed mainly to intrathecal chemotherapy. This finding can be observed long after therapy completion.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Brain/pathology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnostic imaging , Tomography, X-Ray Computed/methods , Adolescent , Atrophy/chemically induced , Atrophy/diagnostic imaging , Brain/diagnostic imaging , Brain/drug effects , Child , Child, Preschool , Female , Humans , Infant , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Retrospective StudiesABSTRACT
A 3-year-old HIV-positive boy developed Pneumocystis carinii pneumonia (PCP) resulting in chronic interstitial pulmonary disease, which persisted for the following 3 years; he was essentially asymptomatic and the lung findings had therefore been attributed to lymphocytic interstitial pneumonia (LIP). He subsequently developed extensive cystic pulmonary disease, documented by CT, leading to recurrent pneumothorax and severe pulmonary insufficiency. Lung biopsy revealed chronic PCP infection associated with extensive pulmonary fibrosis and calcification. This case suggests that Pneumocystis carinii may cause chronic progressive pulmonary fibrosis with cyst formation and respiratory failure.
