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Abstract：
OBJECTIVE: The Risk of Pediatric and Adolescent Cancer Associated with Medical Imaging (RIC) Study is quantifying the association between cumulative radiation exposure from fetal and/or childhood medical imaging and subsequent cancer risk. This manuscript describes the study cohorts and research methods.
METHODS: The RIC Study is a longitudinal study of children in two retrospective cohorts from 6 U.S. healthcare systems and from Ontario, Canada over the period 1995-2017. The fetal-exposure cohort includes children whose mothers were enrolled in the healthcare system during their entire pregnancy and followed to age 20. The childhood-exposure cohort includes children born into the system and followed while continuously enrolled. Imaging utilization was determined using administrative data. Computed tomography (CT) parameters were collected to estimate individualized patient organ dosimetry. Organ dose libraries for average exposures were constructed for radiography, fluoroscopy, and angiography, while diagnostic radiopharmaceutical biokinetic models were applied to estimate organ doses received in nuclear medicine procedures. Cancers were ascertained from local and state/provincial cancer registry linkages.
RESULTS: The fetal-exposure cohort includes 3,474,000 children among whom 6,606 cancers (2394 leukemias) were diagnosed over 37,659,582 person-years; 0.5% had in utero exposure to CT, 4.0% radiography, 0.5% fluoroscopy, 0.04% angiography, 0.2% nuclear medicine. The childhood-exposure cohort includes 3,724,632 children in whom 6,358 cancers (2,372 leukemias) were diagnosed over 36,190,027 person-years; 5.9% were exposed to CT, 61.1% radiography, 6.0% fluoroscopy, 0.4% angiography, 1.5% nuclear medicine.
CONCLUSIONS: The RIC Study is poised to be the largest study addressing risk of childhood and adolescent cancer associated with ionizing radiation from medical imaging, estimated with individualized patient organ dosimetry.
METHODS: The RIC Study is a longitudinal study of children in two retrospective cohorts from 6 U.S. healthcare systems and from Ontario, Canada over the period 1995-2017. The fetal-exposure cohort includes children whose mothers were enrolled in the healthcare system during their entire pregnancy and followed to age 20. The childhood-exposure cohort includes children born into the system and followed while continuously enrolled. Imaging utilization was determined using administrative data. Computed tomography (CT) parameters were collected to estimate individualized patient organ dosimetry. Organ dose libraries for average exposures were constructed for radiography, fluoroscopy, and angiography, while diagnostic radiopharmaceutical biokinetic models were applied to estimate organ doses received in nuclear medicine procedures. Cancers were ascertained from local and state/provincial cancer registry linkages.
RESULTS: The fetal-exposure cohort includes 3,474,000 children among whom 6,606 cancers (2394 leukemias) were diagnosed over 37,659,582 person-years; 0.5% had in utero exposure to CT, 4.0% radiography, 0.5% fluoroscopy, 0.04% angiography, 0.2% nuclear medicine. The childhood-exposure cohort includes 3,724,632 children in whom 6,358 cancers (2,372 leukemias) were diagnosed over 36,190,027 person-years; 5.9% were exposed to CT, 61.1% radiography, 6.0% fluoroscopy, 0.4% angiography, 1.5% nuclear medicine.
CONCLUSIONS: The RIC Study is poised to be the largest study addressing risk of childhood and adolescent cancer associated with ionizing radiation from medical imaging, estimated with individualized patient organ dosimetry.
摘要：
目的：医学影像学（RIC）相关的儿童和青少年癌症风险研究正在量化胎儿和/或儿童医学影像学累积辐射暴露与随后的癌症风险之间的关联。本手稿描述了研究队列和研究方法。
方法：RIC研究是对来自美国6个医疗保健系统和安大略省的两个回顾性队列中的儿童进行的纵向研究。加拿大在1995-2017年期间。胎儿暴露队列包括母亲在整个怀孕期间进入医疗系统并随访至20岁的儿童。儿童暴露队列包括出生在系统中的儿童，并在连续注册的同时随访。使用管理数据确定成像利用率。收集计算机断层扫描（CT）参数以评估个性化的患者器官剂量测定。构建了用于平均曝光的器官剂量库，用于射线照相，透视,血管造影，而诊断放射性药物生物动力学模型被用来估计在核医学程序中接受的器官剂量。根据地方和州/省癌症登记联系确定癌症。
结果：胎儿暴露队列包括3,474,000名儿童，其中6,606名癌症（2394例白血病）被诊断为超过37,659,582人年；0.5％的子宫内暴露于CT，4.0%射线照相术，0.5%透视,0.04%血管造影,0.2%核医学。儿童暴露队列包括3,724,632名儿童，其中6,358例癌症（2,372例白血病）被诊断超过36,190,027人年;5.9％暴露于CT，61.1%射线照相术，6.0%透视,0.4%血管造影,1.5%核医学。
结论：RIC研究有望成为解决与医学成像电离辐射相关的儿童和青少年癌症风险的最大研究。用个体化的患者器官剂量测定法估计。
方法：RIC研究是对来自美国6个医疗保健系统和安大略省的两个回顾性队列中的儿童进行的纵向研究。加拿大在1995-2017年期间。胎儿暴露队列包括母亲在整个怀孕期间进入医疗系统并随访至20岁的儿童。儿童暴露队列包括出生在系统中的儿童，并在连续注册的同时随访。使用管理数据确定成像利用率。收集计算机断层扫描（CT）参数以评估个性化的患者器官剂量测定。构建了用于平均曝光的器官剂量库，用于射线照相，透视,血管造影，而诊断放射性药物生物动力学模型被用来估计在核医学程序中接受的器官剂量。根据地方和州/省癌症登记联系确定癌症。
结果：胎儿暴露队列包括3,474,000名儿童，其中6,606名癌症（2394例白血病）被诊断为超过37,659,582人年；0.5％的子宫内暴露于CT，4.0%射线照相术，0.5%透视,0.04%血管造影,0.2%核医学。儿童暴露队列包括3,724,632名儿童，其中6,358例癌症（2,372例白血病）被诊断超过36,190,027人年;5.9％暴露于CT，61.1%射线照相术，6.0%透视,0.4%血管造影,1.5%核医学。
结论：RIC研究有望成为解决与医学成像电离辐射相关的儿童和青少年癌症风险的最大研究。用个体化的患者器官剂量测定法估计。
