Abstract: Since the first Oxford Survey of Childhood Cancer’s results were published, people have become more aware of the risks associated with prenatal exposure from diagnostic x rays. As a result, it has since been the subject of many studies. In this review, the results of recent epidemiological studies are summarized. The current international guidelines for diagnostic x-ray examinations were compared to the review. All epidemiological studies starting from 2007 and all relevant international guidelines were included. Apart from one study that involved rhabdomyosarcoma, no statistically significant associations were found between prenatal exposure to x rays and the development of cancer during 2007–2020. Most of the studies were constrained in their design due to too small a cohort or number of cases, minimal x-ray exposure, and/or data obtained from the exposed mothers instead of medical reports. In one of the studies, computed tomography exposure was also included, and this requires more and longer follow-up in successive studies. Most international guidelines are comparable, provide risk coefficients that are quite conservative, and discourage abdominal examinations of pregnant women.
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BACKGROUND: Visceral obesity is associated with the metabolic syndrome. The metabolic risk differs per ethnicity, but reference values for visceral obesity for body composition analyses using Computed Tomography (CT) scans in the Caucasian population are lacking. Therefore, the aim of this study was to define gender specific reference values for visceral obesity in a Caucasian cohort based upon the association between the amount of visceral adipose tissue (VAT) and markers of increased metabolic risk.METHODS: Visceral Adipose Tissue Area Index (VATI cm 2/m 2) at the level of vertebra L3 was analyzed using CT scans of 416 healthy living kidney donor candidates. The use of antihypertensive drugs and/or statins was used as an indicator for increased metabolic risk. Gender specific cut-off values for VATI with a sensitivity ≥80% were calculated using receiver operating characteristic (ROC) curves. RESULTS: In both men and women who used antihypertensive drugs, statins or both, VATI was higher than in those who did not use these drugs (p ≤ 0.013). In males and females respectively, a value of VATI of ≥38.7 cm 2/m 2 and ≥24.9 cm 2/m 2 was associated with increased metabolic risk with a sensitivity of 80%. ROC analysis showed that VATI was a better predictor of increased metabolic risk than BMI (area under ROC curve (AUC) = 0.702 vs AUC = 0.556 in males and AUC = 0.757 vs AUC = 0.630 in females). CONCLUSION: Gender and ethnicity specific cut-off values for visceral obesity are important in body composition research, although further validation is needed. This study also showed that quantification of VATI is a better predictor for metabolic risk than BMI.
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Diagnostic reference levels (DRLs) for medical x-ray procedures are being implemented currently in the Netherlands. By order of the Dutch Healthcare Inspectorate, a survey has been conducted among 20 Dutch hospitals to investigate the level of implementation of the Dutch DRLs in current radiological practice. It turns out that hospitals are either well underway in implementing the DRLs or have already done so. However, the DRLs have usually not yet been incorporated in the QAsystem of the department nor in the treatment protocols. It was shown that the amount of radiation used, as far as it was indicated by the hospitals, usually remains below the DRLs. A procedure for comparing dose levels to the DRLs has been prescribed but is not Always followed in practice. This is especially difficult in the case of children, as most general hospitals receive few children. Health Phys. 108(4):462–464; 2015
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