Radiation Exposure from Full Spine X-rays in Adolescents

Radiation dose from a full spine X-ray examination?

Hello! My daughter is 15 years old and has undergone two full-body spinal X-ray examinations in the past year and a half (from the neck to the pelvis).
The first examination included one frontal and one lateral view of the entire body.
The second examination included frontal and lateral views of the cervical, thoracic, and lumbar spine, totaling six images.
I have read online that full-body spinal X-ray examinations involve a significant amount of radiation, and we underwent these procedures without understanding the risks, which has left us very concerned.
I would like to ask:
1.
How much radiation did my daughter actually receive? As she is still a minor, could this radiation have an impact on her body, particularly concerning her breasts and reproductive health? I am very worried...
2.
Given my daughter's situation, is this level of radiation exposure potentially carcinogenic? Does she need to undergo regular "radiation health checks"?
I hope you can help me.
Thank you! A very concerned mother.

E, 10~19 year old female. Ask Date: 2019/12/26

Dr. Ye Weicheng reply Radiology

Dear Concerned Mother,
We have a more authoritative printed report dated March 2019, supported by the ACR (American College of Radiology) and RNSA (Radiological Society of North America).
The authors reviewed the radiation doses to the human body from radiological examinations over the past few years and compiled a table that includes the absorbed doses from computed tomography (CT) scans and standard diagnostic X-rays, which I have attached below.
To help the public understand the accepted dose levels, we often use comparisons.
According to the long-term observations of background radiation by Taiwan's Atomic Energy Commission, the average annual background radiation in Taiwan is approximately 1.6-2.4 millisieverts (mSv).
The absorbed doses provided in the aforementioned table are for routine examinations in adults, while your 15-year-old sister would typically receive a lower dose based on the professional standards set by Taiwanese radiologists.
The table indicates that the absorbed dose from a single spinal X-ray for adults is 1.5 mSv, and it can be inferred that the dose for children, given their different body thickness, should generally be less than 6 mSv for six images.
If no medical radiation exposure occurs, an individual in Taiwan would absorb a similar amount of radiation in approximately 2.5 years just from environmental sources without engaging in any activities.
Regarding your concerns about cancer risk, while I cannot guarantee that there are absolutely no issues, I can assure you that the probability is low enough to be considered negligible.
Medical radiation is essential for diagnosis and treatment, and I trust that the physician's recommendations are made after careful consideration.
Additionally, Taiwanese radiologists are trained to adhere to the principle of justification and optimization in their practice.
Physiological testing combined with medical imaging is necessary to obtain detailed medical information, make accurate medical judgments, and provide appropriate medical interventions.
Delaying medical care due to concerns about radiation exposure could lead to more significant harm, which would be counterproductive.
Sincerely,
Radiation Protection Department, Nantou Hospital, Ministry of Health and Welfare
December 30, 2019

Reply Date: 2019/12/26

More Info

Dear Concerned Mother,
Thank you for reaching out with your concerns regarding your daughter's exposure to radiation from full spine X-rays. It's completely understandable to be worried about the potential effects of radiation, especially in adolescents. Let’s address your questions systematically.

1. Radiation Dose from X-rays: The radiation dose from a full spine X-ray can vary based on the specific equipment used and the technique employed. However, on average, a single spinal X-ray can expose a patient to approximately 1.5 mSv (millisieverts) for adults. For children and adolescents, the dose is typically lower due to their smaller body size. Given that your daughter had two full spine X-rays, the total radiation exposure would likely be around 3 mSv or less, depending on the specifics of the imaging technique. To put this into perspective, the average person is exposed to about 3 mSv of natural background radiation each year from sources like cosmic rays and radon.

2. Health Effects and Cancer Risk: The concern about radiation exposure and its potential link to cancer is valid, particularly for children, as their developing tissues are more sensitive to radiation. However, the risk associated with the doses from diagnostic X-rays is relatively low. According to the International Commission on Radiological Protection (ICRP), doses below 100 mSv are not associated with significant health risks. The estimated additional lifetime cancer risk from a single exposure of 1 mSv is about 1 in 1,000,000, which is quite low. Therefore, the cumulative dose your daughter received from the two X-rays is unlikely to pose a significant cancer risk.

Regarding specific concerns about breast and reproductive health, while it is true that radiation can have effects on sensitive tissues, the doses from diagnostic X-rays are generally considered safe. The risk of developing cancer from such low doses is minimal, especially when weighed against the benefits of obtaining necessary medical information for diagnosis and treatment.

3. Regular Radiation Check-ups: There is no need for your daughter to undergo regular "radiation check-ups" simply due to her previous X-ray exposures. It is essential to maintain a balance between the need for medical imaging and the associated risks. If future imaging is required, it is advisable to discuss the necessity and potential alternatives with her healthcare provider. They can assess whether the benefits of the imaging outweigh the risks based on her medical history and current health status.

In conclusion, while it is natural to be concerned about radiation exposure, the doses from your daughter's X-rays are within safe limits, and the associated risks are low. It is crucial to continue monitoring her health and to consult with her healthcare provider regarding any future imaging needs. Open communication with her medical team will ensure that any necessary precautions are taken, and that her health remains a priority.

Please feel free to reach out if you have any further questions or concerns. Your vigilance as a parent is commendable, and I hope this information helps alleviate some of your worries.

Best regards,
Doctor Q&A Teams

[Your Institution/Organization]

Similar Q&A

Is It Safe to Get Full Spine X-Rays Without Protection?

Hello, doctor! I went to see a rehabilitation specialist because of numbness in my foot. The rehabilitation department recommended that I get X-rays of my entire spine, including lateral views. During the entire procedure, I did not wear a lead apron or any protective clothing. I...

Dr. Wang Yifen reply Radiology
Hello, diagnostic X-ray examinations involve low-dose radiation. According to the American Society of Radiologic Technologists, the radiation dose from a single lumbar spine X-ray is approximately 1.5 millisieverts. The International Commission on Radiological Protection (ICRP) r...

Concerns About Excessive X-Ray Exposure: What You Need to Know

Hello Doctor: Earlier this year, around February, I started experiencing frequent shoulder and neck pain, feeling uncomfortable no matter how I lay down. I suspected it might be related to my cervical spine or vertebrae. I consulted an orthopedic doctor who ordered X-rays: one la...

Dr. Sun Shengyi reply Radiology
Ms. Liang underwent a total of six spinal X-rays. The lumbar spine images had a higher dose, with two lateral views approximately 1.5 mSv (millisieverts), while the cervical spine images totaled about 1.0 mSv for four views. Currently, the equipment is very effective in controlli...

Understanding X-Ray Radiation Exposure: What You Need to Know

The radiation dose for a single cervical X-ray is approximately 0.2 millisieverts (mSv). However, the total radiation exposure can vary based on the specific type of imaging performed and the number of views taken. In your case, if you have undergone cervical X-rays four times,...

Dr. Wang Yifen reply Radiology
Hello, there are many factors that can affect the dose of radiation exposure, including the area of exposure, the range of exposure, the distance from the source, and the duration of exposure. The body size of the individual being examined can also influence the radiation dose. A...

Understanding Radiation Exposure from Lumbar and Thoracic X-rays

Hello, doctor. I would like to ask about the lumbar spine X-ray. Is the 1.5 millisieverts the total for both the frontal and lateral views combined, or is it 1.5 for just one view? I found some sources stating that it could be 1.5 for one view and others saying it's the tota...

Dr. Wang Yifen reply Radiology
Hello, the American Society of Radiologic Technologists states that the radiation dose for a chest X-ray (both frontal and lateral views) is approximately 0.1 millisieverts. The radiation dose for the upper back is about 1 millisievert, while for the lower back it is approximatel...