Kim KP, Berrington de Gonzalez A, Pearce MS, Salotti JA, Parker L, McHugh K, et al. Automatic computed tomography patient dose calculation using DICOM header metadata. Jahnen A, Kohler S, Hermen J, Tack D, Back C. Digital imaging and communications in medicine (DICOM). Progress against cancer in the Netherlands since the late 1980s: an epidemiological evaluation. Karim-Kos HE, Kiemeney LA, Louwman MW, Coebergh JW, de Vries E. Verloop J, van Leeuwen FE, Helmerhorst TJ, van Boven HH, Rookus MA. Cancer mortality after nasopharyngeal radium irradiation in the Netherlands: a cohort study. Ronckers CM, Land CE, Verduijn PG, Hayes RB, Stovall M, van Leeuwen FE. Risk of borderline and invasive ovarian tumours after ovarian stimulation for in vitro fertilization in a large Dutch cohort. Van Leeuwen FE, Klip H, Mooij TM, van de Swaluw AM, Lambalk CB, Kortman M, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, et al. Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. Mathews JD, Forsythe AV, Brady Z, Butler MW, Goergen SK, Byrnes GB, et al. Active bone marrow distribution as a function of age in humans. Effects of ionizing radiation, report of the General Assemble with Scientific Annexes. United Nations Scientific Committee on the Effects of Atomic Radiation. Radiation effective doses to patients undergoing abdominal CT examinations. CT scans in young people in Northern England: trends and patterns 1993–2002. Pearce MS, Salotti JA, McHugh K, Metcalf W, Kim KP, Craft AW, et al. The increasing doses of radiation need to be controlled. The proposed approaches provide useful strategies for data collection and confounder assessment for general retrospective record-linkage studies, particular those using hospital databases on radiological procedures for the assessment of exposure to ionizing or non-ionizing radiation. In this article, we describe several approaches to the collection of data on archived CT scans, the estimation of radiation doses and the assessment of confounding. We will obtain cancer incidence by record linkage with external databases. Information on all archived CT scans of these children will be obtained, including date of examination, scanned body part and radiologist’s report, as well as the machine settings required for organ dose estimation. It is a retrospective record-linkage cohort study with an expected number of 100,000 children who received at least one electronically archived CT scan covering the calendar period since the introduction of digital archiving until 2012. This paper describes the design and methodology of a nationwide study, the Dutch Pediatric CT Study, regarding risk of leukemia and brain tumors in children after radiation exposure from CT scans. Children are of particular concern because they are more sensitive to radiation-induced cancer compared with adults and have a long lifespan to express harmful effects which may offset clinical benefits of performing a scan. Computed tomography (CT) scans are indispensable in modern medicine however, the spectacular rise in global use coupled with relatively high doses of ionizing radiation per examination have raised radiation protection concerns.
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