Patient radiation dose issues resulting from the use of CT in the UK (original) (raw)
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Aim: To assess the radiation dose received in a clinical/real life setting by patients visiting selected radiological centres in Enugu, Enugu State, southeast of Nigeria for diagnostic computed tomography (CT) scans of the heads and thus assess compliance to the diagnostic Original Research Article Chiegwu et al.; BJMMR, 9(9): 1-15, 2015; Article no.BJMMR.15123 2 reference levels (DRL). Study Design: A prospective cross-sectional survey design. Materials and Method: Radiation doses absorbed by 98 patients (60 males and 38 females, age range 3-65years) that presented for CT scans of the head at the study centres were prospectively measured using lithium fluoride thermoluminescent dosimeter, LiF-TLD (TLD-100) chips. The mean absorbed dose, mean effective dose, collective dose and the per caput dose with their standard deviations were obtained. Results: The mean absorbed dose was 4.315 ± 3.815mSv (range 1.005-17.607mSv) and the mean effective dose was 2.244±1.984 mSv. In children (0-15years) the mean absorbed dose was 5.604±4.904mSv and mean effective dose, 2.914±2.278 mSv and these doses were higher than that of the adults. The annual collective dose was 224.40±198.4 person-mSv and the annual per caput dose was 5.9 x 10-7 mSv. The calculated mean organ effective doses were 0.147±0.056mSv, 0.884±0.334mSv, 0.147±0.056mSv, 0.3540±0.134mSv and 0.147±0.056mSv for the brain, eye lenses, thyroid gland, red bone marrow and breast respectively. Conclusion: TLD chip were used to assess patients' radiation dose in a clinical setting. The overall mean effective dose (2.244mSv) was in compliance with the recommended DRL. The radiation dose received correlated positively with the tube current (mA) and number of images obtained but negatively with the scan time, patients' head AP dimension and age. Radiation risks from CT can be reduced through justification of the procedure and dose optimization.
Observation and Management of Patient Radiation Dose in CT
https://ijshr.com/IJSHR\_Vol.7\_Issue.4\_Oct2022/IJSHR-Abstract.05.html, 2022
Purpose: The aim was to observe and manage the patient radiation dose in CT Methodology: A retrospective study of observation and management of patient radiation dose in CT was conducted for 5 months. During this period patient radiation dose was observed. CTDI and DLP were calculated. Patients were divided in three age groups (0-15 yrs, 16-55 yrs, 56-85 yrs) on the basis of pre-reproductive, reproductive & post-reproductive age. All the age groups were compared on the basis of dose received. Radiation dose was also compared in different body parts. Result: A study was conducted in the department of radiology at SGT hospital for observation and management of the patient radiation dose in CT. Total 84 patients were taken in this study. Out of which 50 (59.5%) were males and 34 (40.4%) were females. In the age group of 0-15 yrs DLP was high in abdomen 772.47 mGy.cm and low in chest 234.22 mGy.cm. In the age group of 16-55 yrs DLP was high in head (809.51 mGy.cm) and low in neck (380.27 mGy.cm) and in the age group of 56-85 yrs DLP was high in head (923.63 mGy.cm) and low in chest (477.51 mGy.cm). Among all the age groups head dose was high in the age group of 56-85 yrs, neck dose was high in the age group of 56-85 yrs, chest dose was high in the age group of 16-55 yrs and abdomen dose was high in the age group of 56-85 yrs. The overall radiation dose was high in the age group of 56-85 yrs (37%) and less in the age group of 0-15 yrs (30%). It was observed that radiographers uses lead apron to cover the area of patient which is outside the ROI to protect the patient from unnecessary radiation dose. They always keep in mind that the centering of patient should be correct. They also avoid repeated exposure to the patient. Conclusion: In this study, it was found that in head, neck and abdomen dose was high in the age group of 56-85 yrs and chest dose was high in the age group of 16-55 yrs. The overall radiation dose was high in the age group of 56-85 yrs which was 37% and lowest radiation dose was in the age group of 0-15 yrs which was 30%. It was observed that radiographers uses radiation protection devices to cover the area of patient which is not needed to be examine, to protect the patient from unnecessary radiation dose. They do the proper centering of patient. They also avoid repeated exposure to the patients. It is suggested to give less radiation dose to the patient.
How I Do It: Managing Radiation Dose in CT
Radiology, 2014
Computed tomography (CT) is an imaging test that is widely used worldwide to establish medical diagnoses and perform image-guided interventions. More recently, concern has been raised about the risk of carcinogenesis from medical radiation, with a focus on CT. The purpose of this article is to (a) describe the importance of educating radiology personnel, patients, and referring clinicians about the concerns over CT radiation, (b) describe commonly used CT parameters and radiation units, (c) discuss the importance of establishing a dedicated radiology team to manage CT radiation, and (d) describe specific CT techniques to minimize radiation while providing diagnostic examinations. q RSNA, 2014
Patient dose considerations in computed tomography examinations
World Journal of Radiology, 2010
Ionizing radiation is extensively used in medicine and its contribution to both diagnosis and therapy is undisputable. However, the use of ionizing radiation also involves a certain risk since it may cause damage to tissues and organs and trigger carcinogenesis. Computed tomography (CT) is currently one of the major contributors to the collective population radiation dose both because it is a relatively high dose examination and an increasing number of people are subjected to CT examinations many times during their lifetime. The evolution of CT scanner technology has greatly increased the clinical applications of CT and its availability throughout the world and made it a routine rather than a specialized examination. With the modern multislice CT scanners, fast volume scanning of the whole human body within less than 1 min is now feasible. Two dimensional images of superb quality can be reconstructed in every possible plane with respect to the patient axis (e.g. axial, sagital and coronal). Furthermore, three-dimensional images of all anatomic structures and organs can be produced with only minimal additional effort (e.g. skeleton, tracheobronchial tree, gastrointestinal system and cardio-vascular system). All these applications, which are diagnostically valuable, also involve a significant radiation risk. Therefore, all medical professionals involved with CT, either as referring or examining medical doctors must be aware of the risks involved before they decide to prescribe or perform CT examinations. Ultimately, the final decision concerning justification for a prescribed CT examination lies upon the radiologist. In this paper, we summarize the basic information concerning the detrimental effects of ionizing radiation, as well as the CT dosimetry background. Furthermore, after a brief summary of the evolution of CT scanning, the current CT scanner technology and its special features with respect to patient doses are given in detail. Some numerical data is also given in order to comprehend the magnitude of the potential radiation risk involved in comparison with risk from exposure to natural background radiation levels.
Adult patient radiation doses from non-cardiac CT examinations: a review of published results
The British Journal of Radiology, 2011
Objectives: CT is a valuable tool in diagnostic radiology but it is also associated with higher patient radiation doses compared with planar radiography. The aim of this article is to review patient dose for the most common types of CT examinations reported during the past 19 years. Methods: Reported dosimetric quantities were compared with the European diagnostic reference levels (DRLs). Effective doses were assessed with respect to the publication year and scanner technology (i.e. single-slice vs multislice). Results: Considerable variation of reported values among studies was attributed to variations in both examination protocol and scanner design. Median weighted CT dose index (CTDI w) and dose length product (DLP) are below the proposed DRLs; however, for individual studies the DRLs are exceeded. Median reported effective doses for the most frequent CT examinations were: head, 1.9 mSv (0.3-8.2 mSv); chest, 7.5 mSv (0.3-26.0 mSv); abdomen, 7.9 mSv (1.4-31.2 mSv); and pelvis, 7.6 mSv (2.5-36.5 mSv). Conclusion: The introduction of mechanisms for dose reduction resulted in significantly lower patient effective doses for CT examinations of the head, chest and abdomen reported by studies published after 1995. Owing to the limited number of studies reporting patient doses for multislice CT examinations the statistical power to detect differences with single-slice scanners is not yet adequate.
The theory of radiation carcinogenesis has been debated for decades. Most estimates of the radiation risks from CT have been based on extrapolations from the lifespan follow-up study of atomic bomb survivors and on follow-up studies after therapeutic radiation, using the linear no-threshold theory. Based on this, many population-based projections of induction of future cancers by CT have been published that should not be used to estimate the risk to an individual because of their large margin of error. This has changed recently with the publication of three large international cohort follow-up studies, which link observed cancers to CT scans received in childhood. A fourth ongoing multi-country study in Europe is expected to have enough statistical power to address the limitations of the prior studies. The United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) report released in 2013 specifically addresses variability in response of the pediatric population exposed to ionizing radiation. Most authorities now conclude that there is enough evidence to link future cancers to the radiation exposure from a single CT scan in childhood but that cancer risk estimates for individuals must be based on the specifics of exposure, age at exposure and absorbed dose to certain tissues. Generalizations are not appropriate, and the communication of the CT risk to individuals should be conducted within the framework of personalized medicine.
Comparison of Radiation Dose in CT Examinations At PIMS with European Commission Reference Doses
Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University
OBJECTIVE - The purpose of this study was to assess the radiation dose levels from common computed tomography (CT) examinations performed in Radiology Department of Pakistan Institute of Medical Sciences (PIMS), and evaluate these according to diagnostic reference levels (DRLs) proposed by European Commission (EC) guidelines, and thus contributing towards the establishment of local and national DRLs. To the best of our knowledge, this is the first study of its kind to explore radiation doses from CT examinations in Pakistan. STUDY DESIGN - This was a quantitative study conducted at PIMS, Islamabad, spanning a duration of eight weeks. Scan parameters and dose profile data of 1506 adults undergoing examinations of head, neck, chest and abdomen-pelvis regions, comprising of single- and multi-phase, contrast-enhanced and unenhanced studies. Dose indicators utilized by EC guidelines for DRLs include volume CT dose index (CTDIvol) and Dose Length Product (DLP) for single slice and complet...