Recurrent CT, Cumulative Radiation Exposure, and Associated Radiation-induced Cancer Risks from CT of Adults1 (original) (raw)
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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
Survival and radiation risk in patients obtaining more than six CT examinations during one year
Acta Oncologica, 2009
Background. During a review of the current practice for computer tomography (CT) in 2005 at the Department of Radiology, Aarhus University Hospital, we observed 300 patients with more than six CT examinations during one year. They comprised 8% of the patients and accounted for 27% of all examinations. These patients needed further analysis. Material and methods. The 300 patients were analyzed concerning age, type of diseases indicating multiple CTs and the CT protocols used. The effective dose and risk of low dose radiation was estimated and survival of the patients after 1.5 year was analyzed. Results. A total of 289 patients had malignancies, the most frequent being lung cancer, bladder cancer and colon cancer. A total of 4.3% of the patients with malignancies were 540 year old, 13.3% were 41Á50 years old and 62.7% 51Á70 years old. The highest average number of CT examinations was observed in patients with sarcomas (11.2 examinations per patient). Eleven patients (aged 15Á77 years) had traumatic lesions. Their number of examinations varied from 7 to 20. The total radiation dose for all 300 patients was 21.42 Sv, which may imply induction of a fatal cancer in one of the patients. However, only 102 patients survived their disease. Conclusion. A total of 198 patients had serious disease and were not alive 1.5 years after the examinations. The multiple CT examinations were necessary to monitor their treatment. For the surviving 102 patients the use of CT contributed to an optimal therapy, but the examinations implied a risk for radiation induced malignancies.
International Journal of Research in Pharmaceutical Sciences, 2019
Computed tomography is commonly used for the initial diagnosis of a tumour to provide information about the stage of cancer & to assess whether the disease is responding to treatment. Leukemia & solid tumour may have developed as a result of exposure to a low dose of diagnostic ionizing radiation so another primary tumour may develop as a result of radiation exposure. We used information in the patient sheet to measure patient effective radiation dose(E) in millisievert (mSv) & calculate cumulative dose by summation of dose over three years, estimated life attributed risk & mortality rate. The results of the current study revealed that from 50 patients 37 (74%) of them were female & 13 (26%) of them were male, age range 23- 80yr, breast cancer was the commonest cause of malignancy follow by lung cancer. Cumulative dose in mSv/yr rang 12-80 mSv, about 43(86%) of our patients exposed to more than 20mSv /yr & 7(14%) of them expose to 20 & less than 20 per year. Collective dose in three...
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.
Computed Tomography — An Increasing Source of Radiation Exposure
New England Journal of Medicine, 2007
T he advent of computed tomography (ct) has revolutionized diagnostic radiology. Since the inception of CT in the 1970s, its use has increased rapidly. It is estimated that more than 62 million CT scans per year are currently obtained in the United States, including at least 4 million for children. 1 By its nature, CT involves larger radiation doses than the more common, conventional x-ray imaging procedures . We briefly review the nature of CT scanning and its main clinical applications, both in symptomatic patients and, in a more recent development, in the screening of asymptomatic patients. We focus on the increasing number of CT scans being obtained, the associated radiation doses, and the consequent cancer risks in adults and particularly in children. Although the risks for any one person are not large, the increasing exposure to radiation in the population may be a public health issue in the future.