Effective Doses in Radiology and Diagnostic Nuclear Medicine: A Catalog 1

Department of Radiology and Nuclear Medicine, New Mexico Veterans Administration Healthcare System, 1501 San Pedro Blvd, Albuquerque, NM 87108, USA.
Radiology (Impact Factor: 6.87). 08/2008; 248(1):254-63. DOI: 10.1148/radiol.2481071451
Source: PubMed

ABSTRACT Medical uses of radiation have grown very rapidly over the past decade, and, as of 2007, medical uses represent the largest source of exposure to the U.S. population. Most physicians have difficulty assessing the magnitude of exposure or potential risk. Effective dose provides an approximate indicator of potential detriment from ionizing radiation and should be used as one parameter in evaluating the appropriateness of examinations involving ionizing radiation. The purpose of this review is to provide a compilation of effective doses for radiologic and nuclear medicine procedures. Standard radiographic examinations have average effective doses that vary by over a factor of 1000 (0.01-10 mSv). Computed tomographic examinations tend to be in a more narrow range but have relatively high average effective doses (approximately 2-20 mSv), and average effective doses for interventional procedures usually range from 5-70 mSv. Average effective dose for most nuclear medicine procedures varies between 0.3 and 20 mSv. These doses can be compared with the average annual effective dose from background radiation of about 3 mSv.

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    • "Onepossibleexplanationfortheamountofpatients exposedtoaCEDR>50mSvisthefactthattheywere treatedatatertiaryreferencecenter,whichmore frequentlydealswithsevereandrefractorypatients. Evenso,themajorityofpatientswereexposedtoa CEDR<50mSvofionizationradiationduringthe totalfollow-upperiodand4%wereexposedto >100mSv.Theeffectsofionizingradiationshould notbeunderestimated,consideringtheLNTmodel andtheevidenceforanincreaseinsomecancerrisks atdosesabove~5mSv[19] [21]. Brenneretal.showedthatradiation-inducedcan- "
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    ABSTRACT: Crohn's disease (CD) patients undergo many radiological studies employing ionizing radiation for diagnosis and management purposes. Our aim was to assess the total radiation exposure of our patients over the years, to estimate the risk factors for exposure to high doses, and to correlate radiation exposure to immunosuppression. The cumulative effective dose of radiation (CEDR) was calculated multiplying the number of imaging studies by the effective dose of each examination. A total of 451 patients with CD (226 female) were followed during 11.0 years (interquartile range [IQR]: 6.0-16.0), with 52.1% of the patients being classified with penetrating (B3) and 38.6% being steroid-dependent. About 16% were exposed to high-radiation dose levels (CEDR >50 mSv) and 4% were exposed to CEDR >100 mSv. The mean CEDR between age 26 and 35 years was 12.539 mSv and a significant dose of radiation (over 50 mSv) was achieved at a median age of 40 (IQR: 29.0-47.0). Abdominal-pelvic computed tomography scan was the examination that contributed the most for CEDR. Patients with B3 phenotype, previous surgery, azathioprine, and anti-tumor necrosis factor (TNF)-α therapy were exposed earlier on the course of the disease to CEDR >50 mSv (p < 0.001). The value of CEDR in the patients under immunosuppression mainly increased in the first year of immunosuppression. Penetrating phenotype, abdominal surgery, steroid resistance or steroid dependence, and treatment with anti-TNF-α and azathioprine were predictive factors for high CEDR. It was also demonstrated that immunosuppression and anti-TNF-α treatment were followed by a sustained increment of radiation exposure and that a significant dose of radiation was achieved <40 years of age.
    Scandinavian Journal of Gastroenterology 04/2015; 50(10):1-12. DOI:10.3109/00365521.2015.1037344 · 2.36 Impact Factor
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    • "These results are significantly lower than standard doses for the film medical radiography. For example, the fluoroscopy norm is 0.8 mSv, the radiography norm is 0.4 mSv, the roentgenoscopy norm is 10 mSv [8]. "
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    ABSTRACT: This paper presents the results of designing experimental setups for the X-ray visualization. The setups allow to obtain the projection of two-dimensional images and sinograms that are used to restore the tomographic cross-sections. The results of the computing of the dose burden are supplied. The low values of the equivalent doses, received in the experiment, are analyzed.
    01/2015; 1084:698-701. DOI:10.4028/
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    • "The amount of radiation from a CTPA varies by machine, protocol, and patient characteristics such as patient size, but radiation levels between 10 and 20 mSv are considered typical [3]. This corresponds to three to five year's background radiation or the equivalent of approximately 750 chest X-rays [3]. The overall risk may be small but for certain patient groups such "
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    ABSTRACT: Aims. To study the use of CT pulmonary angiography (CTPA) at Hutt Hospital and investigate the use of pretest probability scoring in the assessment of patients with suspected pulmonary embolism (PE). Methods. We studied patients with suspected PE that underwent CTPA between January and May 2012 and collected data on demographics, use of pretest probability scoring, and use of D Dimer and compared our practice with the British Thoracic Society (BTS) guideline. Results. 105 patients underwent CTPA and 15% of patients had PE. 13% of patients had a Wells score prior to their scan. Wells score calculated by researchers revealed 54%, 36%, and 8% patients had low, medium, and high risk pretest probabilities and 8%, 20%, and 50% of these patients had positive scans. D Dimer was performed in 58% of patients and no patients with a negative D Dimer had a PE. Conclusion. The CTPA positive rate was similar to other contemporary studies but lower than previous New Zealand studies and some international guidelines. Risk stratification of suspected PE using Wells score and D Dimer was underutilised. A number of scans could have been safely avoided by using accepted guidelines reducing resources use and improving patient safety.
    01/2015; 2015:1-5. DOI:10.1155/2015/357576
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