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: 6.21). 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; DOI:10.3109/00365521.2015.1037344 · 2.33 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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    • "Although this method is readily accessible and costeffective, its diagnostic performance is not satisfactory for evaluating small anatomic locations, such as the intervertebral foramen (IVF) and facet joints. Furthermore , the dose of radiation is approximately 2.1 millisievert (mSv) for the anteroposterior view and 1.5 mSv for the lateral view [3] [4], which are considerably higher than doses for plain-film chest radiography that uses 0.15 mSv. Multidetector computed tomography (CT) scans of the lumbar spine (CTLS) with multiplanar reformation show the facet joints, intervertebral disc (IVD), and foramina better than conventional plain films. "
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    ABSTRACT: Background Context CT scans of the lumbar spine (CTLS) have demonstrated a higher level of accuracy than plain film, and have been used to assess patients with spinal disorder when MR is not available. Nevertheless, radiation exposure remains a serious safety concern. Iterative reconstruction (IR) decreases the CT radiation dose for diagnostic imaging. However, the feasibility of using IR in CTLS is unclear. Purpose To evaluate the imaging quality and diagnostic reliability of CTLS with IR. Study Design/Setting A prospective study. Patient Sample All patients from out-patient departments who suffered from spinal disorders and were referred for CTLS Outcome Measures In acquired CT images, the signal-to-noise ratio (SNR) of the dural sac (DS), intervertebral disc (IVD), psoas muscle (PM), and L5 vertebral body (BM), the contrast-to-noise ratio between the dural sac and the intervertebral disc (D-D CNR), and the subjective imaging qualities were compared across groups. Inter-observer agreement was evaluated with Kappa values. The study was supported by a grant from our institution. Methods Patients receiving low radiation CTLS were divided into three groups. A 150 mAs tube current with 120 kVp tube voltage was used with group A and a 230 mAs tube current with 100 kVp tube voltage with group B. Intended end radiation exposure was 50% less than that of the control group. Tube modulation was active for all groups. The images of the two low-radiation groups were reconstructed by IR; those of the control group by filtered back projection. Results The SNRs of the DS, IVD, PM, BM, and D-D CNR of group A were not inferior to those of the control group. All SNRs and D-D CNRs for group B were inferior to those of the control group. Except for that of the facet joint, all subjective imaging ratings for anatomic regions were equivalent between groups A and B. Inter-observer agreement was highest for the control group (0.72-0.88), followed by group A (0.69-0.83) and group B (0.55-0.83). Conclusions Fifty percent tube current reduction combined with IR provides equivalent diagnostic accuracy and improved patient safety when compared with conventional CTLS. Our results support its use as a screening tool. With the tube modulation technique, further adjustments in weighting IR and FBP algorithms based on BMI become unnecessary.
    The spine journal: official journal of the North American Spine Society 11/2014; 14(11). DOI:10.1016/j.spinee.2014.03.007 · 2.80 Impact Factor
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