Analysis of repeated computed tomography scans and cumulative effective dose of patients in a hospital

Authors

  • Ana Luiza Milani Univ. Estadual Paulista Júlio de Mesquita Filho https://orcid.org/0000-0002-7545-9575
  • Allan Felipe Fattori Alves Univ. Estadual Paulista Júlio de Mesquita Filho
  • Matheus Alvarez Univ. Estadual Paulista Júlio de Mesquita Filho
  • Samara Pavan Souza Univ. Estadual Paulista Júlio de Mesquita Filho
  • Túlio Guilherme Soares Marques Univ. Estadual Paulista Júlio de Mesquita Filho
  • Marcos Aureliano Araujo Silva Univ. Estadual Paulista Júlio de Mesquita Filho
  • José Carlos Souza Trindade Filho Univ. Estadual Paulista Júlio de Mesquita Filho
  • Diana Rodrigues Pina Faculdade de Medicina de Botucatu https://orcid.org/0000-0003-1967-1990

DOI:

https://doi.org/10.15392/2319-0612.2023.2241

Keywords:

Radiation Protection, Diagnostic Radiology, Cumulative Effective Dose, Radiation Risk, CT Radiation Dose

Abstract

Computed tomography exams are considered diagnostic imaging exams that generate significant radiation dose to the patient. Justification, optimization, and dose limitation are radiological protection principles used to minimize patient and staff exposure, ensuring the quality of the service provided. The objective of this study was to analyze CT scan data, analyzing the number of exams, the patients' effective cumulated dose, and the repeatability of the exams. The study data covers the 2013 to 2022 period during which a progressive increase was observed in the number of exams performed over time, with exams doubling in this period. The most used Computed Tomography protocols were brain/skull (27.4%), pelvis (17.3%), and abdomen (13.7%) during the study period. Approximately 76.3% of patients have a cumulative dose of less than 25 mSv, while about 1% accumulated more than 100 mSv. The repeatability of CT scans for the same patient over a short period varies, reaching until 17 scans in 30 days for a single patient. The results indicated a necessity to develop strategies for individual dose management methods for the institution’s internal practices. An intervention could be implemented by creating periodically updated handouts and guidelines based on professionals' knowledge.

Downloads

Download data is not yet available.

References

BUSHBERG, J. T.; SEIBERT, J. A.; LEIDHOLDT, E. M.; BOONE, J. M. The essential physics of medical imaging, 3th ed., Philadelphia: Lippincott Williams & Wilkins, 2011, p. 1048.

CURRY, T.S.; DOWDEY. J.E., MURRY, R.C. Christensen's physics of diagnostic radiology, 4th, Philadelphia: Lea & Febiger, 1990, p. 522.

MCCOLLOUGH, C.H.; BUSHBERG, J.T.; FLETCHER, J.G.; ECKEL, L.J. Answers to common questions about the use and safety of CT scans. Mayo Clin Proc. v.90, p.1380-1392, 2015.

HALL, E. J.; GIACCIA, A. J. Radiobiology for the Radiologist, 7th ed., Philadelphia: Lippincott Williams & Wilkins, 2011, p. 556.

ICRP - International Commission on Radiological Protection. Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann ICRP, v. 37(2.4), 2007. 2p.

ICRP - International Commission on Radiological Protection. Radiological Protection in Medicine. ICRP Publication 105. Ann. ICRP, v.37 (6), 2007.

MASJEDI, H., ZARE, M. H., KESHAVARZ SIAHPOUSH, N., RAZAVI-RATKI, S. K., ALAVI, F., & SHABANI, M. European trends in radiology: investigating factors affecting the number of examinations and the effective dose. Radiol Med, v. 125, p. 296-305, 2020.

BROWN N.; JONES L. Knowledge of medical imaging radiation dose and risk among doctors. J Med Imaging Radiat Oncol, v. 57, p. 8-14, 2013.

KOUTALONIS, M.; HORROCKS, J. Justification in clinical radiological practice: A survey among staff of five London hospitals. Radiat Prot Dosimetry, v. 149, p. 124-37, 2012.

DAUDA, A.M.; OZOH, J.O.; TOWOBOLA, O.A. Medical doctors' awareness of radiation exposure in diagnostic radiology investigations in a South African academic institution. SA J Radiol, v. 23, p.1707, 2019.

GERVAISE, A.; ESPERABE-VIGNAU, F.; PERNIN, M.; NAULET, P.; PORTRON, Y.; LAPIERRE-COMBES, M. Evaluation of the knowledge of physicians prescribing CT examinations on the radiation protection of patients. J Radiol, v.92, p. 681-7, 2011.

RON, E. Ionizing radiation and cancer risk: evidence from epidemiology. Radiat Res, v.150.5s, p. S30-41, 1998.

BRENNER, D.J.; DOLL, R.; GOODHEAD, D.T.; HALL, E.J.; LAND, C.E.; LITTLE, J.B.; LUBIN, J.H.; PRESTON, D.L.; PRESTON, R.J.; PUSKIN, J.S.; RON, E.; SACHS, R.K.; SAMET, J.M.; SETLOW, R.B.; ZAIDER, M. Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci U S A, v. 100, p. 13761-6, 2003.

CHARLES, M. Effects of Ionizing Radiation: United Nations Scientific Committee on the Effects of Atomic Radiation: UNSCEAR 2006 Report, v. 1. 2009

BRODY, A.S.; FRUSH, D.P.; HUDA, W.; BRENT, R.L. American Academy of Pediatrics Section on Radiology. Radiation risk to children from computed tomography. Pediatrics, v. 120, p. 677-82, 2007.

AL-RAMMAH, T.Y. CT radiation dose awareness among paediatricians. Ital J Pediatr, v. 42, p.77, 2016.

PINA, D.R.; HORTENCIO, F.B.; TRINDADE FILHO, J.C.S.; JUNIOR, R.L.R.; ALVES, A.F.F. Criação de um indicador eletrônico para acompanhamento de dose no setor de Tomografia Computadorizada. Braz J Radiat Sci, v. 8, p.3, 2020.

ABILIO, V. HCFMB implanta primeiro sistema de indicador de dose radiológica do Brasil. 2019. Available at: http://www.hcfmb.unesp.br/hcfmb-implanta-primeiro-sistema-de-indicador-de-dose-radiologica-do-brasil/. Last accessed: 10 Nov. 2022.

ANVISA - National Health Surveillance Agency. Collegiate Board Resolution -RDC nº 611, March 9, 2022, Official Diary of the Union, edition 511, section 1, p. 107, Published on:16/03/2022.

ANVISA - National Health Surveillance Agency. Normative Instruction - IN nº 93, May 27, 2021, Official Diary of the Union, edition 101, section 1, p: 162, Published on: 31/05/2021.

STOPSACK, K.H.; CERHAN, J.R. Cumulative doses of ionizing radiation from computed tomography: A Population-Based Study. Mayo Clin Proc, v. 94, p.2011-2021, 2019.

REHANI, M.M.; YANG, K.; MELICK, E.R.; HEIL, J.; ŠALÁT, D.; SENSAKOVIC, W.F.; LIU, B. Patients undergoing recurrent CT scans: assessing the magnitude. Eur Radiol, v.30, p. 1828-1836, 2020.

JEUKENS, C.R. ; BOERE, H.; WAGEMANS, B.A.; NELEMANS, P.J.; NIJSSEN, E.C.; SMITH-BINDMAN, R.; WILDBERGER, J.E.; SAILER, A.M. Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort study. BMJ Open, v. 11, p. e041883, 2021.

MOGHADAM, N.; REHANI, M.M.; NASSIRI, M.A. Assessment of patients' cumulative doses in one year and collective dose to population through CT examinations. Eur J Radiol, v. 142, p. 109871, 2021.

SMITH-BINDMAN, R.; AUBIN, C.; BAILITZ, J.; BENGIAMIN, R.N.; CAMARGO JR, C.A.; CORBO, J.; DEAN, A.J.; GOLDSTEIN, R.B.; GRIFFEY, R.T.; JAY, G.D.; KANG, T.L. Ultrasonography versus computed tomography for suspected nephrolithiasis. N Engl J Med, v. 371, p. 1100-10, 2014.

ACR – American College of Radiology. Appropriateness Criteria®. Available at: https://acsearch.acr.org/list. Last accessed: 30 Nov. 2022.

HADLEY, J.L.; AGOLA, J.; WONG, P. Potential impact of the American College of Radiology appropriateness criteria on CT for trauma. AJR Am J Roentgenol, v.186, p. 937-42, 2006.]

Downloads

Published

2023-04-27

How to Cite

Milani, A. L., Alves, A. F. F., Alvarez, M., Souza, S. P., Marques, T. G. S., Silva, M. A. A., Trindade Filho, J. C. S., & Pina, D. R. (2023). Analysis of repeated computed tomography scans and cumulative effective dose of patients in a hospital. Brazilian Journal of Radiation Sciences, 11(2), 01–14. https://doi.org/10.15392/2319-0612.2023.2241

Issue

Section

Articles

Similar Articles

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)