Aims and objectives
In Switzerland,
the annual effective dose (ED) per inhabitant in 2013 was 5.6 mSv.
Diagnostic radiology represents only 20 % of the annual effective dose but it accounts for >94 % of the man-made exposure1.
Frequency of computed tomography (CT) imaging for patients with acute pancreatitis (AP) specially in severe types and the increasing population incidence of AP contributes to this public health issue2.
The purpose of this study is to evaluate the overall dose exposure due to follow-up CT examinations in patients with severe...
Methods and materials
We retrospectively included 27 patients (22 men,
mean age 65y) with AP requiring intensive care unit (ICU) for more than 24h and being followed-up by CT (Fig.1).
Reviewing the CT images in consensus,
two readers registered the CT severity index (CTSI) in each patient and collected patients’ dose exposure parameters,
i.e.
dose-length product (DLP),
effective dose (ED) resulting from follow-up CT.
Clinical,
radiological and laboratory parameters indicating disease’s severity (Table 1),
length of hospital and ICU stay,
acute complications,
need for intervention and/or surgery were...
Results
The distribution of the different etiologies of AP in our study population is shown in Fig 2.
In all patients,
258 CT examinations were performed (mean 9.56,
range 1-25) during their hospital stay (Fig.
3).
Six patients (22%) died from acute complications.
Mean accumulated DLP and ED per patient were 8741mGy.cm (range 682-29194) and 131mSv (range 10-438),
respectively.
The individual CTSI significantly correlated with patients’ laboratory parameters (amylasis,
CRP),
length of hospital stay (Fig.
4),
number of CT examinations,
DLP,
ED,
and number of radiological...
Conclusion
The overall radiation dose exposure resulting from follow-up CT examinations in patients with AP is high.
Our study revealed that it depends on the disease’s severity (CTSI score) and,
thus,
this dose expsosure seems to be justified clinically.
However,
we should keep it in mind given the cancer risk associated with low-dose radiation exposure3.
Efforts,
such as reducing the number of abdominal acquisitions per examination or the lowering of the kV (from 120 to 100kV)4 should be undertaken to reduce the number of these CT-examinations...
References
1)Le Coultre R,
Bize J,
Champendal M,
Wittwer D,
Ryckx N,
Aroua A,
et al.
Exposure of the Swiss population by radiodiagnostics: 2013 review.
Radiat Prot Dosimetry.
2016;169(1-4):221–4.
2)Ball CG,
Correa-Gallego C,
Howard TJ,
Zyromski NJ,
House MG,
Pitt HA,
et al.
Radiation dose from computed tomography in patients with necrotizing pancreatitis: how much is too much? Gastrointest Surg Off J Soc Surg Aliment Tract.
2010 Oct;14(10):1529–35.
3)Brenner DJ,
Doll R,
Goodhead DT,
Hall EJ,
Land CE,
Little JB,
et al.
Cancer risks attributable to...