How much should we be concerned about cumulative effective doses in medical imaging?
Colin John MartinMichael BarnardPublished in: Journal of radiological protection : official journal of the Society for Radiological Protection (2021)
The IAEA issued a statement calling for action to strengthen the radiation protection of patients undergoing recurrent imaging. This followed reports of patients receiving cumulative effective doses over 100 mSv from multiple CT examinations. In order to evaluate excess risks of cancer incidence among UK patients, data from an exposure management system covering three hospitals within one trust have been studied over 5½ years. Cumulative effective doses for 105,757 patients, from whom 719 (0.68%) received effective dose over 100 mSv, have been analysed using age and sex specific risk factors for stochastic effects. Two cancers might be expected to be initiated in the patients receiving over 100 mSv, while five might be expected to develop cancer among patients receiving 50-100 mSv. However, the calculations ignore health conditions for which the patients are being treated that may shorten their lives, and rely on the linear-no-threshold dose-effect model which is a subject of debate, so they are likely to overestimate cancer incidence. If health of the patients receiving >100 mSv is taken into account, the risk of mortality from cancer initiated by medical exposure might be the order of 1 in 2000. Recommendations on further strengthening of optimization should be applied to imaging procedures for all patients with special focus on those performed on children and adolescents.
Keyphrases
- end stage renal disease
- healthcare
- newly diagnosed
- papillary thyroid
- ejection fraction
- chronic kidney disease
- high resolution
- prognostic factors
- risk factors
- peritoneal dialysis
- emergency department
- type diabetes
- squamous cell carcinoma
- machine learning
- patient reported outcomes
- climate change
- fluorescence imaging
- young adults
- deep learning
- molecular dynamics simulations
- lymph node metastasis
- social media
- human health
- image quality