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Potential risks of cardiovascular and cerebrovascular disease and cancer due to cumulative doses received from diagnostic CT scans?

Colin John MartinMichael Barnard
Published in: Journal of radiological protection : official journal of the Society for Radiological Protection (2021)
Potential risks from radiation exposure on the development of cardiovascular and cerebrovascular disease are indicated by epidemiological studies. Medical exposures give the largest dose to the population from artificial sources, with cumulative doses from multiple CT scans being significant. Data on doses from scans performed on 12 CT scanners in three hospitals over a period of 5½ years, derived using RadimetricsTMsoftware, have been reviewed for 105 757 patients. Data have been downloaded for heart, brain, thyroid, and effective doses, and cumulative doses analysed using ExcelTMspreadsheets. 2.4% of patients having body CT scans received cumulative doses to the heart over 100 mSv, 9% of whom were under 50 years. 9.6% of patients having head CT scans received cumulative doses to the brain over 100 mSv with 0.08% over 500 mSv from whom 41% were under 50 years, but only 1.3% of patients scanned had thyroid/carotid artery doses over 100 mSv. An approximate evaluation of potential risks from exposures of the heart above 100 mSv and brain over 500 mSv for patients under 60 years would suggest that at most only one patient would demonstrate any excess risk from vascular disease resulting from the exposures. 0.67% of patients scanned received effective doses over 100 mSv, in line with results from European studies, with 8.4% being under 50 years. The application of age and sex specific risk coefficients relating to excess cancer incidence suggests that two or three patients with effective doses over 100 mSv and five patients with effective doses between 50 and 100 mSv, from those examined, might develop cancer as a result of exposure. However, this will be an overestimate, since it does not take patients' health into account. Exposure management software can aid in evaluating cumulative doses and identifying individual patients receiving substantial doses from repetitive imaging.
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