Patient Safety Analysis in Radiation Burden of Head Computed Tomography Imaging in 1185 Neurosurgical Inpatients

John P Sheppard; Courtney Duong; Prasanth Romiyo; Daniel Azzam; Yasmine Alkhalid; Thien Nguyen; Diana Babayan; Carlito Lagman; Matthew Z Sun; Giyarpuram N Prashant; Joel S Beckett; Isaac Yang

doi:10.1016/j.wneu.2019.09.004

Patient Safety Analysis in Radiation Burden of Head Computed Tomography Imaging in 1185 Neurosurgical Inpatients

World Neurosurg. 2020 Jan:133:e308-e319. doi: 10.1016/j.wneu.2019.09.004. Epub 2019 Sep 12.

Affiliations

¹ Department of Neurosurgery, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA.
² Department of Neurosurgery, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Radiation Safety, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Physics & Biology in Medicine Graduate Program, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Radiology, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Radiological Sciences-Section of Neuroradiology, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Head and Neck Surgery, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Radiation Oncology, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Los Angeles Biomedical Research Institute, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA; Harbor-UCLA Medical Center, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, California, USA. Electronic address: iyang@mednet.ucla.edu.

PMID: 31520752
DOI: 10.1016/j.wneu.2019.09.004

Abstract

Objective: We performed a retrospective analysis in a cohort of 1185 patients at our institution who were identified as undergoing ≥1 head computed tomography (CT) examinations during their inpatient stay on the neurosurgery service, to quantify the number, type, and associated radiation burden of head CT procedures performed by the neurosurgery service.

Methods: CT procedure records and radiology reports were obtained via database search and directly validated against records retrieved from manual chart review. Next, dosimetry data from the head CT procedures were extracted via automated text mining of electronic radiology reports.

Results: Among 4510 identified adult head CT procedures, 88% were standard head CT examinations. A total of 3.65 ± 3.60 head CT scans were performed during an average adult admission. The most common primary diagnoses were neoplasms, trauma, and other hemorrhage. The median cumulative effective dose per admission was 5.66 mSv (range, 1.06-84.5 mSv; mean, 8.56 ± 8.95 mSv). The median cumulative effective dose per patient was 6.4 mSv (range, 1.1-127 mSv; mean, 9.26 ± 10.0 mSv).

Conclusions: The median cumulative radiation burden from head CT imaging in our cohort equates approximately to a single chest CT scan, well within accepted limits for safe CT imaging in adults. Refined methods are needed to characterize the safety profile of the few pediatric patients identified in our study.

Keywords: Computed tomography; Head CT; Neurosurgery; Patient safety; Radiation burden; Radiometry; Risk assessment.

MeSH terms

Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Head / radiation effects*
Humans
Infant
Male
Middle Aged
Neuroimaging / adverse effects*
Patient Admission
Patient Safety*
Radiation Dosage*
Retrospective Studies
Tomography, X-Ray Computed / adverse effects*
Young Adult