Identification and characterization of patients being exposed to computed-tomography associated radiation-doses above 100 mSv in a real-life setting

Gerlig Widmann; Andreas Beyer; Werner Jaschke; Anna Luger; Heinz Zoller; Herbert Tilg; Stefan Schneeberger; Dominik Wolf; Elke R Gizewski; Robert Eder; Pavle Torbica; Michael Verius

doi:10.1016/j.ejro.2022.100470

Identification and characterization of patients being exposed to computed-tomography associated radiation-doses above 100 mSv in a real-life setting

Eur J Radiol Open. 2022 Dec 21:10:100470. doi: 10.1016/j.ejro.2022.100470. eCollection 2023.

Authors

Affiliations

¹ Department of Radiology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
² Department of Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
³ Department Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
⁴ Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI) Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.

Abstract

Rationale and objectives: Patients receiving high cumulative effective doses (CED) from recurrent computed tomography (CT) in a real-life setting are not well identified. Evaluation of causes and patient characteristics may help to define individuals potentially at risk of radiation-induced secondary malignancies.

Materials and methods: Patients who received a CED > 100 mSv from CT scans during October 2012 and April 2020 at a tertiary university center were identified with the help of a radiological radiation dose monitoring system. The primary disease and referral diagnosis, number of CT exams, time period, age, BMI and gender distribution of the 1000 patients with the highest CED were analysed.

Results: 3431 patients had a CED of more than 100 mSv, which corresponded to 2.75% of all patients who received a CT exam. From the 1000 patients with the highest CED, mean number of CT exams per patient was 14.6, mean CED was 257 mSv (SD 98, range 177-1339). Mean age of patients was 63.9 years (SD 10.6), male to female ratio 3:2, and mean BMI 28.7 kg/m2 (SD 5.5). 728 (72.9%) patients had cancer. The leading primary diagnosis was liver cirrhosis in 197 patients and 103 patients had a liver transplantation. In patients with liver cirrhosis, 750 exams were indicated for the follow-up of the disease, 662 for the clarification of an acute clinical condition, and 202 for CT-guided stereotactic radiofrequency ablation.

Conclusion: Recurrent CT scans of patients with cancer, liver cirrhosis and liver transplantation may lead to critically high CED.

Keywords: BMI, body mass index; CED, cumulative effective dose; CT, computed tomography; Computed tomography; DLP, dose length product; Dose management; ED, effective dose; PACS, picture archiving and communications system; Radiation dose; mSv, Millisievert; sRFA, stereotactic radiofrequency ablation.