Multinational data on cumulative radiation exposure of patients from recurrent radiological procedures: call for action

@article{Brambilla2019MultinationalDO,
  title={Multinational data on cumulative radiation exposure of patients from recurrent radiological procedures: call for action},
  author={Marco Brambilla and Jenia Vassileva and Agnieszka Kuchcińska and Madan M. Rehani},
  journal={European Radiology},
  year={2019},
  volume={30},
  pages={2493-2501}
}
Objectives To have a global picture of the recurrent use of CT imaging to a level where cumulative effective dose (CED) to individual patients may be exceeding 100 mSv at which organ doses typically are in a range at which radiation effects are of concern Methods The IAEA convened a meeting in 2019 with participants from 26 countries, representatives of various organizations, and experts in radiology, medical physics, radiation biology, and epidemiology. Participants were asked to collect data… Expand
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A survey carried out in Europe aims to estimate the proportion of patients that undergo CT examinations and are exposed to a CED of more than 100 mSv and suggests some practical actions to support the management of cumulative effective dose and to refine or improve practice where recurrent examinations are required. Expand
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  • The British journal of radiology
  • 2020
TLDR
The challenges to manage the existing situation are summarised and the main aspects identified are: new technology with dose reduction techniques, education on the proper use of cumulative effective dose for referrers and practitioners including information for patients, and patient dose management systems with alerts on the cumulative high doses. Expand
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TLDR
The authors are in an unprecedented era, where patients undergoing multiple CT exams and receiving CED ≥ 100 mSv are not uncommon and a sizable fraction among them are below 50 years of age, which leads to cumulative radiation dose to individual patients at which radiation effects are of real concern. Expand
Estimates of the number of patients with high cumulative doses through recurrent CT exams in 35 OECD countries.
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  • Medicine
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  • 2020
TLDR
The first estimates of the number of patients likely receiving CED ≥ 100 mSv through recurrent CT exams in 35 OECD countries indicate that 2.5 million patients reach this level in a 5-year period. Expand
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TLDR
The finding of a sizeable percentage of patients undergoing CT exams and receiving CED ≥ 100 mSv in a single episode of care points toward the need of imaging appropriateness criteria, to revise the routine protocols, to replace older machines, and to provide to the radiologist the patient’s prior radiation history to facilitate an appropriate decision-making process. Expand
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TLDR
To determine percent of patients without malignancy and ≤ 40 years of age with high cumulative radiation doses through recurrent CT exams and assess imaging appropriateness, a cohort of patients who received cumulative effective dose over a 5-year period was identified. Expand
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TLDR
In the first study of its kind, it is reported that patients with 50 mSv+ in a single day or a single exam are not rare and the information on imaging protocols leading to such doses and their frequency has been provided to help develop dose management strategies. Expand
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TLDR
The usefulness of DMS systems as an optimization tool will be presented and discussed, and the limitations of these metrics will be discussed, so that DMS users are aware of the semantics of the parameters shown in the DMS reports. Expand
Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort study
TLDR
The probability of receiving a high radiation dose from CT examinations is small but not negligible and in the majority (80%) of high effective dose receiving patients, the indication for the initial CT scan was oncology related. Expand
Which patients are prone to undergo disproportionate recurrent CT imaging and should we worry?
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