Patients undergoing recurrent CT scans: assessing the magnitude

@article{Rehani2019PatientsUR,
  title={Patients undergoing recurrent CT scans: assessing the magnitude},
  author={Madan M. Rehani and Kai Yang and Emily R. Melick and John Heil and Du{\vs}an {\vS}al{\'a}t and William F. Sensakovic and Bob Liu},
  journal={European Radiology},
  year={2019},
  volume={30},
  pages={1828-1836}
}
Objectives To assess percent of patients undergoing multiple CT exams that leads to cumulative effective dose (CED) of ≥ 100 mSv and determine their age distribution. Methods Data was retrieved retrospectively from established radiation dose monitoring systems by setting the threshold value of 100 mSv at four institutions covering 324 hospitals. The number of patients with CED ≥ 100 mSv only from recurrent CT exams during a feasible time period between 1 and 5 years was identified. Age and… Expand
Patients undergoing recurrent CT exams: assessment of patients with non-malignant diseases, reasons for imaging and imaging appropriateness
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
Patients undergoing multiphase CT scans and receiving a cumulative effective dose of ≥ 100 mSv in a single episode of care
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
Analysis of patients receiving ≥ 100 mSv during a computed tomography intervention
TLDR
Awareness of the possibility of such high doses and potential for long-term deleterious effects, especially in younger patients, and consideration of alternative imaging guidance and/or further dose optimization should be strongly considered whenever feasible are strongly considered. Expand
Multicentric study of patients receiving 50 or 100 mSv in a single day through CT imaging—frequency determination and imaging protocols involved
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
Multinational data on cumulative radiation exposure of patients from recurrent radiological procedures: call for action
TLDR
There is a need for urgent actions by all stakeholders to address the issue of high cumulative radiation doses to patients, including development of appropriateness criteria/referral guidelines by professional societies for patients who require recurrent imaging studies, development of CT machines with lower radiation dose by manufacturers, and development of policies by risk management organizations to enhance patient radiation safety. Expand
Which patients are prone to undergo disproportionate recurrent CT imaging and should we worry?
TLDR
The non-negligible CT radiation-induced cancer risk and mortality should be taken into account in patients with metastatic disease who experience a relatively long survival, while the effect of cumulatively administered CT contrast agents on kidney function requires further investigation. Expand
Estimates of the number of patients with high cumulative doses through recurrent CT exams in 35 OECD countries.
  • M. Rehani, M. Hauptmann
  • Medicine
  • Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics
  • 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
Cumulative effective dose from recurrent CT examinations in Europe: proposal for clinical guidance based on an ESR EuroSafe Imaging survey
TLDR
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
A survey of the pediatric radiation doses during multiphase abdominal computed tomography examinations
TLDR
The current study indicates the need for dose optimization for pediatric patients by establishing proper imaging protocols based on the international guidelines, and indicates the variation in patients’ doses is attributed to variation in the imaging protocols, scan length and number of phases performed per pediatric CT abdomen procedure. 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
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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
Multinational data on cumulative radiation exposure of patients from recurrent radiological procedures: call for action
TLDR
There is a need for urgent actions by all stakeholders to address the issue of high cumulative radiation doses to patients, including development of appropriateness criteria/referral guidelines by professional societies for patients who require recurrent imaging studies, development of CT machines with lower radiation dose by manufacturers, and development of policies by risk management organizations to enhance patient radiation safety. Expand
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