Radiologic imaging in cystic fibrosis: cumulative effective dose and changing trends over 2 decades
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Date
2015-12-16
Authors
O'Connell, Oisin J.
McWilliams, Sebastian R.
McGarrigle, Anne Marie
O'Connor, Owen J.
Shanahan, Fergus
Mullane, David
Eustace, Joseph A.
Maher, Michael M.
Plant, Barry J.
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Publisher
Elsevier
Published Version
Abstract
Objective: With the increasing life expectancy for patients with cystic fibrosis (CF), and a known predisposition to certain cancers, cumulative radiation exposure from radiologic imaging is of increasing significance. This study explores the estimated cumulative effective radiation dose over a 17-year period from radiologic procedures and changing trends of imaging modalities over this period. Methods: Estimated cumulative effective dose (CED) from all thoracic and extrathoracic imaging modalities and interventional radiology procedures for both adult and pediatric patients with CF, exclusively attending a nationally designated CF center between 1992-2009 for > 1 year, was determined. The study period was divided into three equal tertiles, and estimated CED attributable to all radiologic procedures was estimated for each tertile. Results: Two hundred thirty patients met inclusion criteria (2,240 person-years of follow-up; 5,596 radiologic procedures). CED was > 75 mSv for one patient (0.43%), 36 patients (15.6%) had a CED between 20 and 75 mSv, 56 patients (24.3%) had a CED between 5 and 20 mSv, and in 138 patients (60%) the CED was estimated to be between 0 and 5 mSv over the study period. The mean annual CED per patient increased consecutively from 0.39 mSv/y to 0.47 mSv/y to 1.67 mSv/y over the tertiles one to three of the study period, respectively (P < .001). Thoracic imaging accounted for 46.9% of the total CED and abdominopelvic imaging accounted for 42.9% of the CED, respectively. There was an associated 5.9-fold increase in the use of all CT scanning per patient (P < .001). Conclusions: This study highlights the increasing exposure to ionizing radiation to patients with CF as a result of diagnostic imaging, primarily attributable to CT scanning. Increased awareness of CED and strategies to reduce this exposure are needed.
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Keywords
Computer assisted tomography , Barium meal , Correlation analysis , Cystic fibrosis , Diagnostic imaging , Echography , Fluoroscopy Forced expiratory volume , High resolution computer tomography , Lung angiography , Lung scintiscanning , Radiation dose , Radiation dose distribution , Radiation exposure , Spine radiography , Thorax radiography
Citation
O'Connell, O. J., McWilliams, S., McGarrigle, A., O'Connor, O. J., Shanahan, F., Mullane, D., Eustace, J., Maher, M. M. and Plant, B. J. (2012) 'Radiologic Imaging in Cystic Fibrosis: Cumulative Effective Dose and Changing Trends Over 2 Decades', Chest, 141(6), pp. 1575-1583. doi: 10.1378/chest.11-1972