Radiologic imaging in cystic fibrosis: cumulative effective dose and changing trends over 2 decades
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.
Date:
2015-12-16
Copyright:
© 2012 American College of Chest Physicians. Published by Elsevier. This accepted manuscript version is made available under the CC-BY-NC-ND 4.0 license.
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
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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