Low-dose computed tomography for the optimization of radiation dose exposure in patients with Crohn’s disease

dc.contributor.authorKavanagh, Richard G.
dc.contributor.authorO'Grady, John
dc.contributor.authorCarey, Brian W.
dc.contributor.authorMcLaughlin, Patrick D.
dc.contributor.authorO'Neill, Siobhán B.
dc.contributor.authorMaher, Michael M.
dc.contributor.authorO'Connor, Owen J.
dc.date.accessioned2018-12-17T10:09:56Z
dc.date.available2018-12-17T10:09:56Z
dc.date.issued2018-10-31
dc.date.updated2018-12-14T17:12:51Z
dc.description.abstractMagnetic resonance imaging (MRI) is the mainstay method for the radiological imaging of the small bowel in patients with inflammatory bowel disease without the use of ionizing radiation. There are circumstances where imaging using ionizing radiation is required, particularly in the acute setting. This usually takes the form of computed tomography (CT). There has been a significant increase in the utilization of computed tomography (CT) for patients with Crohn’s disease as patients are frequently diagnosed at a relatively young age and require repeated imaging. Between seven and eleven percent of patients with IBD are exposed to high cumulative effective radiation doses (CEDs) (>35–75 mSv), mostly patients with Crohn’s disease (Newnham E 2007, Levi Z 2009, Hou JK 2014, Estay C 2015). This is primarily due to the more widespread and repeated use of CT, which accounts for 77% of radiation dose exposure amongst patients with Crohn’s disease (Desmond et al., 2008). Reports of the projected cancer risks from the increasing CT use (Berrington et al., 2007) have led to increased patient awareness regarding the potential health risks from ionizing radiation (Coakley et al., 2011). Our responsibilities as physicians caring for these patients include education regarding radiation risk and, when an investigation that utilizes ionizing radiation is required, to keep radiation doses as low as reasonably achievable: the “ALARA” principle. Recent advances in CT technology have facilitated substantial radiation dose reductions in many clinical settings, and several studies have demonstrated significantly decreased radiation doses in Crohn’s disease patients while maintaining diagnostic image quality. However, there is a balance to be struck between reducing radiation exposure and maintaining satisfactory image quality; if radiation dose is reduced excessively, the resulting CT images can be of poor quality and may be nondiagnostic. In this paper, we summarize the available evidence related to imaging of Crohn’s disease, radiation exposure, and risk, and we report recent advances in low-dose CT technology that have particular relevance.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationKavanagh, R. G., O'Grady, J., Carey, B. W., McLaughlin, P. D., O'Neill, S. B., Maher, M. M., and O'Connor, O. J. (2018) 'Low-Dose Computed Tomography for the Optimization of Radiation Dose Exposure in Patients with Crohn's Disease', Gastroenterology Research and Practice, 1768716 (10 pp). doi: 10.1155/2018/1768716en
dc.identifier.doi10.1155/2018/1768716
dc.identifier.endpage1768716-10en
dc.identifier.issn1687-6121
dc.identifier.issn1687-630X
dc.identifier.journaltitleGastroenterology Research & Practiceen
dc.identifier.startpage1768716-1en
dc.identifier.urihttps://hdl.handle.net/10468/7227
dc.identifier.volume2018en
dc.language.isoenen
dc.publisherHindawi Pressen
dc.relation.urihttps://www.hindawi.com/journals/grp/2018/1768716
dc.rights© 2018 Richard G. Kavanagh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectCrohn's diseaseen
dc.subjectMRIen
dc.subjectComputed tomographyen
dc.subjectLow dose CTen
dc.subjectMagnetic resonance imaging (MRI)en
dc.titleLow-dose computed tomography for the optimization of radiation dose exposure in patients with Crohn’s diseaseen
dc.typeArticle (peer-reviewed)en
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