Dataset Information

Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort study.

ABSTRACT:

Objective

High radiation exposure is a concern because of the association with cancer. The objective was to determine the probability of receiving a high radiation dose from CT (from one or more examinations within a 5-year period) and to assess the clinical context by evaluating clinical indications in the high-dose patient group.

Design

Observational cohort study. Effective radiation dose received from one or more CT examinations within a predefined 5-year calendar period was assessed for each patient.

Setting

Hospital setting.

Participants

All patients undergoing a diagnostic CT examination between July 2013 and July 2018 at the Maastricht University Medical Center.

Primary and secondary outcome measures

The primary outcome was the probability of receiving a high effective dose, defined as ≥100 mSv, from one or more CT examinations within 5 years as derived from a time-to-event analysis. Secondary outcomes were the clinical indication for the initial scan of patients receiving a high effective dose.

Results

100 672 CT examinations were performed among 49 978 patients including 482 (1%) who received a high radiation dose. The estimated probability of a high effective dose from a single examination is low (0.002% (95% CI 0.00% to 0.01%)). The 4.5-year probability of receiving a high cumulative effective dose was 1.9% (95% CI 1.6% to 2.2%) for women and 1.5% (95% CI 1.3% to 1.7%) for men. The probability was highest in age categories between 51 and 74 years. A total of 2711 (5.5%) of patients underwent more than six CT examinations, and the probability of receiving a high effective dose was 16%. Among patients who received a high effective dose, most indications (80%) were oncology related.

Conclusions

The probability of receiving a high radiation dose from CT examinations is small but not negligible. In the majority (80%) of high effective dose receiving patients, the indication for the initial CT scan was oncology related.

SUBMITTER: Jeukens CRLPN

PROVIDER: S-EPMC7813417 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort study.

Jeukens Cécile R L P N CRLPN Boere Hub H Wagemans Bart A J M BAJM Nelemans Patty J PJ Nijssen Estelle C EC Smith-Bindman Rebecca R Wildberger Joachim E JE Sailer Anna M AM

BMJ open 20210117 1

<h4>Objective</h4>High radiation exposure is a concern because of the association with cancer. The objective was to determine the probability of receiving a high radiation dose from CT (from one or more examinations within a 5-year period) and to assess the clinical context by evaluating clinical indications in the high-dose patient group.<h4>Design</h4>Observational cohort study. Effective radiation dose received from one or more CT examinations within a predefined 5-year calendar period was as ...[more]

PMID: 33455933

Similar Datasets

Project description:ObjectiveTo determine patient, institution, and machine characteristics that contribute to variation in radiation doses used for computed tomography (CT).DesignProspective cohort study.SettingData were assembled and analyzed from the University of California San Francisco CT International Dose Registry.ParticipantsStandardized data from over 2.0 million CT examinations of adults who underwent CT between November 2015 and August 2017 from 151 institutions, across seven countries (Switzerland, Netherlands, Germany, United Kingdom, United States, Israel, and Japan).Main outcome measuresMean effective doses and proportions of high dose examinations for abdomen, chest, combined chest and abdomen, and head CT were determined by patient characteristics (sex, age, and size), type of institution (trauma center, care provision 24 hours per day and seven days per week, academic, private), institutional practice volume, machine factors (manufacturer, model), country, and how scanners were used, before and after adjustment for patient characteristics, using hierarchical linear and logistic regression. High dose examinations were defined as CT scans with doses above the 75th percentile defined during a baseline period.ResultsThe mean effective dose and proportion of high dose examinations varied substantially across institutions. The doses varied modestly (10-30%) by type of institution and machine characteristics after adjusting for patient characteristics. By contrast, even after adjusting for patient characteristics, wide variations in radiation doses across countries persisted, with a fourfold range in mean effective dose for abdomen CT examinations (7.0-25.7 mSv) and a 17-fold range in proportion of high dose examinations (4-69%). Similar variation across countries was observed for chest (mean effective dose 1.7-6.4 mSv, proportion of high dose examinations 1-26%) and combined chest and abdomen CT (10.0-37.9 mSv, 2-78%). Doses for head CT varied less (1.4-1.9 mSv, 8-27%). In multivariable models, the dose variation across countries was primarily attributable to institutional decisions regarding technical parameters (that is, how the scanners were used).ConclusionsCT protocols and radiation doses vary greatly across countries and are primarily attributable to local choices regarding technical parameters, rather than patient, institution, or machine characteristics. These findings suggest that the optimization of doses to a consistent standard should be possible.Study registrationClinicaltrials.gov NCT03000751.

Dataset Information

Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort study.

Objective

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort study.

Similar Datasets

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