Radiation Dose from Computed Tomography Scanning in Patients at Songklanagarind Hospital: Diagnostic Reference Levels
Abstract
Material and Methods: This was a retrospective analysis of 463 randomly selected head, chest and abdominal CT stuides from 416 patients enrolled from July 1st to 31st 2017. The CTDIvol, DLP and clinical indication for each CT study were conducted. The median and third quartile values were analysed and compared to the standard international DRLs. The DRL was defined as the third quartile value.
Results: The DRLs for CTDIvol, and DLP of head, chest and whole abdominal CT were 57.5, 11.6 and 13.1 milliGray (mGy), and 1,102.6, 474.7 and 624.4 milliGray x centimetre (mGy.cm), respectively. The most common clinical indications were stroke (29.1%) for head CT and malignancy for both chest (73.6%) and abdominal CTs (49.6%).
Conclusion: The DRLs of each CT region were mostly below standard international DRLs of Australia, Europe, Japan, the United Kingdom and the United States. The clinical indication for malignancy had significant difference in the DLP values than other clinical indications in head and chest CT.
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Amis ES, Butler PF, Applegate KE, Birnbaum SB, Brateman LF, Hevezi JM, et al. American college of radiology white paper on radiation dose in medicine. J Am Coll Radiol 2007;4: 272-84.
Fazel R, Krumholz HM, Wang Y, Ross JS, Chen J, Ting HH, et al. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med 2009;361:849-57.
McLean AR, Adlen EK, Cardis E, Elliott A, Goodhead DT, Harms-Ringdahl M, et al. A restatement of the natural science evidence base concerning the health effects of low-level ionizing radiation. Proc Biol Sci 2017;284(1862). doi: 10.1098/ rspb.2017.1070.
Berrington de González A, Mahesh M, Kim KP, Bhargavan M, Lewis R, Mettler F, et al. Projected cancer risks from computed tomographic scans performed in the United States in 2007. Arch Intern Med 2009;169:2071-7.
Royal HD. Effects of low level radiation-what's new? Semin Nucl Med 2008;38:392-402.
Power SP, Moloney F, Twomey M, James K, O’Connor OJ, Maher MM. Computed tomography and patient risk: facts, perceptions and uncertainties. World J Radiol 2016;8:902-15.
Doss M. Linear no-threshold model may not be appropriate for estimating cancer risk from CT. Radiology 2014;270:307-8.
Preston DL, Ron SE, Tokuoka S, Funamoto N, Nishi M, Soda M, et al. Solid cancer incidence in atomic bomb survivors: 1958-1998. Radiat Res 2007;168:1-65.
Linet MS, Kim KP, Miller DL, Kleinerman RA, Simon SL, Berrington de Gonzalez A. Historical review of occupational exposures and cancer risks in medical radiation workers. Radiat Res 2010;174:793-808.
Mettler FA, Bhargavan M, Faulkner K, Gilley DB, Gray JE, Ibbott GS, et al. Radiologic and nuclear medicine studies in the United States and worldwide: frequency, radiation dose, and comparison with other radiation sources 1950–2007. Radiology 2009;253:520–31.
Little MP. Cancer and non-cancer effects in Japanese atomic bomb survivors. J Radiol Prot 2009;29:A43–59.
Report of the United Nations Scientific Committee on the Effects of Atomic Radiation 2010: Fifty-seventh session, includes scientific report: summary of low-dose radiation effects on health [monograph on the Internet]. New York: United Nations Scientific Committee on the Effects of Atomic Radiation; 2011 [cited 2018 Apr 3]. Available from: http://www. unscear.org/unscear/en/publications/2010/UNSCEAR_ 2010_Report_M.pdf
IAEA safety glossary. Terminology used in nuclear safety and radiation protection [monograph on the Internet]. Vienna; International Atomic Energy Agency; 2018 [cited 2019 Feb 15]. Available from: https://www.iaea.org/publications/11098/ iaea-safety-glossary-2018-edition
Mettler FA Jr, Huda W, Yoshizumi TT, Mahesh M. Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology 2008;248:254–63.
Hayton A, Wallace A, Marks P, Edmonds K, Tingey D, Johnston P. Australian diagnostic reference levels for multi detector computed tomography. Australas Phys Eng Sci Med 2013;36: 19-26.
Hatziioannou K, Papanastassiou E, Delichas M, Bousbouras P. A contribution to the establishment of diagnostic reference levels in CT. Br J Radiol 2003;76:541-5.
Ataç GK, Parmaksız A, İnal T, Bulur E, Bulgurlu F, Öncü T, et al. Patient doses from CT examinations in Turkey. Diagn Interv Radiol Ank Turk 2015;21:428-34.
Doses from computed tomography (CT) examinations in the UK – 2011 review [monograph on the Internet]. London: Public Health England; 2011 [cited 2019 Feb 11]. Available from: https://assets.publishing.service.gov.uk/government/ uploads/system/uploads/attachment_data/file/349188/ PHE_CRCE_013.pdf.
Radiation Protection No 180. Diagnostic reference levels in thirty-six European countries [monograph on the Internet]. European Commission (EC). Luxembourg: Publication Office of the European Union; 2014 [cited 2019 Feb 11]. Available from: http://ec.europa>files>RP180 part2
Kanal KM, Butler PF, Sengupta D, Bhargavan-Chatfield M, Coombs LP, Morin RL. U.S. Diagnostic reference levels and achievable doses for 10 adult CT examinations. Radiology 2017; 284:120–33.
Diagnostic Reference Levels Based on latest Surveys in Japan. Japan DRLs 2015 [monograph on the Internet]. Tokyo: The Japan Medical Imaging and Radiological Systems Industries Association and the national Institute of Radiological Sciences; 2015 [cited 2019 Feb 11]. Available from: http:// www.radher.jp/J-RIME/report/DRLhoukokusyoEng.pdf
Najafi M, Deevband MR, Ahmadi M, Kardan MR. Establishment of diagnostic reference levels for common multi-detector computed tomography examinations in Iran. Australas Phys Eng Sci Med 2015;38:603-9
Livingstone RS, Dinakaran PM. Radiation safety concerns and diagnostic reference levels for computed tomography scanners in Tamil Nadu. J Med Phys 2011;36:40-5.
Saravanakumar A, Vaideki K, Govindarajan KN, Jayakumar S. Establishment of diagnostic reference levels in computed tomography for select procedures in Pudhuchery, India. J Med Phys 2014;39:50–5.
Karim MKA, Hashim S, Bradley DA, Bakar KA, Haron MR, Kayun Z. Radiation doses from computed tomography practice in Johor Bahru, Malaysia. Rad Phys Chem 2016;121:69-74.
Ittivisawakul S. An analysis of radiation dose from CT. J Depart Med Serv 2015;40:52-65.
Trinavarat P, Kritsaneepaiboon S, Rongviriyapanich C, Visrutaratna P, Srinakarin J. Radiation dose from CT scanning: can it be reduced? Asian Biomedicine 2011;5:13-21.
Dougeni E, Faulkner K, Panayiotakis G. A review of patient dose and optimisation methods in adult and paediatric CT scanning. Eur J Radiol 2012;81:665-83.
Greess H, Nömayr A, Wolf H, Baum U, Lell M, Böwing B, et al. Dose reduction in CT examination of children by an attenuationbased on-line modulation of tube current (CARE Dose). Eur Radiol 2002;12:1571-6.
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