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

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 indication...

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Main Authors: Cécile R L P N Jeukens, Hub Boere, Bart A J M Wagemans, Patty J Nelemans, Estelle C Nijssen, Rebecca Smith-Bindman, Joachim E Wildberger, Anna M Sailer
Format: Article
Language:English
Published: BMJ Publishing Group 2021-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/1/e041883.full
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spelling doaj-010416c4fd49450eae2bbed8ebea36092021-02-20T12:31:24ZengBMJ Publishing GroupBMJ Open2044-60552021-01-0111110.1136/bmjopen-2020-041883Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort studyCécile R L P N Jeukens0Hub Boere1Bart A J M Wagemans2Patty J Nelemans3Estelle C Nijssen4Rebecca Smith-Bindman5Joachim E Wildberger6Anna M Sailer7Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, The NetherlandsDepartment of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, The NetherlandsDepartment of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, The NetherlandsDepartment of Epidemiology, Maastricht University, Maastricht, The NetherlandsDepartment of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, The NetherlandsDepartment of Radiology and Biomedical Imaging Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USADepartment of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, The NetherlandsDepartment of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, The NetherlandsObjective 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.https://bmjopen.bmj.com/content/11/1/e041883.full
collection DOAJ
language English
format Article
sources DOAJ
author Cécile R L P N Jeukens
Hub Boere
Bart A J M Wagemans
Patty J Nelemans
Estelle C Nijssen
Rebecca Smith-Bindman
Joachim E Wildberger
Anna M Sailer
spellingShingle Cécile R L P N Jeukens
Hub Boere
Bart A J M Wagemans
Patty J Nelemans
Estelle C Nijssen
Rebecca Smith-Bindman
Joachim E Wildberger
Anna M Sailer
Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort study
BMJ Open
author_facet Cécile R L P N Jeukens
Hub Boere
Bart A J M Wagemans
Patty J Nelemans
Estelle C Nijssen
Rebecca Smith-Bindman
Joachim E Wildberger
Anna M Sailer
author_sort Cécile R L P N Jeukens
title Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort study
title_short Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort study
title_full Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort study
title_fullStr Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort study
title_full_unstemmed Probability of receiving a high cumulative radiation dose and primary clinical indication of CT examinations: a 5-year observational cohort study
title_sort probability of receiving a high cumulative radiation dose and primary clinical indication of ct examinations: a 5-year observational cohort study
publisher BMJ Publishing Group
series BMJ Open
issn 2044-6055
publishDate 2021-01-01
description 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.
url https://bmjopen.bmj.com/content/11/1/e041883.full
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