Radiation dose in Patient Underwent Computed Tomography Scan at Sichon Hospital
Keywords:
diagnostic reference level, computed tomography, radiation doseAbstract
Background: CT scan is the major radiologic examination used nowadays and rapidly growing in a number of performs. The CT scan involves relatively high and more significant radiation dose than conventional general x-ray. Exposure to radiation is concerning because evidence linked to radiation exposure significantly increases risk of cancer. Therefore, radiation dose monitoring and optimization in
CT scan are needed to reduce the potential hazard of the radiation while still obtaining a good quality image.
Objectives: To obtain radiation dose values of the CT scan in head, neck, chest, and abdomen in Sichon hospital using the parameter CT dose index volume (CTDIvol) and dose length product (DLP).
Method: This was a retrospective descriptive study of 100 randomly selected head, neck, chest and abdominal CT scans in 100 patients enrolled between 1 July 2021 to 31 August 2021. CTDIvol and DLP values from each CT studies were collected. The third quartile was analyzed to yield the DRLs of CTDIvol and DLP. The DRLs is set at the third quartile value. The DRLs are compared to the Thai national DRL and international DRLs.
Results: The DRLs of the head, neck chest and abdominal CT were CTDIvol 52.3 mGy/DLP 993 mGy.cm, CTDIvol 7.4 mGy/DLP 256 mGy.cm, CTDIvol 10.0 mGy/, DLP 369 mGy.cm and CTDIvol 17.1 mGy/DLP 843 mGy.cm, respectively. As compare to national and international DRLs, CTDIvol and DLP of CT head, neck and chest were lower, whereas the DRLs for DLP of CT abdomen were higher than standard thai DRLs and international DRLs of ACR, Japan, UK, and EC.
Conclusion: The high DLP value comparing to standard thai and international DRLs of CT abdomen in this study points out the need for optimization of abdominal CT examinations.
References
Brenner DJ, Hall EJ. Computed tomography--an increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277-84. doi: 10.1056/NEJMra072149.
Mettler FA Jr, 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(2):520-31. doi: 10.1148/radiol.2532082010.
Rehani MM, Yang K, Melick ER, Heil J, Šalát D, Sensakovic WF, et al. Patients undergoing recurrent CT scans: assessing the magnitude. Eur Radiol. 2020;30(4):1828-36. doi: 10.1007/s00330-019-06523-y.
Costello JE, Cecava ND, Tucker JE, Bau JL. CT radiation dose: current controversies and dose reduction strategies. AJR Am J Roentgenol. 2013;201(6):1283-90. doi: 10.2214/AJR.12.9720.
Smith-Bindman R, Lipson J, Marcus R, Kim KP, Mahesh M, Gould R, et al. Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med. 2009;169(22):2078-86. doi: 10.1001/archinternmed.2009.427.
Vassileva J, Rehani M. Diagnostic Reference Levels. AJR Am J Roentgenol. 2015;204(1):W1-W3. doi: 10.2214/AJR.14.12794.
Vañó E, Miller DL, Martin CJ, et al. ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging. Ann ICRP. 2017;46(1):1-144. doi: 10.1177/0146645317717209.
Department of Medical Sciences, Bureau of Radiation and Medical Devices. Radiography referencing diagnostic radiography [Internet]. Bangkok: Bureau of Radiation and Medical Devices; 2018. Available from:http://radiation.dmsc.moph.go.th/post-view/107.
The American College of Radiology. ACR–AAPM–SPR PRACTICE PARAMETER FOR DIAGNOSTIC REFERENCE LEVELS AND ACHIEVABLE DOSES IN MEDICAL X-RAY IMAGING. Virginia: The American College of Radiology; 2018. Available from: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/diag-ref-levels.pdf.
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(1):120-33.
National Diagnostic Reference Levels in Japan (2020) Japan: Japan Network for Research and Information on Medical Exposure (J-RIME); 2020. Available from: https://www.jsmp.org/en/info/national-diagnostic-reference-levels-in-japan-2020-has-been-released/
Shrimpton PC, Hillier MC, Meeson S, Golding SJ. Doses from Computed Tomography (CT) Examinations in the UK – 2011 Review [Internet]. London: Public Health England; 2014. Available from: https://www.gov.uk/government/publications/doses-from-computed-tomography-ct-examinations-in-the-uk.
EUROPEAN COMMISSION. RADIATION PROTECTION N° 180 Diagnostic Reference Levels in Thirty-six European Countries Part 2/2 [Internet]. Luxembourg: European Union; 2014. Available from: https://ec.europa.eu/energy/sites/ener/files/documents/RP180%20part2.pdf.
Berrington de Gonzalez A, Darby S. Risk of cancer from diagnostic x-rays: Estimates for the UK and 14 other countries. Lancet. 2004; 363:345–351. doi: 10.1148/radiol.2015142728.
Christner JA, Kofler JM, McCollough CH. Estimating Effective Dose for CT Using Dose–Length Product Compared With Using Organ Doses: Consequences of Adopting International Commission on Radiological Protection Publication 103 or Dual-Energy Scanning. AJR Am J Roentgenol. 2010;194(4):881-9.
Pema D, Kritsaneepaiboon S. Radiation Dose from Computed Tomography Scanning in Patients at Songklanagarind Hospital: Diagnostic Reference Levels. J Health Sci Med Res. 2020;38(2):135-43.
Sookpeng S, Butdee C, Sanbunlerng W. A Survey on Radiation Dose from Computed Tomography Examinations in Phitsanulok Province. J Health Sci. 2017;26(1):210-9.
Atlı E, Uyanık SA, Öğüşlü U, Çevik Cenkeri H, Yılmaz B, Gümüş B. Radiation doses from head, neck, chest and abdominal CT examinations: an institutional dose report. Diagn Interv Radiol. 2021;27(1):147-51. doi: 10.5152/dir.2020.19560.
Badawy MK, Galea M, Mong KS, U P. Computed tomography overexposure as a consequence of extended scan length. J Med Imaging Radiat Oncol. 2015;59(5):586-9.
Singh R, Digumarthy SR, Muse VV, Kambadakone AR, Blake MA, Tabari A, et al. Image Quality and Lesion Detection on Deep Learning Reconstruction and Iterative Reconstruction of Submillisievert Chest and Abdominal CT. AJR Am J Roentgenol. 2020;214(3):566-73. doi: 10.2214/AJR.19.21809.
Downloads
Published
How to Cite
Issue
Section
License
The articles that had been published in the journal is copyright of Journal of Nakornping hospital, Chiang Mai.
Contents and comments in the articles in Journal of Nakornping hospital are at owner’s responsibilities that editor team may not totally agree with.
