Cumulative exposure to ionising radiation from diagnostic imaging tests: a 12-year follow-up population-based analysis in Spain

Abstract

ObjectivesTo calculate each patient’s cumulative radiation exposure and the recurrent tests during a 12-year study period, according to sex and age, in routine practice.DesignRetrospective cohort study.SettingA general hospital with a catchment population of 224 751 people, in the Southeast of Spain.ParticipantsPopulation belonged to the catchment area of that hospital in 2007. We collected all consecutive diagnostic imaging tests undergone by this population until 31 December 2018. We excluded: imaging tests that did not involve radiation exposure.Main outcome measuresThe cumulative effective dose and the recurrent imaging tests by sex and age at entry of study.ResultsOf the 224 751 people, 154 520 (68.8%) underwent an imaging test. The population had 1 335 752 imaging tests during the period of study: 1 110 077 (83.0%) plain radiography; 156 848 (11.8%) CT; 63 157 (4.8%) fluoroscopy and 5670 (0.4%) interventional radiography. 25.4% of the patients who had a CT, underwent five or more CTs (5.4% in the 0–20 years age group). The median total cumulative effective dose was 2.10 mSv (maximum 3980.30) and 16.30 mSv (maximum 1419.30 mSv) if we considered only doses associated with CT. Women received more effective dose than men (median 2.38 vs median 1.90, p<0.001). A total of 7142 (4.6%) patients received more than 50 mSv, with differences in men and women (p<0.001) and 2.5% of the patients in the 0–20 years age group, if we considered only doses associated with CT.ConclusionsNearly 5% of patients received doses higher than 50 mSv during the 12-year period of study and 2.5% of the patients in the 0–20 years age group, if we considered only doses associated with CT. The rate of recurrent examinations was high, especially in older patients, but also relevant in the 0–20 years age group.

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

“…Also, a recent study by Rehani and Hauptman 18 demonstrated up to a sixfold variation between countries in the estimated number of patients receiving high cumulative effective doses relative to the population of a country. Two population-based studies 14 15 used well-defined and large study populations living in specific areas of Spain (224 751 people) 14 and the USA (54 447 adults). 15 They reported analyses of the subgroups of inhabitants undergoing at least one CT examination in the study period.…”

Economic Impact of SARS-COV2 Infection in the Department of Diagnostic Imaging

“…During the COVID-19 pandemic, all studies reported consistent and dramatic declines in all radiology examinations, with significant reductions in outpatient accesses of up to 70%, while examining the various imaging techniques showed reductions of 56% for MR, 53% for conventional radiology, and 47% for CT [15][16]; in particular for outpatients, the most significant decreases peaked for mammography examinations (94%), followed in descending order by nuclear medicine (85%), MRI (74%), ultrasound (64%), interventional radiology (56%), CT (46%), and radiography (22%) (17)(18) One study tracked the trend in wRWUs documenting an average decline of 52% in the United States during the pandemic peak. By modality, CT and traditional radiography (including mammography) together accounted for well over half of the total practice wRVU decreases (19).…”

Gender Differences in the Impact of Recommendations on Diagnostic Imaging Tests: A Retrospective Study 2007–2021

“…For collecting data on imaging test frequency, we carried out procedures similar to those used in a previous study [ 29 ]. Briefly, we collected the following data from the Medical Image Bank of the Valencian Community from the Department of Universal Health and Public Health Service: sex and age at entry in the study, radiological examination, and date.…”