Cumulative Radiation Exposure and Cancer Risk Estimates in Emergency Department Patients Undergoing Repeat or Multiple CT

Griffey, Richard T.; Sodickson, Aaron

doi:10.2214/ajr.08.1351

Cited by 221 publications

(101 citation statements)

References 24 publications

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“…Most correctly identified radiography and CT as sources of ionizing radiation. Although children, pregnant women, and women of reproductive age have been identified previously as having an elevated LAR of malignancy due to CT, [21][22][23] one in two respondents were incorrect in quantifying the potential risk of CT to children. These findings are consistent with studies showing poor physician knowledge of LAR due to CT radiation exposure.…”

Section: Discussionmentioning

confidence: 95%

An exploration of Canadian emergency physicians' and residents' knowledge of computed tomography radiation dosing and risk

Barbic

Dankoff

2015

CJEM

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Objective: The objective of this study was to measure the current knowledge of Canadian emergency physicians and emergency medicine residents regarding computed tomography (CT) radiation dosing and its associated risks. Methods: Three focus groups were conducted as the qualitative element of this study. Cognitive debriefing was carried out to ensure the validity and reliability of the focus group findings and to aid with survey development. A 26-item electronic survey was developed and pilot tested for distribution to the membership of the Canadian Association of Emergency Physicians. Results: Eighteen emergency medicine physicians and three emergency medicine residents participated in the focus groups. Four major themes emerged: 1) physician knowledge of risks associated with CT, 2) risk management strategies, 3) communication, and 4) knowledge translation. The survey response rate was 49.8% (638 of 1,281). The mean respondent age was 40.9 6 9.9 years, and 70.7% were male. Of all respondents, 82.5% were actively practicing attending physicians, 56.4% of all respondents practiced in urban academic emergency departments, and the average time practicing was 10.7 6 9.6 years. Radiography and CT were correctly identified by 92.2% and 95.1% of respondents, respectively, as sources of ionizing radiation, whereas magnetic resonance imaging and ultrasonography were selected by 1.0% and 0.5%, respectively. With respect to the lifetime attributable risk (LAR) of malignancy due to CT, 82.2% of participants correctly identified that abdominal CT increases the risk of cancer by 0.2 to 2%, whereas 51.3% correctly identified that the LAR increases twofold in a 7-year-old boy. When asked to identify populations at risk for potential harm due to ionizing radiation, 92.2% of respondents identified children, 80.3% identified pregnant women, and 71.4% identified women of reproductive age. A minority (37.2%) reported communicating the potential risks of CT to a majority of their patients. Electronic platforms were identified by 74.8% of respondents as their preferred method of knowledge translation on this topic. Conclusions: Canadian emergency medicine physicians and emergency medicine residents demonstrated identifiable gaps in knowledge surrounding CT radiation dose and risk. RÉ SUMÉObjectif: L'é tude visait à mesurer les connaissances actuelles des mé decins d'urgence et des ré sidents en mé decine d'urgence au Canada en ce qui concerne les doses de rayonnement é mis par la tomodensitomé trie (TDM) et les risques associé s. Mé thode: Trois groupes de discussion ont é té formé s à titre d'é lé ment qualitatif de l'é tude. Nous avons procé dé à un bilan cognitif afin de nous assurer de la validité et de la fiabilité des conclusions auxquelles en é taient arrivé s les groupes de discussion, et de faciliter l'é laboration de l'enquê te. Un questionnaire é lectronique en 26 points a é té é laboré , puis soumis à un essai pilote en vue de sa distribution aux membres de l'Association canadienne des mé decins d'urgence. Ré sulta...

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Section: Discussionmentioning

confidence: 95%

An exploration of Canadian emergency physicians' and residents' knowledge of computed tomography radiation dosing and risk

Barbic

Dankoff

2015

CJEM

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“…Griffey y colaboradores (6) estudiaron una población seleccionada de 130 pacientes que consultaron en el departamento de emergencia con al menos tres consultas anuales y con un período de seguimiento de 7,7 años. La mediana de TC fue de 10, media 13, con un máximo de 70.…”

Section: Discussionunclassified

“…En la figura 1 se muestra la evolución temporal de la contribución a la dosis efectiva de fuentes artificiales (4) . Numerosos trabajos han demostrado el gran incremento de los estudios radiológicos diagnósticos en paí-ses desarrollados, en particular la TC (63 millones de estudios anuales en Estados Unidos), que representa el 60% de la radiación artificial, debiéndose este hecho a múltiples causas: aumento de la disponibilidad de tomó-grafos, demanda de estudios por los propios pacientes, medicina defensiva, repetición de estudios por falta de información, entre otros (5)(6)(7)(8) (figura 2). A pesar de las crecientes preocupaciones con respecto a la exposición a la radiación médica, todavía hay una conciencia limitada acerca de los riesgos de cáncer inducido (9) .…”

Section: Introducción Y Antecedentesunclassified

Dosis acumulada en tomografía computada 2014-2017: análisis descriptivo de una población del Hospital de Clínicas

Luquetti

Silva

Lecuna

et al. 2018

RMU

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ResumenIntroducción: el uso creciente de la tomografía computada produce un aumento de la dosis colectiva con el potencial riesgo de las radiaciones ionizantes. El objetivo del trabajo fue determinar la frecuencia de estudios tomográficos repetidos y estimar la dosis de radiación acumulada en el período 2014/2017 de una muestra de pacientes asistida durante julio/agosto de 2017 en el Hospital de Clínicas.Método: se incluyeron pacientes que en julio/agosto de 2017 concurrieron al Departamento de Imagenología del Hospital de Clínicas, a quienes su médico tratante indicó la realización de una tomografía computada. Se trató de un estudio descriptivo, longitudinal, retrospectivo. Se completó una planilla con datos demográficos y del procedimiento. Se realizó la búsque-da de estudios tomográficos previos en el sistema de archivo de imágenes médicas y registro de informes de los últimos tres años.Resultados: en la muestra se incluyeron 110 pacientes; 59 (54,1%) se hicieron más de una tomografía, siendo abdomen y pelvis las regiones más estudiadas. Siete pacientes (6,4%) superaron el umbral de dosis de 100 mSv y 16 (14,5%) recibieron dosis entre 50 y 100 mSv. A su vez, 23 pacientes (20,9%) se hicieron más de cuatro tomografías, es decir, en promedio más de una al año.Conclusiones: la tomografía computada es una herramienta beneficiosa para el diagnóstico siempre y cuando se use racionalmente haciendo un balance entre riesgo/beneficio. Se debe tomar conciencia de los riesgos vinculados a la dosis acumulada en múltiples estudios tomográficos.

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“…The increased cancer risk is echoed in other more focused clinical situations such as in the emergency department and evaluation of endovascular aneurysm repair. In these studies, an increased risk is appreciated in younger patients given that they have a longer time to develop cancer from CT imaging 14,15 .…”

Section: Ionizing Radiation Ct and Cancer Riskmentioning

confidence: 99%

Comparison of Radiation Dose From Conventional and Triple-bolus Computed Tomography Urography Protocols in the Diagnosis and Management of Patients With Renal Cortical Neoplasms

Abedi

Okhunov

Lall

et al. 2014

Urology

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Cumulative Radiation Exposure and Cancer Risk Estimates in Emergency Department Patients Undergoing Repeat or Multiple CT

Cited by 221 publications

References 24 publications

An exploration of Canadian emergency physicians' and residents' knowledge of computed tomography radiation dosing and risk

An exploration of Canadian emergency physicians' and residents' knowledge of computed tomography radiation dosing and risk

Dosis acumulada en tomografía computada 2014-2017: análisis descriptivo de una población del Hospital de Clínicas

Comparison of Radiation Dose From Conventional and Triple-bolus Computed Tomography Urography Protocols in the Diagnosis and Management of Patients With Renal Cortical Neoplasms

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