Patients With IBD are Exposed to High Levels of Ionizing Radiation Through CT Scan Diagnostic Imaging

Kroeker, Karen I.; Lam, S; Birchall, I. W. J.; Fedorak, Richard N.

doi:10.1097/mcg.0b013e3181e5d1c5

Cited by 105 publications

(69 citation statements)

References 17 publications

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“…It seems to be a very powerful technique which can be performed quickly in most radiological departments, even though some concerns have been raised regarding radiation exposure [15,16]. In this respect, correlating CD clinical activity with the CTE findings could help to select patients to be referred for CTE, reducing unnecessary radiation exposure [9].…”

Section: Introductionmentioning

confidence: 99%

CT enterography as a powerful tool for the evaluation of inflammatory activity in Crohn’s disease: relationship of CT findings with CDAI and acute-phase reactants

Cappello

Tudisca

et al. 2014

Radiol med

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Purpose Few studies have correlated computed tomography enterography (CTE) findings with Crohn's disease (CD) clinical and biochemical activity. The aim of this study was to evaluate correlations between CTE findings with CD activity. Materials and methods The CTE datasets from 62 patients were retrospectively reviewed for different parameters: bowel wall thickening and hyperenhancement, mesenteric alterations, abdominal free fluid and complications related to the disease (fistulas, strictures, abscesses). Activity was assessed using the Crohn's Disease Activity Index (CDAI) and some biochemical markers (Creactive protein, erythrocyte sedimentation rate, alpha 2-globulins, fibrinogen, platelets, haemoglobin). Correlations between CTE parameters, clinical activity score and laboratory parameters were assessed by logistic regression. Results CDAI was significantly correlated with increased fat density (p = 0.03) and intestinal strictures (p = 0.04). Platelet counts were elevated in patients with enlarged mesenteric lymph nodes (p = 0.009) and the comb sign (p = 0.05). Serum alpha 2-globulins were higher in the presence of the comb sign (p = 0.03). Conclusion The CTE finding of perienteric inflammation (increased fat density) and vascular engorgement of the vasa recta in CD patients suggest that the disease is clinically active and that these patients may require more aggressive treatment than patients without these findings.

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Section: Introductionmentioning

confidence: 99%

CT enterography as a powerful tool for the evaluation of inflammatory activity in Crohn’s disease: relationship of CT findings with CDAI and acute-phase reactants

Cappello

Tudisca

et al. 2014

Radiol med

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“…Stein et al 2 reported a mean total CED after 3 years of 12.3 mSv for 1711 patients with hydrocephalus, 21.7 mSv for 3220 patients with pulmonary thromboembolic disease, 18.7 mSv for 5855 patients with renal colic, and 14 mSv for 11,072 patients with cardiac disease. Kroecker et al 25 reported a mean total CED of 14.3 mSv after 5 years for 371 patients with a diagnosis of Crohn's disease. Chen et al 26 reported a mean total CED over 3 years of 23.1 mSv for 90,121 patients who underwent more than one cardiac imaging procedure.…”

Section: Discussionmentioning

confidence: 99%

Estimated Radiation Exposure from Medical Imaging in Hemodialysis Patients

Mauri¹,

Brambilla²,

Chiarinotti³

et al. 2011

Journal of the American Society of Nephrology

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Radiation exposure accompanying medical imaging associates with cancer risk. Patients with recurrent or chronic diseases may be especially at risk, because they may undergo more of these procedures. The aim of this study was to assess the individual cumulative effective doses (CEDs), which quantify radiation from medical imaging procedures, in a cohort of 106 hemodialysis patients during a median follow-up of 3 years. We retrospectively calculated individual radiation exposures by collecting the number and type of radiologic procedures from hospital records. We also estimated organ doses for computed tomography procedures. The mean and median annual CEDs were 21.9 and 11.7 mSv per patient-year, respectively. The mean and median total CEDs per patient during the study period were 57.7 and 27.3 mSv, respectively. By radiation dose group, we classified 22 patients as low (Ͻ3 mSv/yr), 51 as moderate (3 to Ͻ20 mSv/yr), 22 as high (20 to Ͻ50 mSv/yr), and 11 as very high (Ն50 mSv/yr). Seventeen patients had a total CED Ͼ100 mSv, a value associated with a substantial increase in risk for cancer-related mortality. Of the total CED,s 76% was a result of CT scanning. The annual CED significantly associated with age and transplant waitlist status. In summary, this study shows that a significant fraction of surviving hemodialysis patients during a 3-year period receives estimated radiation doses that may put them at an increased risk for cancer.

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“…Approximately 13.3 % of IBD patients had high CED (defined as the commonly accepted cutoff value of [50 mSV), with CD patients exhibiting the previously reported increased odds of high-dose radiation exposure compared to those with UC [2][3][4]. Other risk factors for increased odds of high-dose radiation exposure uncovered using univariate analyses included the use of IBD therapeutic medications with the exception of mesalamine, prior bowel resection, increased follow-up duration, and a history of perianal disease in CD patients.…”

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confidence: 99%

“…Given a 20-fold rise in the amount of CT imaging between 1980 and 2000, it is not surprising that an estimated three-quarters of the radiation to which IBD patients are exposed is due to CT scanning [1,2], mostly from abdomino-pelvic examinations, which have largely supplanted conventional contrast enterography in IBD patients. As an example, an 840 % increase in CT enterography use was reported between 2002 and 2007 [3].…”

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confidence: 99%