Radiation Exposure among Patients with Inflammatory Bowel Disease: A Single-Medical-Center Retrospective Analysis in Taiwan

Abstract

Inflammatory bowel disease (IBD) is a chronic and relapsing disease that can be complicated by abscesses, fistulas, or strictures of the damaged bowel. Endoscopy or imaging studies are required to diagnose and monitor the treatment response or complications of the disease. Due to the low incidence of the disease in Taiwan, the pattern of radiation exposure from medical imaging has not been well studied previously. This retrospective study aimed to evaluate the pattern of radiation exposure in 134 Taiwanese IBD patients (45 CD and 89 UC) diagnosed and followed at Changhua Christian Hospital from January 2010 to December 2020. We reviewed the patient demographic data and radiation-containing image studies performed during the follow-up. The cumulative effective dose (CED) was calculated for each patient. During a median follow-up of 4 years, the median CED was higher for patients with CD (median CED 21.2, IQR 12.1–32.8) compared to patients with UC (median CED 2.1, IQR 0–5.6) (p < 0.001). In addition, the CD patients had a trend of a higher rate of cumulative ≥50 mSv compared with the UC patients (6.7% vs. 1.1%, p = 0.110). In conclusion, our study found a higher radiation exposure among CD patients compared to patients with UC, representing the complicated nature of the disease. Therefore, increasing the use of radiation-free medical imaging such as intestinal ultrasound or magnetic resonance imaging should be advocated in daily practice to decrease the risk of excessive radiation exposure in these patients.

High prevalence of vitamin D deficiency in Taiwanese patients with inflammatory bowel disease

“…Additionally, the measurement of vitamin D and treatment of its insufficiency are currently not reimbursed by our national health insurance. Indeed, only two-thirds of our IBD population reported having undergone a check-up of vitamin D concentration in our institution 68 . Since therapies and tests to measure vitamin D levels require out of pocket money and given that not all patients are willing to undergo screening, it is critical that more people become aware of the significant lack of vitamin D that this population is experiencing, and the current study represents an important step in this direction.…”

“…First, the number of cases was relatively low, particularly in the CD group. This limited the currently low prevalence of IBD population in our region 67,68 . Second, although this is a prospective and observational study of patient medical records, undergoing a vitamin D check-up and receiving subsequent treatment were not mandatory for participation.…”

The role of intestinal ultrasound with colour Doppler in predicting the response to biologic therapy in inflammatory bowel disease patients

“…The use of endoscopy to monitor the response to therapy in IBD is limited by the difficulty of repeating this invasive examination frequently [16]. Repeated exposure to contrast material together with ionizing radiation has been reported in IBD patients [20,21]. That is where intestinal ultrasound and colour Doppler play a major role.…”