The Risk of Cataract Associated With Repeated Head and Neck CT Studies: A Nationwide Population-Based Study

Yuan, Mei-Kang; Tsai, Der‐Chong; Chang, Shih‐Chieh; Yuan, Mei‐Chun; Su, Chang; Chen, Huan‐Wu; Leu, Hsin‐Bang

doi:10.2214/ajr.12.9652

Cited by 95 publications

(66 citation statements)

References 21 publications

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“…Virtually all (97.11%) of the inhabitants of Taiwan (21,869,478 of 22,520,776 population by the end of 2002) are enrolled in the National Health Insurance program, which has been operating since 1995 [13, 15]. The NHIRD at the National Health Research Institutes (NHRI) in Miaoli, Taiwan, is in charge of the entire National Health Insurance claims database and has published numerous extracted datasets for researchers.…”

Section: Methodsmentioning

confidence: 99%

The risk of cataractogenesis after gamma knife radiosurgery: a nationwide population based case-control study

et al. 2017

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BackgroundMedical radiation is considered a factor responsible for cataractogenesis. However, the incidence of this ophthalmologic complication resulting from gamma knife radiosurgery (GKRS) has not yet been reported. The present study aimed to determine the risk of cataractogenesis associated with radiation exposure from GKRS.MethodsThis study used information from a random sample of one million persons enrolled in the nationally representative Taiwan National Health Insurance Research Database. The GK group consisted of patients who underwent GKRS between 2000 and 2009. The non-GK group was composed of subjects who had never undergone GKRS, but who were matched with the case group for time of enrollment, age, sex, history of coronary artery disease, hypertension, and diabetes.ResultsThere were 277 patients in the GK group and 2770 matched subjects in the non-GK group. The GK group had a higher overall incidence of cataracts (10.11% vs. 7.26%; crude hazard ratio [cHR], 1.59; 95% CI, 1.07–2.36; adjusted hazard ratio [aHR], 1.25; 95% CI, 0.82–1.90) than the non-GK group. Patients who had undergone computed tomography and/or cerebral angiography (CT/angio) studies had a higher risk of developing cataracts than those who did not (10.82% vs. 6.64%; cHR, 1.74; 95% CI, 1.31–2.30; aHR, 1.65; 95% CI, 1.22–2.23). The age group between 30 and 50 years had the highest risk of cataractogenesis in both the GK and CT/angio groups (cHR, 3.50; 95% CI, 1.58–7.72; aHR, 2.43; 95% CI, 1.02–5.81; cHR, 2.96; 95% CI, 1.47–5.99; aHR, 2.27; 95% CI, 1.05–4.93, respectively).ConclusionsRadiation exposure due to GKRS and CT/angio study may be independently associated with increased risk of cataractogenesis. We suggest routine dosimetry measurement of eye lens and proper protection for patients with benign lesions during GKRS. Regular follow-up imaging studies should avoid the use of CT/angio, and particular care should be taken in the 30–50-year-old age group, due to their significantly increased risk of cataract formation.

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Section: Methodsmentioning

confidence: 99%

The risk of cataractogenesis after gamma knife radiosurgery: a nationwide population based case-control study

et al. 2017

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“…However, the mean lens radiation doses in these three studies were low: 28 , 60 and 70 mGy, respectively, and the follow-up times were relatively short for the studies of 131 I and industrial radiographers, so the null findings are not surprising. The study of head/neck CT examinees, which had an endpoint of cataract extraction or prolonged cataract therapy, found a suggestive positive association with CT examinations, but had no lens dose information [18].…”

Section: How Often Do Minor Radiation-associated Opacities Progress Tmentioning

confidence: 99%

“…Investigators in Taiwan studied the association between CT scans of the head and neck and cataract risk [18]. From the Taiwan national health insurance database a group of 2,776 patients with head, neck or brain tumors (but excluding ocular or orbital region tumors to reduce confounding by radiotherapy) was identified who had received one to four or more CT scans, along with 27,761 matched unexposed subjects.…”

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confidence: 99%

Radiation and cataract risk: Impact of recent epidemiologic studies on ICRP judgments

Shore

2016

Mutation Research/Reviews in Mutation Research

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“…Ugyanakkor a determinisztikus hatással ellentétben számos epidemiológiai és kísérletes vizsgálat a sztochasztikus hipotézis mellett áll ki, amely értelmében már jóval alacsonyabb sugárdó-zisok is okozhatnak szürke hályogot, küszöbsugárdózis-tól függetlenül [8]. Egy közelmúltban megjelent, nagy betegpopuláción végzett retrospektív vizsgálat szerint minél több fej-nyaki CT-vizsgálaton vesz részt egy beteg, annál nagyobb az esélye a szürke hályog kialakulásá-ra, továbbá már 4 koponya CT-vizsgálatot követően a szürke hályog kialakulásának szignifi kánsan nagyobb kockázatával kell számolni [9].…”

Section: Sugárterhelésunclassified

A cone-beam komputertomográfia alkalmazása a fül-orr-gégészeti képalkotásban

et al. 2016

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A modern fül-orr-gégészetben a pontos diagnózis és a korrekt műtéti tervezés alapja a részletes vizualizációt eredmé-nyező képalkotás. A csontos keretbe zárt struktúrákat gyakran vizsgálják komputertomográfi ával. Az ionizáló sugár-zás veszélyeit fi gyelembe véve az ismételt vizsgálatok hatványozottan növelik a sugárérzékeny szövetek károsodásának kockázatát. A szerzők összehasonlítják a hagyományos és a cone-beam komputertomográfi át, és bemutatják a conebeam komputertomográfi a fül-orr-gégészeti képalkotásban betöltött helyét, előnyeit és korlátait. Összefoglalják a nemzetközi szakirodalomból és saját betegeik vizsgálatából származó tapasztalataikat. Eredményeik szerint a hagyományos komputertomográfi a effektív sugárdózisának töredékével nagy térbeli felbontású vizsgálatok végezhetők tetszőleges síkú és térbeli rekonstrukciókkal. A cone-beam komputertomográfi a megfelelő indikációban kiváló vizsgáló-módszer a fül-orr-gégészeti diagnosztikában. Lényegesen alacsonyabb sugárterhelése miatt a hagyományos komputertomográfi a alternatívája, valamint a per-és posztoperatív betegkövetés hatékony eszköze is lehet, különö-sen az ismételt komputertomográfi ás vizsgálatot igénylő esetekben. Orv. Hetil., 2016, 157(2), 52-58.Kulcsszavak: fül-orr-gégészet, képalkotás, cone-beam kumputertomográfi a, sugárterhelés, szürke hályog Role of cone-beam computed tomography in diagnostic otorhinolaryngological imagingAccurate diagnosis and preoperative planning in modern otorhinolaryngology is strongly supported by imaging with enhanced visualization. Computed tomography is often used to examine structures within bone frameworks. Given the hazards of ionizing radiation, repetitive imaging studies exponentially increase the risk of damages to radiosensitive tissues. The authors compare multislice and cone-beam computed tomography and determine the role, advantages and disadvantages of cone-beam computed tomography in otorhinolaryngological imaging. They summarize the knowledge from the international literature and their individual imaging studies. They conclude that cone-beam computed tomography enables high-resolution imaging and reconstruction in any optional plane and in space with considerably lower effective radiation dose. Cone-beam computed tomography with appropriate indications proved to be an excellent diagnostic tool in otorhinolaryngological imaging. It makes an alternative to multislice computed tomography and it is an effective tool in perioperative and postoperative follow-up, especially in those cases which necessitate repetitive imaging with computed tomography. Keywords

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The Risk of Cataract Associated With Repeated Head and Neck CT Studies: A Nationwide Population-Based Study

Abstract: Repeated exposure to head and neck CT is significantly associated with increased risk of cataract.

Cited by 95 publications

References 21 publications

The risk of cataractogenesis after gamma knife radiosurgery: a nationwide population based case-control study

The risk of cataractogenesis after gamma knife radiosurgery: a nationwide population based case-control study

Radiation and cataract risk: Impact of recent epidemiologic studies on ICRP judgments

A cone-beam komputertomográfia alkalmazása a fül-orr-gégészeti képalkotásban

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