CT scanning: A major source of radiation exposure

Wiest, Philip W.; Locken, Julie A; Heintz, Philip H.; Mettler, Fred A.

doi:10.1016/s0887-2171(02)90011-9

Cited by 146 publications

(66 citation statements)

References 41 publications

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“…Plain film radiography (kidney, ureter, and bladder, or abdominal radiography), ultrasonography and intravenous urography have been used to diagnose urinary tract calculi, with unenhanced helical CT scan currently considered the gold-standard imaging technique. 7 However, the need for sedation, concern over long-term effects of high doses of radiation exposure 15 and availability of the exam are major disadvantages to CT scanning in the pediatric population. In our series,…”

Section: Discussionmentioning

confidence: 99%

Pediatric urolithiasis: experience at a tertiary care pediatric hospital

Kit

Filler

Pike

et al. 2013

CUAJ

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Objective: We aimed to determine the epidemiology, risk factors, clinical characteristics, evaluation and course of patients with urolithiasis at the Children's Hospital of Eastern Ontario to improve current diagnostic and management strategies. Methods:This was a retrospective study of children with newly identified urolithiasis between Jan. 1, 1999, and July 31, 2004. Cases were reviewed for demographics, presentation, family history, diagnostic methods and findings, metabolic and anatomic abnormalities, management, stone analysis and stone recurrence.Results: Seventy-two patients (40 male, 32 female; mean age 11.3 yr) were assessed. Mean follow-up was at 1.5 years. Eighteen patients (25%) had a family history of stones. Flank pain (63%) was the most common presentation. Eighty-two percent of urinalyses showed microscopic hematuria. Imaging comprised abdominal plain film radiography (56%) and (or) abdominal ultrasonography (74%). The mean stone size was 5 mm. Forty-one percent (28/69) of patients who underwent metabolic investigation had an abnormality. Fourteen percent of patients (10/72) had a genitourinary anatomical abnormality. Thirtyfour patients (47%) passed their stones spontaneously, 25 patients (35%) required surgical intervention and 13 patients (18%) had yet to pass their stone. The mean size of spontaneously passed stones was 4 mm. Of 42 stones analyzed, 39 (93%) were composed of calcium oxalate or phosphate. Seventeen (24%) patients had stone recurrence during follow-up. Conclusion:Pediatric patients with stones present in a manner similar to adults.Abdominal plain film radiography and ultrasonography are the preferred initial radiological investigations in children as they limit radiation exposure. Metabolic abnormalities are common and may coexist with anatomic abnormalities, therefore investigations must rule these out. One-half of patients will pass their stones spontaneously. Recurrence rates are high and long-term followup is recommended.

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Section: Discussionmentioning

confidence: 99%

Pediatric urolithiasis: experience at a tertiary care pediatric hospital

Kit

Filler

Pike

et al. 2013

CUAJ

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“…[3][4][5][6] CT scanning comprises approximately 15% of radiologic examinations but represents the largest single source of medical radiation exposure, accounting for up to 70% of the radiation dose to patients. 7 Patients are becoming more aware of the radiation dose related to CT scanning due to increasing coverage in the lay press.…”

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confidence: 99%

Radiation Dose-Reduction Strategies for Neuroradiology CT Protocols

Smith¹,

Dillon²,

Gould³

et al. 2007

American Journal of Neuroradiology

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SUMMARY:Within the past 2 decades, the number of CT examinations performed has increased almost 10-fold. This is in large part due to advances in multidetector-row CT technology, which now allows faster image acquisition and improved isotropic imaging. The increased use, along with multidetector technique, has led to a significantly increased radiation dose to the patient from CT studies. This places increased responsibility on the radiologist to ensure that CT examinations are indicated and that the "as low as reasonably achievable" concept is adhered to. Neuroradiologists are familiar with factors that affect patient dose such as pitch, milliamperes, kilovolt peak (kVp), collimation, but with increasing attention being given to dose reduction, they are looking for additional ways to further reduce the radiation associated with their CT protocols. In response to increasing concern, CT manufacturers have developed dose-reduction tools, such as dose modulation, in which the tube current is adjusted along with the CT acquisition, according to patient's attenuation. This review will describe the available techniques for reducing dose associated with neuroradiologic CT imaging protocols.T he increase in the number of CT studies in the United States and Europe 1,2 that followed the introduction of multidetector-row technology has led to a significant increase in the radiation dose related to CT scanning.3-6 CT scanning comprises approximately 15% of radiologic examinations but represents the largest single source of medical radiation exposure, accounting for up to 70% of the radiation dose to patients. 7 Patients are becoming more aware of the radiation dose related to CT scanning due to increasing coverage in the lay press. 8 The radiation risk to children is of particular concern; the estimated lifetime cancer risk for a 1-year-old child from the radiation exposure of a head CT is 0.07%. 9The potential health risks associated with radiation have placed increasing pressure on the radiology community to ensure that CT imaging protocols are optimized for diagnostic image quality at the lowest radiation dose possible ("as low as reasonably achievable"). Because the latest generation of CT scanners automatically records the CT dose for each study and archives this as part of the patient's permanent medical record, exaggerated delays in implementing dose-reduction strategies may also have medical-legal implications. The purpose of this review is to discuss available methods to achieve dose reduction for neuroradiology CT protocols while preserving the diagnostic quality of imaging studies. CT-Associated Radiation-Dose MeasurementIn 2001, in response to the growing concern over CT-associated radiation dose, the US Food and Drug Administration published guidelines to address this issue, especially in pediatric patients and in the small-adult population. These guidelines give recommendations on how to optimize CT protocols and encourage the elimination of inappropriate referrals for CT as well as the reduction of the numbe...

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“…In this case, the counselor can more readily reassure the patient that the reproductive risks are not increased because the exposure was protracted. The newer techniques using CT scans have the potential for exposing the embryo or fetus to doses above 0.05 Gy, although there has been a major effort by the radiologists and manufacturers to reduce the exposure from CT scans (11)(12)(13)(14).…”

Section: Risks To the Embryo From Ionizing Radiationmentioning

confidence: 99%

Counseling patients exposed to ionizing radiation during pregnancy

Brent¹

2006

Rev Panam Salud Publica

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Health physicists and knowledgeable clinicians have the responsibility to counsel women of reproductive age about the reproductive risks of ionizing radiation exposure that occurs either before conception or during pregnancy. Medical personnel need to realize that lay individuals have many misconceptions about the reproductive risks of ionizing radiation. Further, many patients are apprehensive about the reproductive and developmental risks of diagnostic radiological procedures. Counseling patients requires knowledge of embryology, genetics, radiation teratology, and the principles Artículos e informes especiales / Articles and special reports Key words: pregnancy; pregnancy outcome; radiation, ionizing; abnormalities; risk factors; teratogens; counseling.

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CT scanning: A major source of radiation exposure

Cited by 146 publications

References 41 publications

Pediatric urolithiasis: experience at a tertiary care pediatric hospital

Pediatric urolithiasis: experience at a tertiary care pediatric hospital

Radiation Dose-Reduction Strategies for Neuroradiology CT Protocols

Counseling patients exposed to ionizing radiation during pregnancy

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