Cumulative Doses of Ionizing Radiation From Computed Tomography: A Population-Based Study

Konrad H. Stopsack, James R Cerhan

Research output: Contribution to journalArticle

Abstract

Objective: To assess cumulative radiation doses from computed tomography (CT), patient characteristics, and clinical indications for CT in a population-based sample. Patients and Methods: A cohort study using medical records linkage through the Rochester Epidemiology Project was conducted to ascertain all CT examinations in Olmsted County, Minnesota, performed between January 1, 2004, and December 31, 2013, among all adults who were alive for 3 or more years after the end of follow-up (to exclude exposures preceding death). Ten-year cumulative effective ionizing radiation doses were estimated on the basis of typical doses per CT modality. Among patients with high doses (≥100 mSv/10 years), CT scans were reviewed for clinical setting, indications, and results. Results: Of 54,447 adults (median age, 44.0 years at inclusion), 26,377 (48.4%) underwent at least one CT. Ten-year radiation doses from CT were 0.1 to 9.9 mSv in 15.8% of the population (8593 patients), 10 to 24.9 mSv in 16.9% (9502), 25 to 99.9 mSv in 13.8% (7492), and 100 mSv or greater in 1.9% (1041). Computed tomography of the abdomen and pelvis accounted for 67.2% of the estimated dose. In multivariable models, doses differed 1.21-fold to 2.16-fold between extreme categories of age, body mass index, education level, smoking status, and by race. Of 600 CTs in 200 patients with high doses, 70.5% were obtained for restaging of solid cancers and lymphoma, abdominal pain, infection, kidney stones, follow-up of nodules or masses, and chest pain/evaluation for pulmonary embolism. Conclusion: Exposure to ionizing radiation from CT occurred disproportionally in specific subgroups of the population. A limited number of clinical indications contributed the majority of radiation among adults with high doses.

Original languageEnglish (US)
Pages (from-to)2011-2021
Number of pages11
JournalMayo Clinic proceedings
Volume94
Issue number10
DOIs
StatePublished - Oct 1 2019

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Ionizing Radiation
Tomography
Population
Radiation
Medical Record Linkage
Kidney Calculi
Chest Pain
Pelvis
Pulmonary Embolism
Abdomen
Abdominal Pain
Lymphoma
Epidemiology
Body Mass Index
Cohort Studies
Smoking
Education
Infection

ASJC Scopus subject areas

  • Medicine(all)

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Cumulative Doses of Ionizing Radiation From Computed Tomography : A Population-Based Study. / Stopsack, Konrad H.; Cerhan, James R.

In: Mayo Clinic proceedings, Vol. 94, No. 10, 01.10.2019, p. 2011-2021.

Research output: Contribution to journalArticle

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abstract = "Objective: To assess cumulative radiation doses from computed tomography (CT), patient characteristics, and clinical indications for CT in a population-based sample. Patients and Methods: A cohort study using medical records linkage through the Rochester Epidemiology Project was conducted to ascertain all CT examinations in Olmsted County, Minnesota, performed between January 1, 2004, and December 31, 2013, among all adults who were alive for 3 or more years after the end of follow-up (to exclude exposures preceding death). Ten-year cumulative effective ionizing radiation doses were estimated on the basis of typical doses per CT modality. Among patients with high doses (≥100 mSv/10 years), CT scans were reviewed for clinical setting, indications, and results. Results: Of 54,447 adults (median age, 44.0 years at inclusion), 26,377 (48.4{\%}) underwent at least one CT. Ten-year radiation doses from CT were 0.1 to 9.9 mSv in 15.8{\%} of the population (8593 patients), 10 to 24.9 mSv in 16.9{\%} (9502), 25 to 99.9 mSv in 13.8{\%} (7492), and 100 mSv or greater in 1.9{\%} (1041). Computed tomography of the abdomen and pelvis accounted for 67.2{\%} of the estimated dose. In multivariable models, doses differed 1.21-fold to 2.16-fold between extreme categories of age, body mass index, education level, smoking status, and by race. Of 600 CTs in 200 patients with high doses, 70.5{\%} were obtained for restaging of solid cancers and lymphoma, abdominal pain, infection, kidney stones, follow-up of nodules or masses, and chest pain/evaluation for pulmonary embolism. Conclusion: Exposure to ionizing radiation from CT occurred disproportionally in specific subgroups of the population. A limited number of clinical indications contributed the majority of radiation among adults with high doses.",
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