Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.
BMJ Open. 2021 Jan 17;11(1):e041883. doi: 10.1136/bmjopen-2020-041883.
High radiation exposure is a concern because of the association with cancer. The objective was to determine the probability of receiving a high radiation dose from CT (from one or more examinations within a 5-year period) and to assess the clinical context by evaluating clinical indications in the high-dose patient group.
Observational cohort study. Effective radiation dose received from one or more CT examinations within a predefined 5-year calendar period was assessed for each patient.
Hospital setting.
All patients undergoing a diagnostic CT examination between July 2013 and July 2018 at the Maastricht University Medical Center.
The primary outcome was the probability of receiving a high effective dose, defined as ≥100 mSv, from one or more CT examinations within 5 years as derived from a time-to-event analysis. Secondary outcomes were the clinical indication for the initial scan of patients receiving a high effective dose.
100 672 CT examinations were performed among 49 978 patients including 482 (1%) who received a high radiation dose. The estimated probability of a high effective dose from a single examination is low (0.002% (95% CI 0.00% to 0.01%)). The 4.5-year probability of receiving a high cumulative effective dose was 1.9% (95% CI 1.6% to 2.2%) for women and 1.5% (95% CI 1.3% to 1.7%) for men. The probability was highest in age categories between 51 and 74 years. A total of 2711 (5.5%) of patients underwent more than six CT examinations, and the probability of receiving a high effective dose was 16%. Among patients who received a high effective dose, most indications (80%) were oncology related.
The probability of receiving a high radiation dose from CT examinations is small but not negligible. In the majority (80%) of high effective dose receiving patients, the indication for the initial CT scan was oncology related.
由于与癌症有关，高辐射暴露是一个令人担忧的问题。目的是确定从 CT 检查中（在 5 年内进行一次或多次检查）接受高剂量辐射的概率，并通过评估高剂量患者组的临床指征来评估临床情况。
观察性队列研究。对每位患者在预定义的 5 年内进行一次或多次 CT 检查所接受的有效辐射剂量进行评估。
医院环境。
所有在 2013 年 7 月至 2018 年 7 月期间在马斯特里赫特大学医学中心接受诊断性 CT 检查的患者。
主要结果是从时间事件分析中得出的，5 年内接受一次或多次 CT 检查且有效剂量≥100mSv 的概率。次要结果是接受高有效剂量的患者首次扫描的临床指征。
对 49978 名患者的 100672 次 CT 检查进行了分析，其中 482 名（1%）患者接受了高辐射剂量。单次检查高有效剂量的估计概率较低（0.002%（95%置信区间 0.00%至 0.01%））。女性 4.5 年累积有效剂量接受高剂量的概率为 1.9%（95%置信区间 1.6%至 2.2%），男性为 1.5%（95%置信区间 1.3%至 1.7%）。年龄在 51 至 74 岁之间的患者概率最高。共有 2711 名（5.5%）患者接受了超过 6 次 CT 检查，接受高有效剂量的概率为 16%。在接受高有效剂量的患者中，大多数（80%）的指征与肿瘤学相关。
从 CT 检查中接受高辐射剂量的概率虽然较小，但不容忽视。在大多数（80%）接受高有效剂量的患者中，首次 CT 扫描的指征与肿瘤学有关。
