Trends of Computed Tomography Scan Usage among Adults and Children in Yazd Province, Iran, before the Outbreak of COVID-19
-
Ghazale Perota
,
Hamidreza Masjedi
,
Hamed Zamani
,
Saman Dalvand
,
Reza Omidi
,
Elham Razavi
,
Shiva Rahbar
,
Mohammad Hosein Zare
Abstract
ABSTRACT
Background: Excessive use of computed tomography (CT) has become a worrying issue due to the potential risks corresponding to the radiation exposure.
Purpose: This study was to investigate trends in CT usage in Yazd Province, Iran.
Material and Methods: Patients were categorized in regard to sex and their age into two general groups, pediatrics (<18 years old) and adults (≥18 years old) ), each group fall into multiple subcategorizations. The performed CT scans have been classified into six categories, based on the anatomical area of interest, including head/neck, chest, spine, abdomen-pelvis, extremities, and CT angiography (CTA). The data were collected for the period 2015–2018.
Results: The number of CT scans province increased by the compound annual growth rate of 11%. We found points to the growth rate of CT was higher in men than in women. Across the procedures, head/neck by an average contribution of 52% to all the CT scans was the most frequently examined region but spine examinations have decreased by 32%. More than half of the scans are performed on people over the age of 90 and among age<18 years old, most CT scan rates are related to 13-18 years old children.
Conclusion: The number of CT services is clearly increasing in Yazd. Some increase may be warranted because of improvements in the diagnostic power of CT. The estimated number of pediatric CT scans has more than past. Due to the risk of cancer, efforts should be made to reduce unnecessary CT scans.
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5- Khoramian D, Sistani S, Firouzjah RA. Assessment and comparison of radiation dose and image quality in multi-detector CT scanners in non-contrast head and neck examinations. Pol J Radiol. 2019; 84: e61.
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9- Trinavarat P, Pisuchpen N, Petcharunpaisan S, Sosothikul D, Deerojanawong J, Veeravigrom M, et al. “Appropriateness of pediatric CT utilization in clinical practice.” ASEAN J Radiol; 20(1):4–17, 2019.
10- Goldberg-Stein S, Liu B, Hahn PF, Lee SI. Body CT during pregnancy: utilization trends, examination indications, and fetal radiation doses. Am J Roentgenol; 196(1): 146–151, 2011.
11- Brenner DJ, Hall EJ. “Computed tomography—an increasing source of radiation exposure.” N Engl J Med; 357(22): 2277–2284, 2007.
12- Afzalipour R, Abdollahi H, Hajializadeh MS, Jafari S, Mahdavi SR. “Estimation of diagnostic reference levels for children computed tomography: A study in Tehran, Iran.” Int J Radiat Res; 17(3): 407–413, 2019.
13- Zacharias C, Alessio AM, Otto RK, Iyer RS, Philips GS, Swanson JO, et al. “Pediatric CT: strategies to lower radiation dose.” Am J Roentgenol; 200(5): 950–956, 2013.
14- Brody AS, Frush DP, Huda W, Brent RL. “Radiation risk to children from computed tomography.” Pediatrics; 120(3): 677–682, 2007.
15- “Commission E. Radiation protection 118: referral guidelines for imaging.” Luxemb Off Off Publ Eur Communities; p–19, 2001.
16- Shahi V, Brinjikji W, Cloft HJ, Thomas KB, Kallmes DF. “Trends in CT utilization for pediatric fall patients in US emergency departments.” Acad Radiol; 22(7): 898–903, 2015.
17- Dovales AC, Da Rosa LA, Kesminiene A, Pearce MS, Veiga LH. “Patterns and trends of computed tomography usage in outpatients of the Brazilian public healthcare system 2001–2011.” J Radiol Prot; 36(3): 547, 2016.
18- Brady Z, Forsythe AV, Mathews JD. “The changing use of pediatric CT in Australia.” Pediatr Radiol; 46(8): 1199–1208, 2016.
19- Roudsari BS, Psoter KJ, Vavilala MS, Mack CD, Jarvik JG. “CT use in hospitalized pediatric trauma patients: 15-year trends in a level I pediatric and adult trauma center.” Radiology; 267(2): 479–486, 2013.
20- Pearce MS, Salotti JA, McHugh K, Metcalf W, Kim KP, Craft AW, et al. “CT scans in young people in Northern England: trends and patterns 1993–2002.” Pediatr Radiol; 41(7): 832–838, 2011.
21- Prabhakar AM, Misono AS, Hemingway J, Hughes DR, Duszak Jr R. Medicare utilization of CT angiography from 2001 through 2014: continued growth by radiologists. J Vasc Interv Radiol; 27(10): 1554–1560, 2016.
22- Schunk JE, Rodgerson JD, Woodward GA. “The utility of head computed tomographic scanning in pediatric patients with normal neurologic examination in the emergency department.” Pediatr Emerg Care; 12(3): 160–165, 1996.
23- Larson DB, Johnson LW, Schnell BM, Goske MJ, Salisbury SR, Forman HP. “Rising use of CT in child visits to the emergency department in the United States, 1995–2008.” Radiology; 259(3): 793–801, 2011.
24- Adelgais KM, Browne L, Holsti M, Metzger RR, Murphy SC, Dudley N. “Cervical spine computed tomography utilization in pediatric trauma patients.” J Pediatr Surg; 49(2): 333–337, 2014.
25- Mettler Jr FA, Wiest PW, Locken JA, Kelsey CA. “CT scanning: patterns of use and dose.” J Radiol Prot; 20(4): 353, 2000.
26- Vassileva J, Rehani MM, Al-Dhuhli H, Al-Naemi HM, Al-Suwaidi JS, Appelgate K, et al. “IAEA survey of pediatric CT practice in 40 countries in Asia, Europe, Latin America, and Africa: Part 1, frequency and appropriateness.” Am J Roentgenol; 198(5): 1021–1031, 2012.
27- Alkhorayef M, Sulieman A, Alonazi B, Alnaaimi M, Alduaij M, Bradley D. “Estimation of radiation-induced cataract and cancer risks during routine CT head procedures.” Radiat Phys Chem; 155: 65–68, 2019.
28- Børretzen I, Lysdahl KB, Olerud HM. “Diagnostic radiology in Norway—trends in examination frequency and collective effective dose.” Radiat Prot Dosimetry; 124(4): 339–347, 2007.
29- Ohana O, Soffer S, Zimlichman E, Klang E. “Overuse of CT and MRI in paediatric emergency departments.” Br J Radiol; 91(1085): 20170434, 2018.
30- Sheppard JP, Nguyen T, Alkhalid Y, Beckett JS, Salamon N, Yang I. “Risk of brain tumor induction from pediatric head CT procedures: a systematic literature review.” Brain Tumor Res Treat; 6(1): 1, 2018.
31- Mehyar LS, Abu-Arja MH, Stanek JR, Elbeshlawi I, AbdelBaki MS. “The risk of developing secondary central nervous system tumors after diagnostic irradiation from computed tomography in pediatrics: a literature review.” Pediatr Neurol; 98: 18–24, 2019.
32- Meulepas JM, Ronckers CM, Smets AM, Nievelstein RA, Gradowska P, Lee C, et al. “Radiation exposure from pediatric CT scans and subsequent cancer risk in the Netherlands.” JNCI J Natl Cancer Inst; 111(3): 256–263, 2019.
33- Kharita MH, Al-Naemi H, Arru C, Omar AJ, Aly A, Tsalafoutas I, et al. “Relation between age and CT radiation doses: Dose trends in 705 pediatric head CT.” Eur J Radiol; 130: 109138, 2020.
34- Tsze DS, Asnis LM, Merchant RC, Amanullah S, Linakis JG. “Increasing computed tomography use for patients with appendicitis and discrepancies in pain management between adults and children: an analysis of the NHAMCS.” Ann Emerg Med; 59(5): 395–403, 2012.
35- Rezak A, Abbas HM, Ajemian MS, Dudrick SJ, Kwasnik EM. “Decreased use of computed tomography with a modified clinical scoring system in diagnosis of pediatric acute appendicitis.” Arch Surg; 146(1): 64–67, 2011.
36- Brenner DJ. “Should we be concerned about the rapid increase in CT usage?” Rev Environ Health; 25(1): 63, 2010.
37- Brenner DJ, Elliston CD, Hall EJ, Berdon WE. “Estimated risks of radiation-induced fatal cancer from pediatric CT.” Am J Roentgenol; 176(2): 289–296, 2001.
2- Davoudi M, Khoramian D, Abedi-Firouzjah R, Ataei G. Strategy of computed tomography image optimisation in cervical vertebrae and neck soft tissue in emergency patients. Radiat Prot Dosimetry; 187(1): 98–102, 2019.
3- Masoud Rezaeijo S, Abedi-Firouzjah R, Ghorvei M, Sarnameh S. “Screening of COVID-19 based on the extracted radiomics features from chest CT images.” J X-Ray Sci Technol; (Preprint): 1–15, 2021.
4- Rezaeijo SM, Ghorvei M, Abedi-Firouzjah R, Mojtahedi H, Zarch HE. “Detecting COVID-19 in chest images based on deep transfer learning and machine learning algorithms.” Egypt J Radiol Nucl Med; 52(1): 1–12, 2021.
5- Khoramian D, Sistani S, Firouzjah RA. Assessment and comparison of radiation dose and image quality in multi-detector CT scanners in non-contrast head and neck examinations. Pol J Radiol. 2019; 84: e61.
6- Tahmasebzadeh A, Paydar R, Soltani-Kermanshahi M, Maziar A, Reiazi R. “Lifetime attributable cancer risk related to prevalent CT scan procedures in pediatric medical imaging centers.” Int J Radiat Biol; 1–7, 2021.
7- Tahmasebzadeh A, Paydar R, Soltani kermanshahi M, Maziar A, Rezaei M, Reiazi R. “Pediatric Regional Drl Assessment in Common Ct Examinations For Medical Exposure Optimization in Tehran, Iran.” Radiat Prot Dosimetry; 192(3): 341–349, 2020.
8- Pola A, Corbella D, Righini A, Torresin A, Colombo PE, Vismara L, et al. “Computed tomography use in a large Italian region: trend analysis 2004-2014 of emergency and outpatient CT examinations in children and adults.” Eur Radiol;28(6): 2308–2318, 2018.
9- Trinavarat P, Pisuchpen N, Petcharunpaisan S, Sosothikul D, Deerojanawong J, Veeravigrom M, et al. “Appropriateness of pediatric CT utilization in clinical practice.” ASEAN J Radiol; 20(1):4–17, 2019.
10- Goldberg-Stein S, Liu B, Hahn PF, Lee SI. Body CT during pregnancy: utilization trends, examination indications, and fetal radiation doses. Am J Roentgenol; 196(1): 146–151, 2011.
11- Brenner DJ, Hall EJ. “Computed tomography—an increasing source of radiation exposure.” N Engl J Med; 357(22): 2277–2284, 2007.
12- Afzalipour R, Abdollahi H, Hajializadeh MS, Jafari S, Mahdavi SR. “Estimation of diagnostic reference levels for children computed tomography: A study in Tehran, Iran.” Int J Radiat Res; 17(3): 407–413, 2019.
13- Zacharias C, Alessio AM, Otto RK, Iyer RS, Philips GS, Swanson JO, et al. “Pediatric CT: strategies to lower radiation dose.” Am J Roentgenol; 200(5): 950–956, 2013.
14- Brody AS, Frush DP, Huda W, Brent RL. “Radiation risk to children from computed tomography.” Pediatrics; 120(3): 677–682, 2007.
15- “Commission E. Radiation protection 118: referral guidelines for imaging.” Luxemb Off Off Publ Eur Communities; p–19, 2001.
16- Shahi V, Brinjikji W, Cloft HJ, Thomas KB, Kallmes DF. “Trends in CT utilization for pediatric fall patients in US emergency departments.” Acad Radiol; 22(7): 898–903, 2015.
17- Dovales AC, Da Rosa LA, Kesminiene A, Pearce MS, Veiga LH. “Patterns and trends of computed tomography usage in outpatients of the Brazilian public healthcare system 2001–2011.” J Radiol Prot; 36(3): 547, 2016.
18- Brady Z, Forsythe AV, Mathews JD. “The changing use of pediatric CT in Australia.” Pediatr Radiol; 46(8): 1199–1208, 2016.
19- Roudsari BS, Psoter KJ, Vavilala MS, Mack CD, Jarvik JG. “CT use in hospitalized pediatric trauma patients: 15-year trends in a level I pediatric and adult trauma center.” Radiology; 267(2): 479–486, 2013.
20- Pearce MS, Salotti JA, McHugh K, Metcalf W, Kim KP, Craft AW, et al. “CT scans in young people in Northern England: trends and patterns 1993–2002.” Pediatr Radiol; 41(7): 832–838, 2011.
21- Prabhakar AM, Misono AS, Hemingway J, Hughes DR, Duszak Jr R. Medicare utilization of CT angiography from 2001 through 2014: continued growth by radiologists. J Vasc Interv Radiol; 27(10): 1554–1560, 2016.
22- Schunk JE, Rodgerson JD, Woodward GA. “The utility of head computed tomographic scanning in pediatric patients with normal neurologic examination in the emergency department.” Pediatr Emerg Care; 12(3): 160–165, 1996.
23- Larson DB, Johnson LW, Schnell BM, Goske MJ, Salisbury SR, Forman HP. “Rising use of CT in child visits to the emergency department in the United States, 1995–2008.” Radiology; 259(3): 793–801, 2011.
24- Adelgais KM, Browne L, Holsti M, Metzger RR, Murphy SC, Dudley N. “Cervical spine computed tomography utilization in pediatric trauma patients.” J Pediatr Surg; 49(2): 333–337, 2014.
25- Mettler Jr FA, Wiest PW, Locken JA, Kelsey CA. “CT scanning: patterns of use and dose.” J Radiol Prot; 20(4): 353, 2000.
26- Vassileva J, Rehani MM, Al-Dhuhli H, Al-Naemi HM, Al-Suwaidi JS, Appelgate K, et al. “IAEA survey of pediatric CT practice in 40 countries in Asia, Europe, Latin America, and Africa: Part 1, frequency and appropriateness.” Am J Roentgenol; 198(5): 1021–1031, 2012.
27- Alkhorayef M, Sulieman A, Alonazi B, Alnaaimi M, Alduaij M, Bradley D. “Estimation of radiation-induced cataract and cancer risks during routine CT head procedures.” Radiat Phys Chem; 155: 65–68, 2019.
28- Børretzen I, Lysdahl KB, Olerud HM. “Diagnostic radiology in Norway—trends in examination frequency and collective effective dose.” Radiat Prot Dosimetry; 124(4): 339–347, 2007.
29- Ohana O, Soffer S, Zimlichman E, Klang E. “Overuse of CT and MRI in paediatric emergency departments.” Br J Radiol; 91(1085): 20170434, 2018.
30- Sheppard JP, Nguyen T, Alkhalid Y, Beckett JS, Salamon N, Yang I. “Risk of brain tumor induction from pediatric head CT procedures: a systematic literature review.” Brain Tumor Res Treat; 6(1): 1, 2018.
31- Mehyar LS, Abu-Arja MH, Stanek JR, Elbeshlawi I, AbdelBaki MS. “The risk of developing secondary central nervous system tumors after diagnostic irradiation from computed tomography in pediatrics: a literature review.” Pediatr Neurol; 98: 18–24, 2019.
32- Meulepas JM, Ronckers CM, Smets AM, Nievelstein RA, Gradowska P, Lee C, et al. “Radiation exposure from pediatric CT scans and subsequent cancer risk in the Netherlands.” JNCI J Natl Cancer Inst; 111(3): 256–263, 2019.
33- Kharita MH, Al-Naemi H, Arru C, Omar AJ, Aly A, Tsalafoutas I, et al. “Relation between age and CT radiation doses: Dose trends in 705 pediatric head CT.” Eur J Radiol; 130: 109138, 2020.
34- Tsze DS, Asnis LM, Merchant RC, Amanullah S, Linakis JG. “Increasing computed tomography use for patients with appendicitis and discrepancies in pain management between adults and children: an analysis of the NHAMCS.” Ann Emerg Med; 59(5): 395–403, 2012.
35- Rezak A, Abbas HM, Ajemian MS, Dudrick SJ, Kwasnik EM. “Decreased use of computed tomography with a modified clinical scoring system in diagnosis of pediatric acute appendicitis.” Arch Surg; 146(1): 64–67, 2011.
36- Brenner DJ. “Should we be concerned about the rapid increase in CT usage?” Rev Environ Health; 25(1): 63, 2010.
37- Brenner DJ, Elliston CD, Hall EJ, Berdon WE. “Estimated risks of radiation-induced fatal cancer from pediatric CT.” Am J Roentgenol; 176(2): 289–296, 2001.
| Files | ||
| Issue | Vol 8 No 4 (2021) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/fbt.v8i4.7752 | |
| Keywords | ||
| X-Ray Computed Tomography Trends Ionizing Radiation Risk of Cancer | ||
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How to Cite
1.
Perota G, Masjedi H, Zamani H, Dalvand S, Omidi R, Razavi E, Rahbar S, Zare MH. Trends of Computed Tomography Scan Usage among Adults and Children in Yazd Province, Iran, before the Outbreak of COVID-19. Frontiers Biomed Technol. 2021;8(4):246-252.
