Evaluation of Cancer Risk Induced by Radiation Exposure from Normal Head CT Scans
-
Golshan Mohmoudi
,
Ali Bahrami
,
Nima Rostampour
,
Reza Maskani
,
Farzaneh Joukar
,
Ali Hosseinzadeh
Abstract
Purpose: Radiology examinations are growing significantly every year. Analysis of the CT scan reports can highlight defects and is a good way to develop safety in healthcare. This study aimed to evaluate the rate of normal head Computed Tomography (CT) scans at a hospital radiology department in Shahroud and estimate the cancer risk associated with these normal CT scans.
Materials and Methods: In total, the data of 400 patients referred to the emergency radiology center of Imam Hossein hospital in Shahroud from November 23 to December 10, 2021, were collected. CT scan reports were categorized into three groups according to the interpretation of the radiologist. The BEIR VII model was used to estimate the radiation cancer risk.
Results: Among the 400 patients, 248 (62%) were males and the average age of the patients was 49.05 ± 22.60 years. CT scans in 270 (67.5%) cases were reported normal. The average age of the patients with normal, and abnormal CT scans were 41.86 ± 20.27, and 63.03 ± 20.27 years, respectively and the difference was significant (p-value <0.001). The average effective dose was obtained 1.72±0.09, 1.31±0.11, and 0.87±0.09 mSv for different age groups of 1-5, 5-10, >10-year-old. The average risks of all solid cancers were 7.82 cases per 100,000 patients, while the average risk of leukemia was 0.71 cases per 100,000 patients.
Conclusion: A large percentage of CT examinations are normal in our country which leads to many public health issues in the future years. Therefore, efforts should be made to establish predictor clinical factors to reduce unnecessary radiology examinations.
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25- R. W. Gimbel et al., "Radiation exposure and cost influence physician medical image decision making: a randomized controlled trial." (in eng), Med Care, Vol. 51 (No. 7), pp. 628-32, Jul (2013).
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27- A. B. Syed and A. C. Zoga, "Artificial Intelligence in Radiology: Current Technology and Future Directions." (in eng), Semin Musculoskelet Radiol, Vol. 22 (No. 5), pp. 540-45, Nov (2018).
28- Markus Kopp et al., "Individual Calculation of Effective Dose and Risk of Malignancy Based on Monte Carlo Simulations after Whole Body Computed Tomography." Scientific Reports, Vol. 10 (No. 1), p. 9475, 2020/06/11 (2020).
29- Patrick D. McLaughlin et al., "Body composition determinants of radiation dose during abdominopelvic CT." Insights into Imaging, Vol. 9 (No. 1), pp. 9-16, 2018/02/01 (2018).
30- Y. Inoue, H. Itoh, A. Waga, R. Sasa, and K. Mitsui, "Radiation Dose Management in Pediatric Brain CT According to Age and Weight as Continuous Variables." (in eng), Tomography, Vol. 8 (No. 2), pp. 985-98, Apr 1 (2022).
31- G. Compagnone et al., "Provision of Italian diagnostic reference levels for diagnostic and interventional radiology." (in eng), Radiol Med, Vol. 126 (No. 1), pp. 99-105, Jan (2021).
32- E. J. Hall, "Lessons we have learned from our children: cancer risks from diagnostic radiology." (in eng), Pediatr Radiol, Vol. 32 (No. 10), pp. 700-6, Oct (2002).
33- W. R. Hendee and M. K. O'Connor, "Radiation risks of medical imaging: separating fact from fantasy." (in eng), Radiology, Vol. 264 (No. 2), pp. 312-21, Aug (2012).
34- M. K. O'Connor, "Risk of low-dose radiation and the BEIR VII report: A critical review of what it does and doesn't say." (in eng), Phys Med, Vol. 43pp. 153-58, Nov (2017).
2- Ali Tarighatnia, Gurkaran Johal, Ayuob Aghanejad, Hossein Ghadiri, and Nader Nader, "Tips and Tricks in Molecular Imaging." Frontiers in Biomedical Technologies, Vol. 8 (No. 3), 09/01 (2021).
3- Syed Gilani, Saba Mushtaq, Sajid Malik, and Baneen Baneen, "To Determine the Frequency of Unnecessary Computed Tomography Scan Occurring in a Tertiary Care Hospital." Saudi medical journal, Vol. 3pp. 160-65, 10/30 (2018).
4- Aida Khaleghi Fard, Amir Hossein Mohammad Alian, Leili Pourafkari, Morteza Ghojazadeh, Ali Tarighatnia, and Alireza Farajollahi, "Impact of pelvic and rad-board lead shields on operator and patient radiation dose in trans-radial coronary procedures." Radiation Protection Dosimetry, Vol. 187 (No. 1), pp. 108-14, (2019).
5- Husam H Mansour, Yasser S Alajerami, and Thomas Foster, "Estimation of Radiation Doses and Lifetime Attributable Risk of Radiation-induced Cancer from A Single Coronary Artery Bypass Graft Computed Tomography Angiography." J Electronic Journal of General Medicine, Vol. 18 (No. 6), (2021).
6- Mohamad Bagher Tavakoli, K. Heydari, and Salman Jafari, "Evaluation of Diagnostic Reference Levels for CT scan in Isfahan." (2014).
7- F. A. Mettler, Jr., P. W. Wiest, J. A. Locken, and C. A. Kelsey, "CT scanning: patterns of use and dose." (in eng), J Radiol Prot, Vol. 20 (No. 4), pp. 353-9, Dec (2000).
8- C. H. Schultz, R. Fairley, L. S. Murphy, and M. Doss, "The Risk of Cancer from CT Scans and Other Sources of Low-Dose Radiation: A Critical Appraisal of Methodologic Quality." (in eng), Prehosp Disaster Med, Vol. 35 (No. 1), pp. 3-16, Feb (2020).
9- E. P. Hess, L. R. Haas, N. D. Shah, R. J. Stroebel, C. R. Denham, and S. J. Swensen, "Trends in computed tomography utilization rates: a longitudinal practice-based study." (in eng), J Patient Saf, Vol. 10 (No. 1), pp. 52-8, Mar (2014).
10- C. Ghetti, O. Ortenzia, M. Maddalo, L. Altabella, and N. Sverzellati, "Dosimetric and radiation cancer risk evaluation of high resolution thorax CT during COVID-19 outbreak." (in eng), Phys Med, Vol. 80pp. 119-24, Dec (2020).
11- John D Mathews et al., "Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians." Vol. 346p. f2360, (2013).
12- (June 4, 2022). What are the Radiation Risks from CT? [Online]. Available: https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/what-are-radiation-risks-ct.
13- Amy Berrington de González et al., "Projected cancer risks from computed tomographic scans performed in the United States in 2007." (in eng), Archives of internal medicine, Vol. 169 (No. 22), pp. 2071-77, (2009).
14- "The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103." (in eng), Ann ICRP, Vol. 37 (No. 2-4), pp. 1-332, (2007).
15- T. Tarkiainen, M. Haapea, E. Liukkonen, O. Tervonen, M. Turpeinen, and J. Niinimäki, "Adverse events due to unnecessary radiation exposure in medical imaging reported in Finland." (in eng), Radiography (Lond), Vol. 26 (No. 4), pp. e195-e200, Nov (2020).
16- C. Martins, M. Godycki-Cwirko, B. Heleno, and J. Brodersen, "Quaternary prevention: reviewing the concept." (in eng), Eur J Gen Pract, Vol. 24 (No. 1), pp. 106-11, Dec (2018).
17- Mehmet Kilin, Evrim Ozmen, and Oktay Algin, "Unnecessary computed tomography and magnetic resonance imaging rates in a tertiary care hospital." The European Research Journal, 11/30 (2016).
18- M. Wasay, N. Dubey, and R. Bakshi, "Dizziness and yield of emergency head CT scan: is it cost effective?" (in eng), Emerg Med J, Vol. 22 (No. 4), p. 312, Apr (2005).
19- M. Haghighi, M. H. Baghery, F. Rashidi, Z. Khairandish, and M. Sayadi, "Abnormal Findings in Brain CT Scans Among Children." (in en %J), Research Article Vol. 5 (No. 2), p. e13761, (2014).
20- Ali Chaparian, Jamshid Shoushtarian, Zahra Sadeghi, Somaieh Soosani, Mahshid Sabaghm, and Elham Askarieh, "Evaluating the Justification of Computed Tomography (CT) Scan Requests to Reduce the Risk of Radiation-Induced Cancers." (in Fa), Journal Of Isfahan Medical School, Vol. 36 (No. 477), pp. 433-38, (2018).
21- Hadi Moradi et al., "Evaluating the Necessity and Radiation Risk of Brain CT Scans Requested by the Trauma Emergency Department." Journal of Biomedical Physics and Engineering, pp. -, (2021).
22- National Research Council, Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2. Washington, DC: The National Academies Press, (2006), p. 422.
23- C. Schoeneberg, M. D. Kauther, B. Hussmann, J. Keitel, D. Schmitz, and S. Lendemans, "Gender-specific differences in severely injured patients between 2002 and 2011: data analysis with matched-pair analysis." (in eng), Crit Care, Vol. 17 (No. 6), p. R277, Nov 29 (2013).
24- I. Gunes Tatar, H. Aydin, V. Kizilgoz, K. B. Yilmaz, and B. Hekimoglu, "Appropriateness of selection criteria for CT examinations performed at an emergency department." (in eng), Emerg Radiol, Vol. 21 (No. 6), pp. 583-8, Dec (2014).
25- R. W. Gimbel et al., "Radiation exposure and cost influence physician medical image decision making: a randomized controlled trial." (in eng), Med Care, Vol. 51 (No. 7), pp. 628-32, Jul (2013).
26- Christopher Bent, Paul S. Lee, Peter Y. Shen, Heejung Bang, and Mathew Bobinski, "Clinical scoring system may improve yield of head CT of non-trauma emergency department patients." (in eng), Emerg Radiol, Vol. 22 (No. 5), pp. 511-16, (2015).
27- A. B. Syed and A. C. Zoga, "Artificial Intelligence in Radiology: Current Technology and Future Directions." (in eng), Semin Musculoskelet Radiol, Vol. 22 (No. 5), pp. 540-45, Nov (2018).
28- Markus Kopp et al., "Individual Calculation of Effective Dose and Risk of Malignancy Based on Monte Carlo Simulations after Whole Body Computed Tomography." Scientific Reports, Vol. 10 (No. 1), p. 9475, 2020/06/11 (2020).
29- Patrick D. McLaughlin et al., "Body composition determinants of radiation dose during abdominopelvic CT." Insights into Imaging, Vol. 9 (No. 1), pp. 9-16, 2018/02/01 (2018).
30- Y. Inoue, H. Itoh, A. Waga, R. Sasa, and K. Mitsui, "Radiation Dose Management in Pediatric Brain CT According to Age and Weight as Continuous Variables." (in eng), Tomography, Vol. 8 (No. 2), pp. 985-98, Apr 1 (2022).
31- G. Compagnone et al., "Provision of Italian diagnostic reference levels for diagnostic and interventional radiology." (in eng), Radiol Med, Vol. 126 (No. 1), pp. 99-105, Jan (2021).
32- E. J. Hall, "Lessons we have learned from our children: cancer risks from diagnostic radiology." (in eng), Pediatr Radiol, Vol. 32 (No. 10), pp. 700-6, Oct (2002).
33- W. R. Hendee and M. K. O'Connor, "Radiation risks of medical imaging: separating fact from fantasy." (in eng), Radiology, Vol. 264 (No. 2), pp. 312-21, Aug (2012).
34- M. K. O'Connor, "Risk of low-dose radiation and the BEIR VII report: A critical review of what it does and doesn't say." (in eng), Phys Med, Vol. 43pp. 153-58, Nov (2017).
| Files | ||
| Issue | Vol 10 No 3 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/fbt.v10i3.13154 | |
| Keywords | ||
| Head Computed Tomography Scan Unnecessary Radiology Examination Radiation Cancer Risk | ||
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How to Cite
1.
Mohmoudi G, Bahrami A, Rostampour N, Maskani R, Joukar F, Hosseinzadeh A. Evaluation of Cancer Risk Induced by Radiation Exposure from Normal Head CT Scans. Frontiers Biomed Technol. 2023;10(3):259-267.
