radiation exposure
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Epidemiology
- USA residents receive approximately 3 mSv annually from background environmental radiation
- healthcare workers who are exposed to radiation are restricted to a total of 100 mSv every 5 years
- largest contributions to cumulative radiation doses include computed tomography of the abdomen & pelvis (30%), myocardial perfusion imaging (22%), & CT of the chest (8%)
- abdominal CT delivers 50-fold more radiation than plain films[7]
- routine chest CT delivers 400-fold more radiation than plain films[5]
- high-resolution chest CT delivers 43-fold more radiation than plain films[5]
- low-dose chest CT delivers 33-fold more radiation than plain films[5]
- exposure to about 9-10 mSv of radiation with CT of the neck, chest, abdomen, or pelvis[4]
- coronary angiography (diagnostic) delivers 200-500 fold more radiation than chest X-ray[5]
- myocardial perfusion study delivers 100-500 fold more radiation than chest X-ray[5]
- CT angiography delivers 700-2100 fold more radiation than chest X-ray[5]
- positron emission tomography of the heart delivers 100-400 fold more radiation than chest X-ray[5]
- FDG-PET/CT of thorax delivers 800 fold more radiation than chest X-ray[5]
- coronary artery calcium delivers 20-40 fold more radiation than chest X-ray[5]
- magnetic resonance imaging & echocardiography do not result in signficant exposure to radiation[5]
- radiation exposure from diagnostic imaging has doubled from 1996-2010[6]
- children who undergo complex heart surgery receive substantial radiation
- ~ 20 mSv with the Norwood operation
- ~ 43 mSv with cardiac transplantation
- increased risk for cancer later in life
- breast cancer, thyroid cancer
- risk higher for girls than boys[7]
Complications
- 1 cancer per 1000 patients receiving 10 mSv of radiation[4]
- radiation exposure from CT may cause 1.5-2% of cancers in USA[2]
- no safe dose; thus benefits of procedure must be weighed against risks[1]
- predicted to be responsible for 2% of future cancers
More general terms
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Additional terms
References
- ↑ Jump up to: 1.0 1.1 Fazel R et al. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med 2009 Aug 27; 361:849. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19710483
- ↑ Jump up to: 2.0 2.1 Brenner DJ and Hall EJ Computed tomography - An increasing source of radiation exposure. N Engl J Med 2007, 357:2277 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18046031
- ↑ FDA MedWatch http://www.fda.gov/medwatch/safety/2008/safety08.htm#ElectronicMedical
- ↑ Jump up to: 4.0 4.1 4.2 Griffey RT and Sodickson A. Cumulative radiation exposure and cancer risk estimates in emergency department patients undergoing repeat or multiple CT. AJR Am J Roentgenol 2009 Apr; 192:887. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19304691
- ↑ Jump up to: 5.00 5.01 5.02 5.03 5.04 5.05 5.06 5.07 5.08 5.09 5.10 Medical Knowledge Self Assessment Program (MKSAP) 15, 17. American College of Physicians, Philadelphia 2009, 2015
- ↑ Jump up to: 6.0 6.1 Smith-Bindman R et al. Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996-2010. JAMA 2012 Jun 13; 307:2400 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22692172 <Internet> http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2012.5960
O'Connor GT and Hatabu H. Lung cancer screening, radiation, risks, benefits, and uncertainty. JAMA 2012 Jun 13; 307:2434. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22692175 <Internet> http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2012.6096 - ↑ Jump up to: 7.0 7.1 7.2 Johnson JN et al Cumulative Radiation Exposure and Cancer Risk Estimation in Children with Heart Disease. Circulation. June 9, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24914037 <Internet> http://circ.ahajournals.org/content/early/2014/05/08/CIRCULATIONAHA.113.005425.abstract
Andreassi MG and Picano E Reduction of Radiation to Children: Our Responsibility to Change. Circulation. June 9, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24914036 <Internet> http://circ.ahajournals.org/content/early/2014/05/08/CIRCULATIONAHA.114.010699.abstract - ↑ Jump up to: 8.0 8.1 Fazel R et al Approaches to Enhancing Radiation Safety in Cardiovascular Imaging: A Scientific Statement From the American Heart Association. Circulation. September 29, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25366837 <Internet> http://circ.ahajournals.org/content/early/2014/09/29/CIR.0000000000000048.full.pdf+html
- ↑ Sarma A, Heilbrun ME, Conner KE et al Radiation and chest CT scan examinations: what do we know? Chest. 2012 Sep;142(3):750-60. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22948579
- ↑ National Cancer Institute Radiation https://www.cancer.gov/about-cancer/causes-prevention/risk/radiation3