ESTIMATION OF THE CUMULATIVE EXPOSURE FREQUENCY AND CUMULATIVE EFFECTIVE DOSE OF DIAGNOSTIC MEDICAL RADIATION IN THE KOREAN POPULATION FROM 2002 TO 2010

Estimating the number of ≥100 mSv patients from CT, fluoroscopic guided interventions, and PET exams in 27 OECD countries

PURPOSE

To estimate the number of patients in 27 OECD (Organization for Economic Co-operation and Development) countries receiving a cumulative effective dose (CED) ≥100 mSv from recurrent imaging in computed tomography (CT), fluoroscopic guided intervention (FGI), and positron emission tomography (PET) examinations.

METHODS

CT and PET utilization and population data for 27 OECD countries were retrieved from a publicly available OECD 2022 report, and FGI utilization data from the European Commission 2015 Report. Data on the number of exams per patient of each modality and the prevalences of ≥100 mSv patients were extracted via a literature review and used to estimate the total number of imaging patients and ≥100 mSv patients in each country.

RESULTS

An estimated 1.36 million patients (0.27 %) received a dose ≥100 mSv among the 513 million residents of the 27 countries. One-third of the countries have more than 3 patients/1,000 population with ≥100 mSv dose in a 5-year period ranging from 1.09 (Finland) to 4.52 (Belgium). A linear trend between the number of ≥100 mSv patients and the total number of CTs in a country was observed, and this can be used for extrapolation at the regional or global level.

CONCLUSION

This is the first study estimating the number of patients who may have received CED ≥100 mSv through recurrent multimodality (CT, FGI, and PET) exams. With the number of such patients being large, a call for attention is needed from relevant national and international organizations.

The cumulative radiation dose paradigm in pediatric imaging

Medical imaging professionals have an accountability for both quality and safety in the care of patients that have unexpected or anticipated repeated imaging examinations that use ionizing radiation. One measure in the safety realm for repeated imaging is cumulative effective dose (CED). CED has been increasingly scrutinized in patient populations, including adults and children. Recognizing the challenges with effective dose, including the cumulative nature, effective dose is still the most prevalent exposure currency for recurrent imaging examinations. While the responsibility for dose monitoring incorporates an element of tracking an individual patient cumulative radiation record, a more complex aspect is what should be done with this information. This challenge also differs between the pediatric and adult population, including the fact that high cumulative doses (e.g.,>100 mSv) are reported to occur much less frequently in children than in the adult population. It is worthwhile, then, to review the general construct of CED, including the comparison between the relative percentage occurrence in adult and pediatric populations, the relevant pediatric medical settings in which high CED occurs, the advances in medical care that may affect CED determinations in the future, and offer proposals for the application of the CED paradigm, considering the unique aspects of pediatric care.

THE FREQUENCIES OF X-RAY EXAMINATIONS AND CT SCANS: FINDINGS FROM A SAMPLE INVESTIGATION IN JIANGSU, CHINA

OBJECTIVE

The present study was performed to evaluate the frequencies of two kinds of examinations using a proportional sample of 262 medical institutions and to observe the factors affecting the amount of examination-related exposure. The other aim of the present study was to observe the relationship between X-ray and CT frequency with GDP per capita, which could indicate the connection between medical exposure practice and economy.

METHODS

A random sample was taken from a pool of 316 medical institutions, and correlation analyses were performed to identify the factors affecting the amount of examination-related exposure. A representative sample of 262 medical institutions, proportional to the distribution of hospitals across grades, was used, and a multiple linear regression model was constructed.

RESULTS

The frequencies of X-ray examinations and CT scans were 523 per 1000 people and 223 per 1000 people, respectively. The two kinds of radio-diagnostic examinations showed different patterns in their relationships with GDP per capita. The factors correlated with the amounts of exposure due to the two kinds of examinations and the outpatient and equipment numbers showed distinctive patterns in the group of grade three institutions.

CONCLUSIONS

The improvement in the economy has caused a rapid increase in the use of radio-diagnostic examinations. The differences in factors correlated with the two types of examinations may stem from the workload statuses of CT scans and X-ray examinations in grade three hospitals.