A family of statistical distributions for modelling occupational radiation doses in low dose occupations

Magnetic resonance imaging (MRI) is the mainstay method for the radiological imaging of the small bowel in patients with inflammatory bowel disease without the use of ionizing radiation. There are circumstances where imaging using ionizing radiation is required, particularly in the acute setting. This usually takes the form of computed tomography (CT). There has been a significant increase in the utilization of computed tomography (CT) for patients with Crohn’s disease as patients are frequently diagnosed at a relatively young age and require repeated imaging. Between seven and eleven percent of patients with IBD are exposed to high cumulative effective radiation doses (CEDs) (>35–75 mSv), mostly patients with Crohn’s disease (Newnham E 2007, Levi Z 2009, Hou JK 2014, Estay C 2015). This is primarily due to the more widespread and repeated use of CT, which accounts for 77% of radiation dose exposure amongst patients with Crohn’s disease (Desmond et al., 2008). Reports of the projected cancer risks from the increasing CT use (Berrington et al., 2007) have led to increased patient awareness regarding the potential health risks from ionizing radiation (Coakley et al., 2011). Our responsibilities as physicians caring for these patients include education regarding radiation risk and, when an investigation that utilizes ionizing radiation is required, to keep radiation doses as low as reasonably achievable: the “ALARA” principle. Recent advances in CT technology have facilitated substantial radiation dose reductions in many clinical settings, and several studies have demonstrated significantly decreased radiation doses in Crohn’s disease patients while maintaining diagnostic image quality. However, there is a balance to be struck between reducing radiation exposure and maintaining satisfactory image quality; if radiation dose is reduced excessively, the resulting CT images can be of poor quality and may be nondiagnostic. In this paper, we summarize the available evidence related to imaging of Crohn’s disease, radiation exposure, and risk, and we report recent advances in low-dose CT technology that have particular relevance.

Download Full-text

Assessing the health effects associated with occupational radiation exposure in Korean radiation workers: protocol for a prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2017-017359 ◽

2018 ◽

Vol 8 (3) ◽

pp. e017359 ◽

Cited By ~ 4

Author(s):

Songwon Seo ◽

Wan Young Lim ◽

Dal Nim Lee ◽

Jung Un Kim ◽

Eun Shil Cha ◽

...

Keyword(s):

Cohort Study ◽

Cancer Risk ◽

Radiation Exposure ◽

Health Effects ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Low Dose ◽

Occupational Radiation Exposure ◽

Radiation Workers ◽

Occupational Radiation

IntroductionThe cancer risk of radiation exposure in the moderate-to-high dose range has been well established. However, the risk remains unclear at low-dose ranges with protracted low-dose rate exposure, which is typical of occupational exposure. Several epidemiological studies of Korean radiation workers have been conducted, but the data were analysed retrospectively in most cases. Moreover, groups with relatively high exposure, such as industrial radiographers, have been neglected. Therefore, we have launched a prospective cohort study of all Korean radiation workers to assess the health effects associated with occupational radiation exposure.Methods and analysisApproximately 42 000 Korean radiation workers registered with the Nuclear Safety and Security Commission from 2016 to 2017 are the initial target population of this study. Cohort participants are to be enrolled through a nationwide self-administered questionnaire survey between 24 May 2016 and 30 June 2017. As of 31 March 2017, 22 982 workers are enrolled in the study corresponding to a response rate of 75%. This enrolment will be continued at 5-year intervals to update information on existing study participants and recruit newly hired workers. Survey data will be linked with the national dose registry, the national cancer registry, the national vital statistics registry and national health insurance data via personal identification numbers. Age-specific and sex-specific standardised incidence and mortality ratios will be calculated for overall comparisons of cancer risk. For dose–response assessment, excess relative risk (per Gy) and excess absolute risk (per Gy) will be estimated with adjustments for birth year and potential confounders, such as lifestyle factors and socioeconomic status.Ethics and disseminationThis study has received ethical approval from the institutional review board of the Korea Institute of Radiological and Medical Sciences (IRB No. K-1603-002-034). All participants provided written informed consent prior to enrolment. The findings of the study will be disseminated through scientific peer-reviewed journals and be provided to the public, including radiation workers, via the study website (http://www.rhs.kr/) and onsite radiation safety education.

Download Full-text

Low-dose CT scan screening for lung cancer: comparison of images and radiation doses between low-dose CT and follow-up standard diagnostic CT

SpringerPlus ◽

10.1186/2193-1801-2-393 ◽

2013 ◽

Vol 2 (1) ◽

Cited By ~ 14

Author(s):

Koji Ono ◽

Toru Hiraoka ◽

Asami Ono ◽

Eiji Komatsu ◽

Takehiko Shigenaga ◽

...

Keyword(s):

Lung Cancer ◽

Ct Scan ◽

Low Dose ◽

Radiation Doses ◽

Low Dose Ct ◽

Diagnostic Ct

Download Full-text

Low-Dose-Rate Irradiation for 1 Hour Induces Protection Against Lethal Radiation Doses but Does Not Affect Life Span of DBA/2 Mice

Dose-Response ◽

10.1177/1559325816673901 ◽

2016 ◽

Vol 14 (4) ◽

pp. 155932581667390 ◽

Cited By ~ 3

Author(s):

Nina Frederike Jeppesen Edin ◽

Čestmír Altaner ◽

Veronika Altanerova ◽

Peter Ebbesen ◽

Erik O. Pettersen

Keyword(s):

Life Span ◽

Dose Rate ◽

Low Dose ◽

Radiation Doses ◽

Low Dose Rate

Download Full-text

P6551Evaluation of a new ultra low-dose radiation protocol during electrophysiological device implantation

European Heart Journal ◽

10.1093/eurheartj/ehz746.1141 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M Eichenlaub ◽

K Astheimer ◽

C Restle ◽

C Maring ◽

T Blum ◽

...

Keyword(s):

Low Dose ◽

De Novo ◽

Cardiac Resynchronisation Therapy ◽

Radiation Doses ◽

Procedure Time ◽

Low Dose Radiation ◽

Dose Area Product ◽

Device Implantation ◽

The Impact ◽

Dose Radiation

Abstract Objectives The aim of this study was to evaluate the impact of a new ultra low-dose radiation protocol on radiation doses, feasibility and safety during electrophysiological device implantation. Background Radiation is one of the main hazards during electrophysiological procedures. Shielding is especially difficult during device implantation and particularly implantation of cardiac resynchronisation therapy devices (CRT) is associated with high radiation doses. Methods From January 2005 to January 2019, 8612 patients underwent de novo device implantation at our University Heart Center. During 2018, we established a new ultra low-dose radiation protocol and compared 661 patients who were treated during 2017 utilizing the conventional low-dose protocol with 512 patients after the application of the new program (11.5% one-chamber devices, 68.5% two-chamber devices and 19.9% CRT). Results After establishment of the radiation reduction protocol, dose area products could be reduced by 62% and the effective doses by 59% (113 (47–292) vs. 43 (14–130) cGycm2, p<0.0001 and 0.25 (0.11–0.63) vs. 0.10 (0.03–0.28) mSv, p<0.0001). These results could be achieved without prolonging procedure time, increasing complication and decreasing success rate. Male gender, higher BMI, longer procedure and fluoroscopy duration and the use of the conventional radiation protocol were statistically significant factors for the need of higher radiation doses in multivariate regression analysis. Clinical and procedural characteristics All (n=1173) Group pre (n=661) Group post (n=512) P Age, years 77 (69–82) 77 (69–82) 77 (69–83) 0.6 Male, n (%) 726 (62) 403 (61) 323 (63) 0.5 Body mass index, kg/m2 26.6 (24–29.8) 26.6 (24–29.8) 26.4 (24–29.4) 0.5 Procedure time, minutes 35 (25–50) 37 (26–50) 35 (25–54.5) 0.5 Fluoroscopy time, minutes 3.7 (2–7.8) 4 (2–7.8) 3.4 (1.9–7.7) 0.07 Dose area product, cGy cm2 80 (28–228) 113 (47–292) 43 (14–130) <0.0001 Effective dose, mSv 0.18 (0.06–0.51) 0.25 (0.11–0.63) 0.1 (0.03–0.28) <0.0001 Complications, n (%) 11 (0.9) 7 (1.1) 4 (0.8) 0.8 Conclusions Radiation exposure during electrophysiological device implantation has been continuously reduced over the last years. By establishing a new ultra low-dose radiation protocol, we could further decrease the radiation dose significantly and reach the lowest radiation values published so far. This protocol can easily be implemented in the workflow of other hospitals and should become standard during implantation procedures.

Download Full-text