COUNTERPOINT: Should Radiation Dose From CT Scans Be a Factor in Patient Care? No

Aims To benchmark the radiation dose to patients during the course of treatment for a spinal deformity. Methods Our radiation dose database identified 25,745 exposures of 6,017 children (under 18 years of age) and adults treated for a spinal deformity between 1 January 2008 and 31 December 2016. Patients were divided into surgical (974 patients) and non-surgical (5,043 patients) cohorts. We documented the number and doses of ionizing radiation imaging events (radiographs, CT scans, or intraoperative fluoroscopy) for each patient. All the doses for plain radiographs, CT scans, and intraoperative fluoroscopy were combined into a single effective dose by a medical physicist (milliSivert (mSv)). Results There were more ionizing radiation-based imaging events and higher radiation dose exposures in the surgical group than in the non-surgical group (p < 0.001). The difference in effective dose for children between the surgical and non-surgical groups was statistically significant, the surgical group being significantly higher (p < 0.001). This led to a higher estimated risk of cancer induction for the surgical group (1:222 surgical vs 1:1,418 non-surgical). However, the dose difference for adults was not statistically different between the surgical and non-surgical groups. In all cases the effective dose received by all cohorts was significantly higher than that from exposure to natural background radiation. Conclusion The treatment of spinal deformity is radiation-heavy. The dose exposure is several times higher when surgical treatment is undertaken. Clinicians should be aware of this and review their practices in order to reduce the radiation dose where possible.

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ESTIMATION OF ENTRANCE SURFACE RADIATION DOSE TO THYROID REGION IN COMPUTED TOMOGRAPHY BRAIN EXAMINATION

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v12i1.28932 ◽

2019 ◽

Vol 12 (1) ◽

pp. 121

Author(s):

Visakh T ◽

Suresh Sukumar ◽

Abhimanyu Pradhan

Keyword(s):

Computed Tomography ◽

Radiation Dose ◽

Maximum Dose ◽

Surface Radiation ◽

Ct Scans ◽

Surface Dose ◽

Brain Scan ◽

Convenience Sampling ◽

Ct Brain ◽

Brain Examination

Objective: The objective of this study was to estimate the entrance surface radiation dose to the thyroid region in a computed tomography (CT) brain scan.Methods: Unfors Multi-O-Meter equipment was used to measure the entrance surface at the thyroid region of adult patients ranging from 18 to 70 years of age. A total of 115 patients were included in the study based on convenience sampling. The Multi-O-Meter was kept at the thyroid region during the scan, and the values for entrance surface dose (ESD) were noted from its monitor after the scan was complete.Results: The obtained data were analyzed and violate normal distribution; therefore, the median and quartiles were computed. The overall median (Q1, Q2), ESD of the patients, was 1.335 (1.213, 1.529) mGy. The minimum and maximum dose values recorded were 1.015 mGy and 1.964 mGy, respectively.Conclusions: The result showed a significant amount of entrance surface radiation dose to the thyroid region while taking a brain scan. This data can be used for optimization of radiation protection while undergoing CT scans of brain to reduce exposure to thyroid region.

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Is the Additional Effort for an Intraoperative CT Scan Justified for Distal Radius Fracture Fixations? A Comparative Clinical Feasibility Study

Journal of Clinical Medicine ◽

10.3390/jcm9072254 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2254 ◽

Cited By ~ 1

Author(s):

Sascha Halvachizadeh ◽

Till Berk ◽

Alexander Pieringer ◽

Emanuael Ried ◽

Florian Hess ◽

...

Keyword(s):

Surgical Treatment ◽

Radiation Dose ◽

Ct Scan ◽

Distal Radius ◽

Distal Radius Fractures ◽

Ct Scans ◽

Radius Fractures ◽

Ao Classification ◽

Intraoperative Ct ◽

Duration Of Surgery

Introduction: It is currently unclear whether the additional effort to perform an intraoperative computed tomography (CT) scan is justified for articular distal radius fractures (DRFs). The purpose of this study was to assess radiological, functional, and clinical outcomes after surgical treatment of distal radius fractures when using conventional fluoroscopy vs. intraoperative CT scans. Methods: Inclusion criteria: Surgical treatment of DRF between 1 January 2011 and 31 December 2011, age 18 and above. Group distribution: intraoperative conventional fluoroscopy (Group Conv) or intraoperative CT scans (Group CT). Exclusion criteria: Use of different image intensifier devices or incomplete data. DRF classification according to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification. Outcome variables included requirement of revision surgeries, duration of surgery, absorbed radiation dose, and requirement of additional CT scans during hospitalization. Results: A total of 187 patients were included (Group Conv n = 96 (51.3%), Group CT n = 91 (48.7%)). AO Classification: Type A fractures n = 40 (50%) in Group Conv vs. n = 16 (17.6%) in Group CT, p < 0.001; Type B: 10 (10.4%) vs. 11 (12.1%), not significant (n.s.); Type C: 38 (39.6%) vs. 64 (70.3%), p < 0.001. In Group Conv, four (4.2%) patients required revision surgeries within 6 months, but in Group CT no revision surgery was required. The CT scan led to an intraoperative screw exchange/reposition in 23 (25.3%) cases. The duration of the initial surgery (81.7 ± 46.4 min vs. 90.1 ± 43.6 min, n.s.) was comparable. The radiation dose was significantly higher in Group CT (6.9 ± 1.3 vs. 2.8 ± 7.8 mGy, p < 0.001). In Group Conv, 11 (11.5%) patients required additional CT scans during hospitalization. Conclusion: The usage of intraoperative CT was associated with improved reduction and more adequate positioning of screws postoperatively with comparable durations of surgery. Despite increased efforts by utilizing the intraoperative CT scan, the decrease in reoperations may justify its use.

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