Cumulative radiation exposure estimates of hospitalized patients from radiological imaging

Arielle C. Lutterman, Courtney C. Moreno, Pardeep Kumar Mittal, Jian Kang, Kimberly E. Applegate

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose To examine the use of inpatient diagnostic imaging and image-guided procedures to estimate cumulative radiation exposure, radiation exposure based on imaging modality, and compare estimated doses based on patient demographics including age, gender, and diagnoses. Methods Two hundred consecutive hospitalized adult patients who underwent diagnostic imaging studies at 2 large, affiliated hospitals were identified, and every study in each patient's electronic record that took place during a single hospitalization was reviewed. Dose estimates were calculated for each CT, fluoroscopy, nuclear medicine, plain film, and interventional radiology study or procedure based on reported dose length product, published reference values, and conversion factors. Medical records were reviewed to determine patient gender, age, diagnoses, length of stay, admitting service, and time in an intensive care unit (ICU). Results Two hundred inpatients (46.5% male; mean age, 60.4 years) underwent 2,751 imaging studies (79.3% radiographs, 9.7% CT, 6.1% ultrasound, 2.5% interventional radiology, 2.2% MRI, 0.4% nuclear medicine). The mean dose estimate per patient was 14.8 milliSieverts (mSv) and the range was 0 mSv to 130.5 mSv. Mean cumulative dose estimates were significantly higher for patients whose hospitalizations included time in an ICU (17.9 mSv versus 11.3 mSv [P =.01]). CT examinations accounted for 82.1% of the total radiation dose estimate. Eleven patients (5.5%) received radiation dose estimates ≥50 mSv, including 2 ≥100 mSv. Conclusions Of imaged inpatients, 62% underwent at least 1 CT and the majority (82.1%) of inpatient radiation exposure was attributable to CT examinations. Mean dose estimate was 14.8 mSv per patient; 5.5% of patients experienced estimated doses ≥50 mSv.

Original languageEnglish (US)
Pages (from-to)169-175
Number of pages7
JournalJournal of the American College of Radiology
Volume11
Issue number2
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Inpatients
Interventional Radiology
Nuclear Medicine
Diagnostic Imaging
Intensive Care Units
Hospitalization
Radiation
Radiation Exposure
Fluoroscopy
Motion Pictures
Medical Records
Length of Stay
Reference Values
Demography

Keywords

  • CT
  • Imaging utilization
  • cumulative
  • hospitalization
  • inpatients
  • radiation exposure

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Cumulative radiation exposure estimates of hospitalized patients from radiological imaging. / Lutterman, Arielle C.; Moreno, Courtney C.; Mittal, Pardeep Kumar; Kang, Jian; Applegate, Kimberly E.

In: Journal of the American College of Radiology, Vol. 11, No. 2, 01.01.2014, p. 169-175.

Research output: Contribution to journalArticle

Lutterman, Arielle C. ; Moreno, Courtney C. ; Mittal, Pardeep Kumar ; Kang, Jian ; Applegate, Kimberly E. / Cumulative radiation exposure estimates of hospitalized patients from radiological imaging. In: Journal of the American College of Radiology. 2014 ; Vol. 11, No. 2. pp. 169-175.
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abstract = "Purpose To examine the use of inpatient diagnostic imaging and image-guided procedures to estimate cumulative radiation exposure, radiation exposure based on imaging modality, and compare estimated doses based on patient demographics including age, gender, and diagnoses. Methods Two hundred consecutive hospitalized adult patients who underwent diagnostic imaging studies at 2 large, affiliated hospitals were identified, and every study in each patient's electronic record that took place during a single hospitalization was reviewed. Dose estimates were calculated for each CT, fluoroscopy, nuclear medicine, plain film, and interventional radiology study or procedure based on reported dose length product, published reference values, and conversion factors. Medical records were reviewed to determine patient gender, age, diagnoses, length of stay, admitting service, and time in an intensive care unit (ICU). Results Two hundred inpatients (46.5{\%} male; mean age, 60.4 years) underwent 2,751 imaging studies (79.3{\%} radiographs, 9.7{\%} CT, 6.1{\%} ultrasound, 2.5{\%} interventional radiology, 2.2{\%} MRI, 0.4{\%} nuclear medicine). The mean dose estimate per patient was 14.8 milliSieverts (mSv) and the range was 0 mSv to 130.5 mSv. Mean cumulative dose estimates were significantly higher for patients whose hospitalizations included time in an ICU (17.9 mSv versus 11.3 mSv [P =.01]). CT examinations accounted for 82.1{\%} of the total radiation dose estimate. Eleven patients (5.5{\%}) received radiation dose estimates ≥50 mSv, including 2 ≥100 mSv. Conclusions Of imaged inpatients, 62{\%} underwent at least 1 CT and the majority (82.1{\%}) of inpatient radiation exposure was attributable to CT examinations. Mean dose estimate was 14.8 mSv per patient; 5.5{\%} of patients experienced estimated doses ≥50 mSv.",
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