Arielle C Lutterman MD, Presenter: Nothing to Disclose

Courtney Ann Coursey MD, Abstract Co-Author: Research support, Becton, Dickinson and Company

Jian Kang PhD, Abstract Co-Author: Nothing to Disclose

William C. Small MD, PhD, Abstract Co-Author: Nothing to Disclose

Pardeep Kumar Mittal MD, Abstract Co-Author: Nothing to Disclose

Kimberly E. Applegate MD, MS, Abstract Co-Author: Nothing to Disclose

To determine per patient estimated cumulative radiation dose estimates in a cohort of 200 hospitalized adult patients due to diagnostic imaging and image-guided procedures during a single hospitalization.

Inpatient imaging worklists for two urban university hospitals on October 1, 2010 were reviewed and the first 100 inpatients imaged that day at each institution were identified. Every study in each patient's electronic film jacket was reviewed and recorded for the hospitalization spanning October 1, 2010. Dose estimates were calculated for each CT, fluoroscopy, nuclear medicine, plain film and interventional radiology study based on recorded DLP values, published reference values, and conversion factors. Medical records were reviewed to identify each patient’s diagnoses, demographic data, length of hospital stay, hospital service, and time in an intensive care unit (ICU). One way ANOVA models were used to evaluate the association between demographic variables and cumulative dose estimates.  

200 patients (46.5% male, mean age 60.41) underwent 2739 imaging studies and image-guided procedures (79.4% x-ray, 9.7% CT, 6.2% US, 2.5% interventional radiology, 2.2% MRI, 0.2% nuclear medicine). The mean dose estimate per patient for one hospitalization was 14.76 mSv. CT examinations comprised 9.7% of the total studies, but accounted for 81.7% of the total radiation dose estimate. Two-thirds of the study population received at least one CT scan, and 16% received at least 3 scans. Nine patients received radiation doses >50 mSv, and two patients received >100 mSv. Mean cumulative dose estimates were not statistically significantly different for gender, age, or hospital service, but were statistically significantly higher for patients whose hospitalizations included time in an ICU.  

Two-thirds of hospitalized patients received CT scanning. The majority (82%) of inpatient radiation exposure was attributable to CT scans. It is imperative that physicians critically evaluate the necessity of imaging tests, routinely consider cumulative radiation doses, and optimize scan parameters to minimize radiation exposure.

Physicians rely on imaging studies to guide patient diagnosis and treatment, resulting in non-trivial radiation dose estimates associated with common imaging modalities during a single hospitalization

Lutterman, A, Coursey, C, Kang, J, Small, W, Mittal, P, Applegate, K, Cumulative Radiation Exposure of Hospitalized Patients due to Diagnostic Imaging and Image-guided Procedures.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12043853.html