TY - JOUR
T1 - Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer
AU - Smith-Bindman, Rebecca
AU - Lipson, Jafi
AU - Marcus, Ralph
AU - Kim, Kwang Pyo
AU - Mahesh, Mahadevappa
AU - Gould, Robert
AU - Berrington De González, Amy
AU - Miglioretti, Diana L.
PY - 2009/12/14
Y1 - 2009/12/14
N2 - Background: Use of computed tomography (CT) for diagnostic evaluation has increased dramatically over the past 2 decades. Even though CT is associated with substantially higher radiation exposure than conventional radiography, typical doses are not known. We sought to estimate the radiation dose associated with common CT studies in clinical practice and quantify the potential cancer risk associated with these examinations. Methods: We conducted a retrospective cross-sectional study describing radiation dose associated with the 11 most common types of diagnosticCTstudies performed on 1119 consecutive adult patients at 4 San Francisco Bay Area institutions in California between January 1 andMay30, 2008. Weestimated lifetime attributable risks of cancer by study type from these measured doses. Results: Radiation doses varied significantly between the different types of CT studies. The overall median effective doses ranged from 2 millisieverts (mSv) for a routine head CT scan to 31 mSv for a multiphase abdomen and pelvis CT scan. Within each type of CT study, effective dose varied significantly within and across institutions, with a mean 13-fold variation between the highest and lowest dose for each study type. The estimated number of CT scans that will lead to the development of a cancer varied widely depending on the specific type of CT examination and the patient's age and sex. An estimated 1 in 270 women who underwent CT coronary angiography at age 40 years will develop cancer from that CT scan (1 in 600 men), compared with an estimated 1 in 8100 women who had a routine head CT scan at the same age (1 in 11 080 men). For 20-year-old patients, the risks were approximately doubled, and for 60-year-old patients, they were approximately 50% lower. Conclusion: Radiation doses from commonly performed diagnostic CT examinations are higher and more variable than generally quoted, highlighting the need for greater standardization across institutions.
AB - Background: Use of computed tomography (CT) for diagnostic evaluation has increased dramatically over the past 2 decades. Even though CT is associated with substantially higher radiation exposure than conventional radiography, typical doses are not known. We sought to estimate the radiation dose associated with common CT studies in clinical practice and quantify the potential cancer risk associated with these examinations. Methods: We conducted a retrospective cross-sectional study describing radiation dose associated with the 11 most common types of diagnosticCTstudies performed on 1119 consecutive adult patients at 4 San Francisco Bay Area institutions in California between January 1 andMay30, 2008. Weestimated lifetime attributable risks of cancer by study type from these measured doses. Results: Radiation doses varied significantly between the different types of CT studies. The overall median effective doses ranged from 2 millisieverts (mSv) for a routine head CT scan to 31 mSv for a multiphase abdomen and pelvis CT scan. Within each type of CT study, effective dose varied significantly within and across institutions, with a mean 13-fold variation between the highest and lowest dose for each study type. The estimated number of CT scans that will lead to the development of a cancer varied widely depending on the specific type of CT examination and the patient's age and sex. An estimated 1 in 270 women who underwent CT coronary angiography at age 40 years will develop cancer from that CT scan (1 in 600 men), compared with an estimated 1 in 8100 women who had a routine head CT scan at the same age (1 in 11 080 men). For 20-year-old patients, the risks were approximately doubled, and for 60-year-old patients, they were approximately 50% lower. Conclusion: Radiation doses from commonly performed diagnostic CT examinations are higher and more variable than generally quoted, highlighting the need for greater standardization across institutions.
UR - http://www.scopus.com/inward/record.url?scp=73149110471&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=73149110471&partnerID=8YFLogxK
U2 - 10.1001/archinternmed.2009.427
DO - 10.1001/archinternmed.2009.427
M3 - Article
C2 - 20008690
AN - SCOPUS:73149110471
SN - 0003-9926
VL - 169
SP - 2078
EP - 2086
JO - Archives of internal medicine
JF - Archives of internal medicine
IS - 22
ER -