Cumulative dose

Last updated

Cumulative dose is the total dose resulting from repeated exposures of ionizing radiation to an occupationally exposed worker to the same portion of the body, or to the whole body, over a period of time.

In medicine, the total amount of a drug or radiation given to a patient over time; for example, the total dose of radiation given in a series of radiation treatments or imaging exams. Recent studies have drawn attention to high cumulative doses (>100 mSv) to millions of patients undergoing recurrent CT scans during a 1- to 5-year period. [1] [2] [3] This has resulted in a debate on whether CT is really a low-dose imaging modality. [4]

See also

Related Research Articles

<span class="mw-page-title-main">Positron emission tomography</span> Medical imaging technique

Positron emission tomography (PET) is a functional imaging technique that uses radioactive substances known as radiotracers to visualize and measure changes in metabolic processes, and in other physiological activities including blood flow, regional chemical composition, and absorption. Different tracers are used for various imaging purposes, depending on the target process within the body.

<span class="mw-page-title-main">CT scan</span> Medical imaging procedure using X-rays to produce cross-sectional images

A computed tomography scan is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or radiology technologists.

<span class="mw-page-title-main">Radiography</span> Imaging technique using ionizing and non-ionizing radiation

Radiography is an imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical radiography and industrial radiography. Similar techniques are used in airport security. To create an image in conventional radiography, a beam of X-rays is produced by an X-ray generator and is projected toward the object. A certain amount of the X-rays or other radiation is absorbed by the object, dependent on the object's density and structural composition. The X-rays that pass through the object are captured behind the object by a detector. The generation of flat two dimensional images by this technique is called projectional radiography. In computed tomography an X-ray source and its associated detectors rotate around the subject which itself moves through the conical X-ray beam produced. Any given point within the subject is crossed from many directions by many different beams at different times. Information regarding attenuation of these beams is collated and subjected to computation to generate two dimensional images in three planes which can be further processed to produce a three dimensional image.

<span class="mw-page-title-main">Medical imaging</span> Technique and process of creating visual representations of the interior of a body

Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to reveal internal structures hidden by the skin and bones, as well as to diagnose and treat disease. Medical imaging also establishes a database of normal anatomy and physiology to make it possible to identify abnormalities. Although imaging of removed organs and tissues can be performed for medical reasons, such procedures are usually considered part of pathology instead of medical imaging.

<span class="mw-page-title-main">Nuclear medicine</span> Medical specialty

Nuclear medicine or nucleology is a medical specialty involving the application of radioactive substances in the diagnosis and treatment of disease. Nuclear imaging, in a sense, is "radiology done inside out" because it records radiation emitted from within the body rather than radiation that is transmitted through the body from external sources like X-ray generators. In addition, nuclear medicine scans differ from radiology, as the emphasis is not on imaging anatomy, but on the function. For such reason, it is called a physiological imaging modality. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) scans are the two most common imaging modalities in nuclear medicine.

Technetium (<sup>99m</sup>Tc) sestamibi Pharmaceutical drug

Technetium (99mTc) sestamibi (INN) is a pharmaceutical agent used in nuclear medicine imaging. The drug is a coordination complex consisting of the radioisotope technetium-99m bound to six (sesta=6) methoxyisobutylisonitrile (MIBI) ligands. The anion is not defined. The generic drug became available late September 2008. A scan of a patient using MIBI is commonly known as a "MIBI scan".

<span class="mw-page-title-main">Virtual colonoscopy</span> Medical imaging of the colon

Virtual colonoscopy is the use of CT scanning or magnetic resonance imaging (MRI) to produce two- and three-dimensional images of the colon, from the lowest part, the rectum, to the lower end of the small intestine, and to display the images on an electronic display device. The procedure is used to screen for colon cancer and polyps, and may detect diverticulosis. A virtual colonoscopy can provide 3D reconstructed endoluminal views of the bowel. VC provides a secondary benefit of revealing diseases or abnormalities outside the colon.

<span class="mw-page-title-main">Computed tomography angiography</span>

Computed tomography angiography is a computed tomography technique used for angiography—the visualization of arteries and veins—throughout the human body. Using contrast injected into the blood vessels, images are created to look for blockages, aneurysms, dissections, and stenosis. CTA can be used to visualize the vessels of the heart, the aorta and other large blood vessels, the lungs, the kidneys, the head and neck, and the arms and legs. CTA can also be used to localise arterial or venous bleed of the gastrointestinal system.

<span class="mw-page-title-main">CT pulmonary angiogram</span>

A CT pulmonary angiogram (CTPA) is a medical diagnostic test that employs computed tomography (CT) angiography to obtain an image of the pulmonary arteries. Its main use is to diagnose pulmonary embolism (PE). It is a preferred choice of imaging in the diagnosis of PE due to its minimally invasive nature for the patient, whose only requirement for the scan is an intravenous line.

A coronary CT calcium scan is a computed tomography (CT) scan of the heart for the assessment of severity of coronary artery disease. Specifically, it looks for calcium deposits in atherosclerotic plaques in the coronary arteries that can narrow arteries and increase the risk of heart attack. These plaques are the cause of most heart attacks, and become calcified as they develop.

<span class="mw-page-title-main">Molecular breast imaging</span>

Molecular breast imaging (MBI), also known as scintimammography, is a type of breast imaging test that is used to detect cancer cells in breast tissue of individuals who have had abnormal mammograms, especially for those who have dense breast tissue, post-operative scar tissue or breast implants.

Paediatric radiology is a subspecialty of radiology involving the imaging of fetuses, infants, children, adolescents and young adults. Many paediatric radiologists practice at children's hospitals.

<span class="mw-page-title-main">PET-MRI</span>

Positron emission tomography–magnetic resonance imaging (PET–MRI) is a hybrid imaging technology that incorporates magnetic resonance imaging (MRI) soft tissue morphological imaging and positron emission tomography (PET) functional imaging.

<span class="mw-page-title-main">Cone beam computed tomography</span> Medical imaging technique

Cone beam computed tomography is a medical imaging technique consisting of X-ray computed tomography where the X-rays are divergent, forming a cone.

<span class="mw-page-title-main">Coronary CT angiography</span> Use of computed tomography angiography to assess the coronary arteries of the heart

Coronary CT angiography is the use of computed tomography (CT) angiography to assess the coronary arteries of the heart. The patient receives an intravenous injection of radiocontrast and then the heart is scanned using a high speed CT scanner, allowing physicians to assess the extent of occlusion in the coronary arteries, usually in order to diagnose coronary artery disease.

Radiation Exposure Monitoring (REM) is a framework developed by Integrating the Healthcare Enterprise (IHE), for utilizing existing technical standards, such as DICOM, to provide information about the dose delivered to patients in radiology procedures, in an interoperable format.

<span class="mw-page-title-main">Madan M. Rehani</span>

Madan M. Rehani is an Indian-born medical physicist.

<span class="mw-page-title-main">EOS imaging</span>

EOS imaging is a medical device company based in Paris, France, that designs, develops, and markets EOSedge and the EOS system, innovative, orthopedic medical imaging systems, associated with several orthopedic solutions along the patient care pathway – from diagnosis to post-operative treatments. The EOS platform targets musculoskeletal disorders and orthopedic surgical care through 2D X-ray scans and 3D skeletal models from stereo-radiographic images of patients in a seated or standing position.

<span class="mw-page-title-main">Breast imaging</span>

In medicine, breast imaging is a sub-speciality of diagnostic radiology that involves imaging of the breasts for screening or diagnostic purposes. There are various methods of breast imaging using a variety of technologies as described in detail below. Traditional screening and diagnostic mammography uses x-ray technology and has been the mainstay of breast imaging for many decades. Breast tomosynthesis is a relatively new digital x-ray mammography technique that produces multiple image slices of the breast similar to, but distinct from, computed tomography (CT). Xeromammography and galactography are somewhat outdated technologies that also use x-ray technology and are now used infrequently in the detection of breast cancer. Breast ultrasound is another technology employed in diagnosis and screening that can help differentiate between fluid filled and solid lesions, an important factor to determine if a lesion may be cancerous. Breast MRI is a technology typically reserved for high-risk patients and patients recently diagnosed with breast cancer. Lastly, scintimammography is used in a subgroup of patients who have abnormal mammograms or whose screening is not reliable on the basis of using traditional mammography or ultrasound.

<span class="mw-page-title-main">Radiation exposure</span> Measure of ionization of air by ionizing radiation

Radiation exposure is a measure of the ionization of air due to ionizing radiation from photons. It is defined as the electric charge freed by such radiation in a specified volume of air divided by the mass of that air. As of 2007, "medical radiation exposure" was defined by the International Commission on Radiological Protection as exposure incurred by people as part of their own medical or dental diagnosis or treatment; by persons, other than those occupationally exposed, knowingly, while voluntarily helping in the support and comfort of patients; and by volunteers in a programme of biomedical research involving their exposure. Common medical tests and treatments involving radiation include X-rays, CT scans, mammography, lung ventilation and perfusion scans, bone scans, cardiac perfusion scan, angiography, radiation therapy, and more. Each type of test carries its own amount of radiation exposure. There are two general categories of adverse health effects caused by radiation exposure: deterministic effects and stochastic effects. Deterministic effects are due to the killing/malfunction of cells following high doses; and stochastic effects involve either cancer development in exposed individuals caused by mutation of somatic cells, or heritable disease in their offspring from mutation of reproductive (germ) cells.

References

  1. Rehani, Madan M.; Yang, Kai; Melick, Emily R.; Heil, John; Šalát, Dušan; Sensakovic, William F.; Liu, Bob (2020). "Patients undergoing recurrent CT scans: assessing the magnitude". European Radiology. 30 (4): 1828–1836. doi:10.1007/s00330-019-06523-y. PMID   31792585. S2CID   208520824.
  2. Brambilla, Marco; Vassileva, Jenia; Kuchcinska, Agnieszka; Rehani, Madan M. (2020). "Multinational data on cumulative radiation exposure of patients from recurrent radiological procedures: call for action". European Radiology. 30 (5): 2493–2501. doi:10.1007/s00330-019-06528-7. PMID   31792583. S2CID   208520544.
  3. Rehani, Madan M.; Melick, Emily R.; Alvi, Raza M.; Doda Khera, Ruhani; Batool-Anwar, Salma; Neilan, Tomas G.; Bettmann, Michael (2020). "Patients undergoing recurrent CT exams: assessment of patients with non-malignant diseases, reasons for imaging and imaging appropriateness". European Radiology. 30 (4): 1839–1846. doi:10.1007/s00330-019-06551-8. PMID   31792584. S2CID   208520463.
  4. Rehani, Madan M.; Szczykutowicz, Timothy P.; Zaidi, Habib (2020). "CT is still not a low-dose imaging modality". Medical Physics. 47 (2): 293–296. doi: 10.1002/mp.14000 . PMID   31883346. S2CID   209499310.