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radiation exposure

Epidemiology: - USA residents receive approximately 3 mSv annually from background environmental radiation - healthcare workers who are exposed to radiation are restricted to a total of 100 mSv every 5 years - largest contributions to cumulative radiation doses include computed tomography of the abdomen & pelvis (30%), myocardial perfusion imaging (22%), & CT of the chest (8%) - heart imaging procedures account for almost 40& of radiation exposure from medical imaging [8] - abdominal CT delivers 50-fold more radiation than plain films [7] - routine chest CT delivers 400-fold more radiation than plain films [5] - high-resolution chest CT delivers 43-fold more radiation than plain films [5] - low-dose chest CT delivers 33-fold more radiation than plain films [5] - exposure to about 9-10 mSv of radiation with CT of the neck, chest, abdomen, or pelvis [4] - coronary angiography (diagnostic) delivers 200-500 fold more radiation than chest X-ray [5] - myocardial perfusion study delivers 100-500 fold more radiation than chest X-ray [5] - CT angiography delivers 700-2100 fold more radiation than chest X-ray [5] - positron emission tomography of the heart delivers 100-400 fold more radiation than chest X-ray [5] - FDG-PET/CT of thorax delivers 800 fold more radiation than chest X-ray [5] - coronary artery calcium delivers 20-40 fold more radiation than chest X-ray [5] - magnetic resonance imaging & echocardiography do not result in signficant exposure to radiation [5] - radiation exposure from diagnostic imaging has doubled from 1996-2010 [6] - children who undergo complex heart surgery receive substantial radiation - ~ 20 mSv with the Norwood operation - ~ 43 mSv with cardiac transplantation - increased risk for cancer later in life - breast cancer, thyroid cancer - risk higher for girls than boys [7] Complications: - 1 cancer per 1000 patients receiving 10 mSv of radiation [4] - radiation exposure from CT may cause 1.5-2% of cancers in USA [2] - no safe dose; thus benefits of procedure must be weighed against risks [1] - predicted to be responsible for 2% of future cancers

Related

electromagnetic radiation radiation injury; radiation toxicity radiation therapy (XRT) sun exposure

Specific

indoor lighting radiofrequency field

General

exposure

References

  1. Fazel R et al. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med 2009 Aug 27; 361:849. PMID: 19710483
  2. Brenner DJ and Hall EJ Computed tomography - An increasing source of radiation exposure. N Engl J Med 2007, 357:2277 PMID: 18046031
  3. FDA MedWatch http://www.fda.gov/medwatch/safety/2008/safety08.htm#ElectronicMedical
  4. Griffey RT and Sodickson A. Cumulative radiation exposure and cancer risk estimates in emergency department patients undergoing repeat or multiple CT. AJR Am J Roentgenol 2009 Apr; 192:887. PMID: 19304691
  5. Medical Knowledge Self Assessment Program (MKSAP) 15, 17. American College of Physicians, Philadelphia 2009, 2015
  6. Smith-Bindman R et al. Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996-2010. JAMA 2012 Jun 13; 307:2400 PMID: 22692172 http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2012.5960 - O'Connor GT and Hatabu H. Lung cancer screening, radiation, risks, benefits, and uncertainty. JAMA 2012 Jun 13; 307:2434. PMID: 22692175 http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2012.6096
  7. Johnson JN et al Cumulative Radiation Exposure and Cancer Risk Estimation in Children with Heart Disease. Circulation. June 9, 2014 PMID: 24914037 http://circ.ahajournals.org/content/early/2014/05/08/CIRCULATIONAHA.113.005425.abstract - Andreassi MG and Picano E Reduction of Radiation to Children: Our Responsibility to Change. Circulation. June 9, 2014 PMID: 24914036 http://circ.ahajournals.org/content/early/2014/05/08/CIRCULATIONAHA.114.010699.abstract
  8. Fazel R et al Approaches to Enhancing Radiation Safety in Cardiovascular Imaging: A Scientific Statement From the American Heart Association. Circulation. September 29, 2014 PMID: 25366837 http://circ.ahajournals.org/content/early/2014/09/29/CIR.0000000000000048.full.pdf+html
  9. Sarma A, Heilbrun ME, Conner KE et al Radiation and chest CT scan examinations: what do we know? Chest. 2012 Sep;142(3):750-60. Review. PMID: 22948579
  10. National Cancer Institute Radiation https://www.cancer.gov/about-cancer/causes-prevention/risk/radiation3