Table 2.
Population-based studies aimed to identify patients with recurrent procedures and high cumulative effective dose (CED)
| Author, year | Country/ region | Cohort (specific criteria, # patients, age group) | Type of procedures | Period of exposure history | Main findings in number of procedures or % of patient with CED above a certain value in mSv |
|---|---|---|---|---|---|
| Sodickson et al77 | USA | 31,462 patients, mean age 56.9 y in an academic medical center | CT | 22 years | 33% had ≥5 CTs, 5% had 22–132 CTs 15% had CED ≥100 mSv, 4% had 250–1375 mSv |
| Fazel et al78 | USA | 952,420 nonelderly adults, mean age 35.6 y in five health care markets | All | 3 years | 1.9% had annual CED > 3–20 mSv; 0.2% had >50 mSv 75.4% of CED from CT and NM |
| Dorfman et al79 | USA | 355,088 children, mean age 9.0 (0–18) y, in five health care markets | All | 3 years | 25.2% had ≥2 and 16% had ≥3 imaging procedures 22.3% had ≥2 X-rays, 3.5% had ≥2 CT scans |
| Lutterman et al80 | USA | 200 consecutive inpatients ≥ 18 y, mean 60.4 y, two academic hospitals | All | During a single hospital stay | 16% had ≥3 CTs, 5.5% had CED ≥50 mSv, 1% had ≥100 mSv |
| Bostani et al81 | USA | 34,672 patients, academic hospital | CT | 1 year | 2.7% with CED ≥100 mSv 1/3 trauma patients |
| Lee et al82 | Korea | 13,803 children age <15 y In an academic hospital |
CT | 5 years | 0.07% had ≥3 CTs, in this group, median 9 (3-28) CTs 0.1% had CED ≥20 mSv, 0.001% had ≥30 mSv |
| Stopsack et al83 | USA | 26,377 adults, median age 44 y | CT | 10 years | 17.5% had 5–10 CTs, 8.8% had ≥10 CTs. 1.9% had CED ≥100 mSv |
| Lumbreras et al84 | Spain | 154,520 (68.8% of all patients) with ≥1 exam, 14% children < 15 y | All | 12 years | 52.9% had ≥5 exams; 25.4% had ≥5 CTs 3.1% had CED 50–100 mSv, 1.5% ≥ 100 mSv. |
| Rehani et al14 | USA, Europe | 2,504,585 patients in 4 institutions (A, B, C, D) with 324 hospitals | CT | 1–5 years | 1.33% had CED ≥100 mSv: 3.4% in institution A (5 y), 1.4% in B (2y7m), 1.5% in C (5 y), 0.64% in D (1y1m). |
| Brambilla et al15 | USA, Europe, Asia, Africa | 702,205 patients in 20 hospitals in 20 countries | CT | 0.4–6.1 years | CED ≥ 100 mSv from 0 to 5% across institutions Average 0.65% patients with CED ≥100 mSv |
| Rehani et al85 | USA | 8,952 with CED ≥100 mSv in an academic hospital | CT | 5 years | 123 patients: 9.6% with non-malignant conditions and 1.4% with age ≤40 y (mean age 31.9 y) |
| Fitousi et al86 | Belgium | 900,000 patients in 23 hospitals | CT, FGI | 1 year | 0.14% had CED ≥100 mSv Median CED 125 (IQR 110–151) mSv Mean 6.2 (IQR: 5–6.8) exams |
| IRSN87 | France | National sample of 319,187 patients with ≥1 exam | CT | 1–6 years | 0.49% had CED ≥100 mSv in 1 year, 1.44% in 3 year and 2.25% in 6 year; 25% aged <55 y |
| Kwee et al88 | Netherlands | 100,966 patients with ≥1 CT in a tertiary care center | CT | 10 years | 0.06% had ≥40 CTs (40-92) Mean CED 187.4 mSv (120.7–278.4) |
| Arellano et al89 | USA | 8,952 who had CED ≥100 mSv in an academic hospital | CT | 5 years | 33 had E ≥100 mSv in a single CT guided intervention, 12% age <50 y |
| Li et al90 | USA | 25,253 patients, mean age 58.2 (≥18) y, academic hospital | FGI | 109 months | 4.0% had CED ≥100 mSv 41.7% had only 1 FGI, 79.1% had 100 mSv in 1 year |
| Jeukens et al91 | Netherlands | 49,978 patients, median age 62 (0–103) y, academic hospital | CT | Maximum 5 years | 4.7% had 6–10 CTs, 0.8% had ≥11 CTs 482 (1%) had CED ≥100 mSv |
| Frija et al92 | Europe | 1,218,429 patients from 18 hospitals in Europe | CT | 4 years | Between 0 and 2.7% (mean 0.5%) had CED ≥100 mSv |
| Rehani et al93 | USA | 3,880,524 patient-days, mean age 57.8 y in 279 USA hospitals | CT | 5 years | 0.8% had ≥50 mSv, 0.03% had CED ≥100 mSv in a single day |
| Brambilla et al25 | Italy | 28,870 patients, tertiary care center | CT | 2.4 years | 6.1% had CED ≥100 mSv; 4% of them had 100 mSv in a single procedure and 24% in a month |
CED, cumulative effective dose.