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Published in: Digestive Diseases and Sciences 3/2014

01-03-2014 | Original Article

Radiation Exposure from Diagnostic Imaging Studies Among Patients with Inflammatory Bowel Disease in a Safety-Net Health-Care System

Authors: Jason K. Hou, Hoda M. Malaty, Selvi Thirumurthi

Published in: Digestive Diseases and Sciences | Issue 3/2014

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Abstract

Background/Aims

Radiographic imaging studies are important in the management of patients with inflammatory bowel disease (IBD), but are associated with radiation exposure. IBD patients in a safety-net health-care system may be at risk of high exposure to radiation. Our purpose was to identify associations of high-dose radiation exposure among an ethnically diverse cohort of IBD patients in a safety-net health-care system.

Methods

A study was performed on patients with IBD receiving care from the Harris County Hospital District. Radiation exposure was calculated using total number of imaging studies performed between from 2000 and 2010 and estimates of radiation dose per study. Associations of high-dose radiation exposure, defined as a cumulative effective dose (CED) >50 mSv, were identified by using univariate and multivariate logistic regression.

Results

The study cohort of 278 patients with IBD was ethnically diverse, with 30 % Caucasian, 44 % African–American, and 26 % Hispanic. The median CED was 10.40 mSv (SD 20.02). Annualized radiation doses were 3.45 mSv/year among patients with Crohn’s disease (CD) and 1.27 mSv/year among patients with ulcerative colitis, p < 0.02. Approximately 13 % of IBD patients received a CED >50 mSv. There were no differences in radiation exposure based on age, gender, or race/ethnicity.

Conclusions

A small proportion of IBD patients in a safety-net health-care system received high doses of diagnostic radiation exposure. Use of diagnostic imaging studies that limit radiation exposure should be encouraged.
Literature
1.
go back to reference Cardis E, Vrijheid M, Blettner M, et al. Risk of cancer after low doses of ionising radiation: retrospective cohort study in 15 countries. BMJ. 2005;331:77.PubMedCrossRef Cardis E, Vrijheid M, Blettner M, et al. Risk of cancer after low doses of ionising radiation: retrospective cohort study in 15 countries. BMJ. 2005;331:77.PubMedCrossRef
2.
go back to reference Muirhead CR, Goodill AA, Haylock RG, et al. Occupational radiation exposure and mortality: second analysis of the National Registry for Radiation Workers. J Radiol Prot. 1999;19:3–26.PubMedCrossRef Muirhead CR, Goodill AA, Haylock RG, et al. Occupational radiation exposure and mortality: second analysis of the National Registry for Radiation Workers. J Radiol Prot. 1999;19:3–26.PubMedCrossRef
3.
4.
go back to reference Amis ES Jr, Butler PF, Applegate KE, et al. American College of Radiology white paper on radiation dose in medicine. J Am Coll Radiol. 2007;4:272–284.PubMedCrossRef Amis ES Jr, Butler PF, Applegate KE, et al. American College of Radiology white paper on radiation dose in medicine. J Am Coll Radiol. 2007;4:272–284.PubMedCrossRef
5.
go back to reference Berrington de González A, Mahesh M, Kim KP, et al. Projected cancer risks from computed tomographic scans performed in the United States in 2007. Arch Intern Med. 2009;69:2071–2077.CrossRef Berrington de González A, Mahesh M, Kim KP, et al. Projected cancer risks from computed tomographic scans performed in the United States in 2007. Arch Intern Med. 2009;69:2071–2077.CrossRef
6.
go back to reference Desmond AN, O’Regan K, Curran C, et al. Crohn’s disease: factors associated with exposure to high levels of diagnostic radiation. Gut. 2008;57:1524–1529.PubMedCrossRef Desmond AN, O’Regan K, Curran C, et al. Crohn’s disease: factors associated with exposure to high levels of diagnostic radiation. Gut. 2008;57:1524–1529.PubMedCrossRef
7.
go back to reference Newnham E, Hawkes E, Surender A, et al. Quantifying exposure to diagnostic medical radiation in patients with inflammatory bowel disease: are we contributing to malignancy? Aliment Pharmacol Ther. 2007;26:1019–1024.PubMedCrossRef Newnham E, Hawkes E, Surender A, et al. Quantifying exposure to diagnostic medical radiation in patients with inflammatory bowel disease: are we contributing to malignancy? Aliment Pharmacol Ther. 2007;26:1019–1024.PubMedCrossRef
8.
go back to reference Levi Z, Fraser E, Krongrad R, et al. Factors associated with radiation exposure in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2009;30:1128–1136.PubMedCrossRef Levi Z, Fraser E, Krongrad R, et al. Factors associated with radiation exposure in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2009;30:1128–1136.PubMedCrossRef
9.
go back to reference Nguyen GC, LaVeist TA, Harris ML, et al. Racial disparities in utilization of specialist care and medications in inflammatory bowel disease. Am J Gastroenterol. 2010;105:2202–2208.PubMedCentralPubMedCrossRef Nguyen GC, LaVeist TA, Harris ML, et al. Racial disparities in utilization of specialist care and medications in inflammatory bowel disease. Am J Gastroenterol. 2010;105:2202–2208.PubMedCentralPubMedCrossRef
10.
go back to reference Income, Poverty, and Health Insurance Coverage in the United States: 2009. U.S. Census Bureau. p. 22. Issued September 2010. Income, Poverty, and Health Insurance Coverage in the United States: 2009. U.S. Census Bureau. p. 22. Issued September 2010.
11.
go back to reference Nguyen GC, Sam J, Murthy SK, et al. Hospitalizations for inflammatory bowel disease: profile of the uninsured in the United States. Inflamm Bowel Dis. 2009;15:726–733.PubMedCrossRef Nguyen GC, Sam J, Murthy SK, et al. Hospitalizations for inflammatory bowel disease: profile of the uninsured in the United States. Inflamm Bowel Dis. 2009;15:726–733.PubMedCrossRef
12.
go back to reference Lennard-Jones JE. Classification of inflammatory bowel disease. Scand J Gastroenterol Suppl. 1989;24:2–6.CrossRef Lennard-Jones JE. Classification of inflammatory bowel disease. Scand J Gastroenterol Suppl. 1989;24:2–6.CrossRef
14.
go back to reference Malaty HM, Hou JK, Thirumurthi S. Epidemiology of inflammatory bowel disease among an indigent multi-ethnic population in the United States. Clin Exp Gastroenterol. 2010;3:165–170.PubMedCentralPubMedCrossRef Malaty HM, Hou JK, Thirumurthi S. Epidemiology of inflammatory bowel disease among an indigent multi-ethnic population in the United States. Clin Exp Gastroenterol. 2010;3:165–170.PubMedCentralPubMedCrossRef
15.
go back to reference Hou J, El-Serag H, Sellin J, et al. Inflammatory bowel disease characteristics and treatment in Hispanics and Caucasians. Dig Dis Sci.. 2011;56:1476–1481.PubMedCrossRef Hou J, El-Serag H, Sellin J, et al. Inflammatory bowel disease characteristics and treatment in Hispanics and Caucasians. Dig Dis Sci.. 2011;56:1476–1481.PubMedCrossRef
16.
go back to reference Tanner RJ, Wall BF, Shrimptom PC. Radiation exposure of the UK Population from medical and dental X-ray examination: publication W4. Chilton: UK National Radiation Protection Board; 2002. Tanner RJ, Wall BF, Shrimptom PC. Radiation exposure of the UK Population from medical and dental X-ray examination: publication W4. Chilton: UK National Radiation Protection Board; 2002.
17.
go back to reference Satsangi J, Silverberg MS, Vermeire S, et al. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. 2006;55:749–753.PubMedCrossRef Satsangi J, Silverberg MS, Vermeire S, et al. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. 2006;55:749–753.PubMedCrossRef
18.
go back to reference Brenner DJ, Hall EJ. Computed tomography—an increasing source of radiation exposure. N Engl J Med. 2007;357:2277–2284.PubMedCrossRef Brenner DJ, Hall EJ. Computed tomography—an increasing source of radiation exposure. N Engl J Med. 2007;357:2277–2284.PubMedCrossRef
19.
go back to reference Guimarães LS, Fidler JL, Fletcher JG, et al. Assessment of appropriateness of indications for CT enterography in younger patients. Inflamm Bowel Dis. 2010;16:226–232.PubMedCrossRef Guimarães LS, Fidler JL, Fletcher JG, et al. Assessment of appropriateness of indications for CT enterography in younger patients. Inflamm Bowel Dis. 2010;16:226–232.PubMedCrossRef
20.
go back to reference Lewin M, Altman S, Institute of Medicine America’s. Health Care Safety Net: Intact but Endangered. Washington, DC: National Academy Press; 2000. Lewin M, Altman S, Institute of Medicine America’s. Health Care Safety Net: Intact but Endangered. Washington, DC: National Academy Press; 2000.
21.
go back to reference National Council on Radiation Protection and Measurements. Exposure of the Population in the United States and Canada from the Natural Background Radiation. NCRP report no. 94. Bethesda, MD, 1987. National Council on Radiation Protection and Measurements. Exposure of the Population in the United States and Canada from the Natural Background Radiation. NCRP report no. 94. Bethesda, MD, 1987.
22.
go back to reference Peloquin JM, Pardi DS, Sandborn WJ, et al. Diagnostic ionizing radiation exposure in a population-based cohort of patients with inflammatory bowel disease. Am J Gastroenterol. 2008;103:2015–2022.PubMedCentralPubMedCrossRef Peloquin JM, Pardi DS, Sandborn WJ, et al. Diagnostic ionizing radiation exposure in a population-based cohort of patients with inflammatory bowel disease. Am J Gastroenterol. 2008;103:2015–2022.PubMedCentralPubMedCrossRef
23.
go back to reference Palmer L, Herfarth H, Porter CQ, et al. Diagnostic ionizing radiation exposure in a population-based sample of children with inflammatory bowel diseases. Am J Gastroenterol. 2009;104:2816–2823.PubMedCentralPubMedCrossRef Palmer L, Herfarth H, Porter CQ, et al. Diagnostic ionizing radiation exposure in a population-based sample of children with inflammatory bowel diseases. Am J Gastroenterol. 2009;104:2816–2823.PubMedCentralPubMedCrossRef
24.
go back to reference Sauer CG, Kugathasan S, Martin DR, et al. Medical radiation exposure in children with inflammatory bowel disease estimates high cumulative doses. Inflamm Bowel Dis. 2011;17:2326–2332.PubMedCrossRef Sauer CG, Kugathasan S, Martin DR, et al. Medical radiation exposure in children with inflammatory bowel disease estimates high cumulative doses. Inflamm Bowel Dis. 2011;17:2326–2332.PubMedCrossRef
25.
go back to reference Chang ML, Hou JK. Cancer risk related to gastrointestinal diagnostic radiation exposure. Curr Gastroenterol Rep. 2011;13:449–457.PubMedCrossRef Chang ML, Hou JK. Cancer risk related to gastrointestinal diagnostic radiation exposure. Curr Gastroenterol Rep. 2011;13:449–457.PubMedCrossRef
27.
go back to reference Brenner DJ, Doll R, Goodhead DT, et al. Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci USA. 2003;100:13761–13766.PubMedCrossRef Brenner DJ, Doll R, Goodhead DT, et al. Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci USA. 2003;100:13761–13766.PubMedCrossRef
Metadata
Title
Radiation Exposure from Diagnostic Imaging Studies Among Patients with Inflammatory Bowel Disease in a Safety-Net Health-Care System
Authors
Jason K. Hou
Hoda M. Malaty
Selvi Thirumurthi
Publication date
01-03-2014
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 3/2014
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-013-2852-1

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