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Published in: BMC Medical Imaging 1/2010

Open Access 01-12-2010 | Research article

Radiation Exposure from CT Examinations in Japan

Authors: Yoshito Tsushima, Ayako Taketomi-Takahashi, Hiroyuki Takei, Hidenori Otake, Keigo Endo

Published in: BMC Medical Imaging | Issue 1/2010

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Abstract

Background

Computed tomography (CT) is the largest source of medical radiation exposure to the general population, and is considered a potential source of increased cancer risk. The aim of this study was to assess the current situation of CT use in Japan, and to investigate variations in radiation exposure in CT studies among institutions and scanners.

Methods

Data-sheets were sent to all 126 hospitals and randomly selected 14 (15%) of 94 clinics in Gunma prefecture which had CT scanner(s). Data for patients undergoing CT during a single month (June 2008) were obtained, along with CT scan protocols for each institution surveyed. Age and sex specific patterns of CT examination, the variation in radiation exposure from CT examinations, and factors which were responsible for the variation in radiation exposure were determined.

Results

An estimated 235.4 patients per 1,000 population undergo CT examinations each year, and 50% of the patients were scanned in two or more anatomical locations in one CT session. There was a large variation in effective dose among hospitals surveyed, particularly in lower abdominal CT (range, 2.6-19.0 mSv). CT examinations of the chest and upper abdomen contributed to approximately 73.2% of the collective dose from all CT examinations. It was estimated that in Japan, approximately 29.9 million patients undergo CT annually, and the estimated annual collective effective dose in Japan was 277.4 *103 Sv person. The annual effective dose per capita for Japan was estimated to be 2.20 mSv.

Conclusions

There was a very large variation in radiation exposure from CT among institutions surveyed. CT examinations of the chest and upper abdomen were the predominant contributors to the collective dose.
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Literature
1.
go back to reference Berrington De Gonzalex A, Darby S: Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries. Lancet. 2004, 363: 345-51. 10.1016/S0140-6736(04)15433-0.CrossRef Berrington De Gonzalex A, Darby S: Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries. Lancet. 2004, 363: 345-51. 10.1016/S0140-6736(04)15433-0.CrossRef
2.
go back to reference Einstein AJ, Henzlova MJ, Rajagopalan S: Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA. 2007, 298: 317-323. 10.1001/jama.298.3.317.CrossRefPubMed Einstein AJ, Henzlova MJ, Rajagopalan S: Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA. 2007, 298: 317-323. 10.1001/jama.298.3.317.CrossRefPubMed
3.
go back to reference Hall EJ, Brenner DJ: Cancer risks from diagnostic radiology. Br J Radiol. 2008, 81: 362-378. 10.1259/bjr/01948454.CrossRefPubMed Hall EJ, Brenner DJ: Cancer risks from diagnostic radiology. Br J Radiol. 2008, 81: 362-378. 10.1259/bjr/01948454.CrossRefPubMed
4.
go back to reference Brix G, Nissen-Meyer S, Lechel U, et al: Radiation exposures of cancer patients from medical X-rays: How relevant are they for individual patients and population exposure?. Eur J Radiol. 2009, 72: 342-347. 10.1016/j.ejrad.2008.07.009.CrossRefPubMed Brix G, Nissen-Meyer S, Lechel U, et al: Radiation exposures of cancer patients from medical X-rays: How relevant are they for individual patients and population exposure?. Eur J Radiol. 2009, 72: 342-347. 10.1016/j.ejrad.2008.07.009.CrossRefPubMed
5.
go back to reference Mettler FA, Wiest PW, Locken JA, Kelsey CA: CT scanning: patterns of use and dose. J Radiol Prot. 2000, 20: 353-359. 10.1088/0952-4746/20/4/301.CrossRefPubMed Mettler FA, Wiest PW, Locken JA, Kelsey CA: CT scanning: patterns of use and dose. J Radiol Prot. 2000, 20: 353-359. 10.1088/0952-4746/20/4/301.CrossRefPubMed
7.
go back to reference Brenner DJ, Hall EJ: Computed tomography: An increasing source of radiation exposure. N Engl J Med. 2007, 357: 2277-2284. 10.1056/NEJMra072149.CrossRefPubMed Brenner DJ, Hall EJ: Computed tomography: An increasing source of radiation exposure. N Engl J Med. 2007, 357: 2277-2284. 10.1056/NEJMra072149.CrossRefPubMed
8.
go back to reference Hurwitz LM, Reiman RE, Yoshizumi TT, et al: Radiation dose from contemporary cardiothoracic multidetector CT protocols with an anthropomorphic female phantom: implication for cancer induction. Radiology. 2007, 245: 742-750. 10.1148/radiol.2453062046.CrossRefPubMed Hurwitz LM, Reiman RE, Yoshizumi TT, et al: Radiation dose from contemporary cardiothoracic multidetector CT protocols with an anthropomorphic female phantom: implication for cancer induction. Radiology. 2007, 245: 742-750. 10.1148/radiol.2453062046.CrossRefPubMed
9.
go back to reference Cho PK, Seo BK, Choi TK, Kim JS, Kim YH, Choi JH: The development of a diagnostic reference level on patient dose for CT examination in Korea. Radiat Prot Dosimetry. 2008, 129: 463-8. 10.1093/rpd/ncm463.CrossRefPubMed Cho PK, Seo BK, Choi TK, Kim JS, Kim YH, Choi JH: The development of a diagnostic reference level on patient dose for CT examination in Korea. Radiat Prot Dosimetry. 2008, 129: 463-8. 10.1093/rpd/ncm463.CrossRefPubMed
10.
go back to reference Kalra MK, Maher MM, Toth TL, et al: Strategies for CT radiation dose optimization. Radiology. 2004, 230: 619-628. 10.1148/radiol.2303021726.CrossRefPubMed Kalra MK, Maher MM, Toth TL, et al: Strategies for CT radiation dose optimization. Radiology. 2004, 230: 619-628. 10.1148/radiol.2303021726.CrossRefPubMed
11.
go back to reference Greess H, Wolf H, Baum U, et al: Dose reduction in computed tomography by attenuation-based on-line modulation of tube current: evaluation of six anatomical regions. Eur Radiol. 2000, 10: 391-394. 10.1007/s003300050062.CrossRefPubMed Greess H, Wolf H, Baum U, et al: Dose reduction in computed tomography by attenuation-based on-line modulation of tube current: evaluation of six anatomical regions. Eur Radiol. 2000, 10: 391-394. 10.1007/s003300050062.CrossRefPubMed
13.
go back to reference Nishizawa K, Matsumoto M, Iwai K, Maruyama T: Survey of CT practice in Japan and collective effective dose estimation. Nippon Acta Radiol. 2004, 64: 151-158.PubMed Nishizawa K, Matsumoto M, Iwai K, Maruyama T: Survey of CT practice in Japan and collective effective dose estimation. Nippon Acta Radiol. 2004, 64: 151-158.PubMed
14.
go back to reference Van der Molen AJ, Veldkamp WJH, Geleijns J: 16-slice CT: achievable effective doses of common protocols in comparison with recent CT dose surveys. Br J Radiol. 2007, 80: 248-255. 10.1259/bjr/52356535.CrossRefPubMed Van der Molen AJ, Veldkamp WJH, Geleijns J: 16-slice CT: achievable effective doses of common protocols in comparison with recent CT dose surveys. Br J Radiol. 2007, 80: 248-255. 10.1259/bjr/52356535.CrossRefPubMed
15.
go back to reference Brix G, Nagel HD, Stamm G, Veit R, Lechel U, Griebel J, Galanski M: Radiation exposure in multi-slice versus single-slice spiral CT: results of a nationwide survey. Eur Radiol. 2003, 13: 1979-1991. 10.1007/s00330-003-1883-y.CrossRefPubMed Brix G, Nagel HD, Stamm G, Veit R, Lechel U, Griebel J, Galanski M: Radiation exposure in multi-slice versus single-slice spiral CT: results of a nationwide survey. Eur Radiol. 2003, 13: 1979-1991. 10.1007/s00330-003-1883-y.CrossRefPubMed
22.
go back to reference Brenner DJ, Elliston CD, Hall EJ, Berdon WE: Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR. 2001, 176: 289-296.CrossRefPubMed Brenner DJ, Elliston CD, Hall EJ, Berdon WE: Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR. 2001, 176: 289-296.CrossRefPubMed
23.
go back to reference Lee CH, Goo JM, Ye HJ, et al: Radiation dose modulation techniques in the multidetector CT era: From basics to practice. RadioGraphics. 2008, 28: 1451-1459. 10.1148/rg.285075075.CrossRefPubMed Lee CH, Goo JM, Ye HJ, et al: Radiation dose modulation techniques in the multidetector CT era: From basics to practice. RadioGraphics. 2008, 28: 1451-1459. 10.1148/rg.285075075.CrossRefPubMed
24.
go back to reference Mulkens TH, Bellinck P, Baeyaert M, et al: Use of an automatic exposure control mechanism for dose optimization in multi-detector row CT examinations: Clinical evaluation. Radiology. 2005, 237: 213-223. 10.1148/radiol.2363041220.CrossRefPubMed Mulkens TH, Bellinck P, Baeyaert M, et al: Use of an automatic exposure control mechanism for dose optimization in multi-detector row CT examinations: Clinical evaluation. Radiology. 2005, 237: 213-223. 10.1148/radiol.2363041220.CrossRefPubMed
26.
go back to reference Nakajima Y, Yamada K, Imamura K, Kobayashi K: Radiologist supply and workload: international comparison-Working group of Japanese college of radiology. Radiat Med. 2008, 26: 455-465. 10.1007/s11604-008-0259-2.CrossRefPubMed Nakajima Y, Yamada K, Imamura K, Kobayashi K: Radiologist supply and workload: international comparison-Working group of Japanese college of radiology. Radiat Med. 2008, 26: 455-465. 10.1007/s11604-008-0259-2.CrossRefPubMed
27.
go back to reference Katada K: CT radiation exposure in Japan: analysis of social factors. Jpn J Radiol Technol. 2006, 62: 649-656.CrossRef Katada K: CT radiation exposure in Japan: analysis of social factors. Jpn J Radiol Technol. 2006, 62: 649-656.CrossRef
Metadata
Title
Radiation Exposure from CT Examinations in Japan
Authors
Yoshito Tsushima
Ayako Taketomi-Takahashi
Hiroyuki Takei
Hidenori Otake
Keigo Endo
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Medical Imaging / Issue 1/2010
Electronic ISSN: 1471-2342
DOI
https://doi.org/10.1186/1471-2342-10-24

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