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Shi HM, Sun ZC, Ju FH. Recommendations for reducing exposure to medical X-ray irradiation (Review). MEDICINE INTERNATIONAL 2022; 2:22. [PMID: 36699506 PMCID: PMC9829209 DOI: 10.3892/mi.2022.47] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/08/2022] [Indexed: 02/01/2023]
Abstract
With the increasing frequency of X-ray examinations in clinical medicine, public concern regarding the harm caused by exposure to X-ray radiation is also increasing. However, some physicians are not completely aware of the dangers of exposure to X-ray irradiation. Individuals specialized in this field, including physicians, have a better understanding of these dangers, which limits the use of X-rays in medicine. The present study aimed to address strategies for reducing the harm caused by exposure to medical X-rays and increase public awareness regarding X-ray radiation. Through a literature search and review, combined with the current status of clinical X-ray examination and the authors' professional experience, the present study highlights the importance of reducing X-ray exposure, and proposes several specific recommendations and measures for reducing the frequency or dose of X-ray irradiation. On the whole, the finding discussed in the present review suggest the minimal use of medical X-ray examinations and that alternative tests should be selected whenever possible. When medical X-ray screening and treatments are necessary, the risk-benefit ratio should be assessed, possibly aiming to achieve avoidable exposure. Further attention should be paid to protect sensitive glands and reduce the risks in children.
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Affiliation(s)
- Hai-Min Shi
- Department of Gynecology and Obstetrics Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, P.R. China,Department of Gynecology and Obstetrics Medicine, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang 310006, P.R. China
| | - Zhi-Chao Sun
- Department of Medical Imaging, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, P.R. China,Department of Medical Imaging, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang 310006, P.R. China
| | - Fang-He Ju
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, P.R. China,Department of Respiratory Medicine, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang 310006, P.R. China,Correspondence to: Dr Fang-He Ju, Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Hangzhou, Zhejiang 310006, P.R. China
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Tækker M, Kristjánsdóttir B, Andersen MB, Fransen ML, Greisen PW, Laursen CB, Mussmann B, Posth S, Graumann O. Diagnostic accuracy of ultra-low-dose chest computed tomography in an emergency department. Acta Radiol 2022; 63:336-344. [PMID: 33663246 DOI: 10.1177/0284185121995804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study examined whether ultra-low-dose chest computed tomography (ULD-CT) could improve detection of acute chest conditions. PURPOSE To determine (i) whether diagnostic accuracy of ULD-CT is superior to supine chest X-ray (sCXR) for acute chest conditions and (ii) the feasibility of ULD-CT in an emergency department. MATERIAL AND METHODS From 1 February to 31 July 2019, 91 non-traumatic patients from the Emergency Department were prospectively enrolled in the study if they received an sCXR. An ULD-CT and a non-contrast chest CT (NCCT) scan were then performed. Three radiologists assessed the sCXR and ULD-CT examinations for cardiogenic pulmonary edema, pneumonia, pneumothorax, and pleural effusion. Resources and effort were compared for sCXR and ULD-CT to evaluate feasibility. Diagnostic accuracy was calculated for sCXR and ULD-CT using NCCT as the reference standard. RESULTS The mean effective dose of ULD-CT was 0.05±0.01 mSv. For pleural effusion and cardiogenic pulmonary edema, no difference in diagnostic accuracy between ULD-CT and sCXR was observed. For pneumonia and pneumothorax, sensitivities were 100% (95% confidence interval [CI] 69-100) and 50% (95% CI 7-93) for ULD-CT and 60% (95% CI 26-88) and 0% (95% CI 0-0) for sCXR, respectively. Median examination time was 10 min for ULD-CT vs. 5 min for sCXR (P<0.001). For ULD-CT 1-2 more staff members were needed compared to sCXR (P<0.001). ULD-CT was rated more challenging to perform than sCXR (P<0.001). CONCLUSION ULD-CT seems equal or better in detecting acute chest conditions compared to sCXR. However, ULD-CT examinations demand more effort and resources.
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Affiliation(s)
- Maria Tækker
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark
- Department of Radiology and OPEN – Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Björg Kristjánsdóttir
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark
- Department of Radiology and OPEN – Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Michael B Andersen
- Department of Radiology, Copenhagen University Hospital Herlev/Gentofte and Roskilde University Hospital, Copenhagen, Denmark
| | - Maja L Fransen
- Department of Radiology, Odense University Hospital, Odense, Denmark
| | | | - Christian B Laursen
- Department of Radiology and OPEN – Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Bo Mussmann
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark
- Department of Radiology, Odense University Hospital, Odense, Denmark
- Faculty of Health Sciences, Oslo Metropolitan University, Norway
| | - Stefan Posth
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
- Department of Emergency Medicine and OPEN - Open Patient data Explorative Network, Odense University Hospital, Denmark
| | - Ole Graumann
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark
- Department of Radiology and OPEN – Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
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Gühne F, Drescher R, Seifert P, Freesmeyer M. Supplemental minimal-activity PET/CT to validate ambiguous findings with less than 1 mSv: Proof of concept. J Med Imaging Radiat Oncol 2021; 65:201-207. [PMID: 33606349 DOI: 10.1111/1754-9485.13164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/02/2021] [Indexed: 11/30/2022]
Abstract
Short-term follow-up examinations could verify ambiguous findings in PET/CT diagnostics, but are often avoided due to radiation and financial burdens. We demonstrate the feasibility of a focused, minimal-activity PET protocol as a supplemental examination for uncertain findings after standard PET/CT. After changing conditions, e.g. patient positioning, preparation and bypassing an interval as well as a targeted tracer change, an additional examination with less than 1 mSv of additional radiation exposure was performed. Lowered administered activity of radiopharmaceuticals could be compensated by prolonged acquisition time, which was made possible by the limitation to a single body region. A sufficient visual and quantitative image quality of scans could be achieved. In all cases, the ambiguous finding could be clarified, so further diagnostic procedures or unnecessary interventions were avoided.
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Affiliation(s)
- Falk Gühne
- Clinic of Nuclear Medicine, Jena University Hospital, Jena, Germany
| | - Robert Drescher
- Clinic of Nuclear Medicine, Jena University Hospital, Jena, Germany
| | - Philipp Seifert
- Clinic of Nuclear Medicine, Jena University Hospital, Jena, Germany
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