Increased radiation dose and projected radiation-related lifetime cancer risk in patients with obesity due to projection radiography
| Autor: | Karen M. Knapp, Susan Jane Rimes, Saeed J M Alqahtani, Rachel M Palfrey, Judith R. Meakin, Richard Welbourn, Katharine E. Thomson |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Radiography Radiation Dosage Risk Assessment 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine Risk Factors Neoplasms medicine Humans Obesity Young adult Waste Management and Disposal Aged Retrospective Studies Aged 80 and over business.industry Public Health Environmental and Occupational Health Retrospective cohort study General Medicine Middle Aged Radiation Exposure medicine.disease medicine.anatomical_structure Quartile Dose area product 030220 oncology & carcinogenesis Abdomen Female Radiology Risk assessment business |
| Zdroj: | Journal of radiological protection : official journal of the Society for Radiological Protection. 39(1) |
| ISSN: | 1361-6498 |
| Popis: | Purpose Primarily to evaluate the radiation dose delivered to patients with obesity in projection radiography and its relationship to the patient's size. A secondary purpose is to estimate the subsequent projected radiation-related lifetime cancer risk to patients with obesity compared to normal-weight patients. Method and material Data from 1964 patients from a bariatric clinic in the UK were reviewed with the relevant permission. 630 patients were identified to have a projection radiography history and were included in the study. Patients' dose area product (DAP) data were collected for all projection radiography. Multiple exams in one day including a single DAP reading and exams with no records of DAP and exposure factors were excluded. Correlations were calculated and data analysed to yield the third quartile for each examination using STATA 14. Absorbed doses were generated from PCXMC simulation, utilising DAP data from this study and the UK national diagnostic reference level (NDRL), to calculate the effective risk for patients with obesity compared to patients with normal-weight. Results Patients with obesity received higher DAPs for all examinations included in this study compared to NDRL. Abdominal and lumbar spine radiographs DAPs were the highest (17.6 and 30.31 Gy cm2) compared to the NDRL (2.5 and 4 Gy cm2). Only moderate to low correlations were found between patient's size and DAPs in the abdomen and chest radiographs. The projected radiation-related lifetime cancer risk for patients with obesity is up to 153% higher than for adult patients with normal weight. Conclusion Patients with obesity receive higher DAPs than normal-weight adults which may be in excess of that expected due to their size. Therefore, radiation-related lifetime cancer risk is increased in patients with obesity as a result of medical radiation exposures. This indicates more dose optimisation research is needed in this group of patients to reduce dose rate and variation. |
| Databáze: | OpenAIRE |
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