Radiation risk and cost-benefit analysis of a paediatric radiology procedure: results from a national study
| Autor: | Karin Fälth-Magnusson, M. Scott, Jan Persliden, Håkan Pettersson |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
medicine.medical_specialty
Neoplasms Radiation-Induced Time Factors Adolescent Biopsy Cost-Benefit Analysis Conscious Sedation Radiation Dosage Radiography Interventional Risk Assessment Life Expectancy Risk Factors Humans Medicine Fluoroscopy Dosimetry Radiology Nuclear Medicine and imaging Risk factor Child Analysis of Variance Computer Storage Devices medicine.diagnostic_test business.industry Infant General Medicine Collective dose Celiac Disease Child Preschool Absorbed dose Radiological weapon Clinical Competence Radiology Radiation protection Paediatric radiology business Nuclear medicine |
| Zdroj: | The British Journal of Radiology. 78:34-38 |
| ISSN: | 1748-880X 0007-1285 |
| Popis: | A national study was performed to investigate radiation doses and associated risks to patients during X-ray fluoroscopy-guided small intestinal biopsies in the investigation of coeliac disease. Thermoluminescent dosemeters (TLD) and questionnaires were sent to 42 of the 43 paediatric departments in Sweden performing these biopsies. During the study period (263 weeks) 257 biopsies were recorded, representing about 10% of annually performed paediatric investigations. The results show that the absorbed dose during biopsy ranged from 0.04 mGy to 23.8 mGy (mean 1.87 mGy). The fluoroscopy time ranged from 2 s to 663 s (mean 60 s). The collective dose from the procedure amounts to 4.7 manSv year 21 . Thus, the annual excess cancer mortality, including severe hereditary effects, can be estimated at 0.6-0.7 cases per year. However, significant dose saving can be obtained by proper choice of sedation and biopsy equipment. Several studies have been performed on dose and related risk to the patient from different diagnostic radiological procedures. The vast majority of these studies have concerned adult patients. However, the risk of lethal cancer from radiation exposure of children is expected to be 2-4 times higher than for adults per dose unit (1, 2). The reason for this difference is not fully clear, but greater cell proliferation rate and longer life expectancy for children both result in a higher risk of developing late effects. Therefore, initiatives have been taken among radiation protection authorities (3-5) to give priority to investigations of dose levels and frequencies of X-ray examinations among children. The main objective is to establish recommendations of upper dose limits for various diagnostic procedures and to implement minimum require- ments for equipment standards (6). In a previous study (7) we measured the radiation dose and assessed the associated long-term risk of paediatric small intestinal biopsies performed at our hospital during a 10-year period. In a follow-up study, performed in co- operation with a neighbouring hospital (8), we found considerably lower radiation doses associated with their biopsy investigations. This urged us to extend our investigations to a national study to obtain extensive information on this diagnostic procedure, including information about equipment and the resulting radiation dose to assess the potential for dose reduction. A full report of patient absorbed doses and fluoroscopy times was published elsewhere (9). In this study we examined parameters such as (i) X-ray equipment; (ii) sedation techniques; (iii) capsule device; (iv) examination frequency, with the purpose of identifying their importance for the dose and associated risk to the patient, and from a cost-benefit point of view to suggest optimal examination conditions. |
| Databáze: | OpenAIRE |
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