Trends of patient exposure from radiologic and nuclear medicine procedures 2009-2018: Comparison of US vs. global data
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pubs.rsna.org/doi/10.1148/ra…
@mmahesh1, Armin J. Ansari, Fred A. Mettler
@radiology_rsna @RadITrainEditor @Hopkins_Rad @HopkinsMedicine
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pubs.rsna.org/doi/10.1148/ra…
@mmahesh1, Armin J. Ansari, Fred A. Mettler
2/ BACKGROUND
Patient radiation exposure is affected by # of procedures, radiation dose per procedure, and population size. Woldwide, which of the following modalities resulted in the most exams annually?
Patient radiation exposure is affected by # of procedures, radiation dose per procedure, and population size. Woldwide, which of the following modalities resulted in the most exams annually?
3/
Answer: Conventional Radiology (XR).
Relative contributions worldwide by modality is shown here:
Answer: Conventional Radiology (XR).
Relative contributions worldwide by modality is shown here:
4/
Meanwhile, which modality confers the most estimated collective effective dose annually?
Meanwhile, which modality confers the most estimated collective effective dose annually?
5/
Answer: Computed Tomography (CT).
Relative contributions by modality are shown here:
Answer: Computed Tomography (CT).
Relative contributions by modality are shown here:
6/
This report compares patient exposure between the US data (the National Council on Radiation Protection and Measurements [NCRP]) and the worldwide data (the United Nations Scientific Committee on the Effects of Atomic Radiation [UNSCEAR]).
This report compares patient exposure between the US data (the National Council on Radiation Protection and Measurements [NCRP]) and the worldwide data (the United Nations Scientific Committee on the Effects of Atomic Radiation [UNSCEAR]).
7/
The US makes up only 4.4% of the world’s population but accounts for a disproportionately large share (15-30%) of global medical radiation procedures.
The US makes up only 4.4% of the world’s population but accounts for a disproportionately large share (15-30%) of global medical radiation procedures.
8/
From 2006 to 2016, medical radiologic usage increased faster than the world population. On the other hand, the annual average effective dose per person decreased worldwide from 0.65 to 0.56 mSv and from 3 to 2.2 mSv in the US.
From 2006 to 2016, medical radiologic usage increased faster than the world population. On the other hand, the annual average effective dose per person decreased worldwide from 0.65 to 0.56 mSv and from 3 to 2.2 mSv in the US.
9/ XR
The total number of procedures decreased. Major shifts include that XR intravenous urography had been replaced by CT and MR urography, and gastrointestinal fluoroscopy has been partially replaced by endosocopy.
The total number of procedures decreased. Major shifts include that XR intravenous urography had been replaced by CT and MR urography, and gastrointestinal fluoroscopy has been partially replaced by endosocopy.
10/ CT
CT scans in the US went up about 20% from 2006 to 2016, while the global number almost doubled. In terms of body parts, the largest increase in numbers are in abdomen, brain, and chest CTs.
CT scans in the US went up about 20% from 2006 to 2016, while the global number almost doubled. In terms of body parts, the largest increase in numbers are in abdomen, brain, and chest CTs.
11/ CT Effective dose per exam
Per the NRCP, in 2016, the CT’s with the highest effective dose (mSv) per exam were spine (8.8), cardiac (8.7), and abdomen and pelvis (7.7).
Per the NRCP, in 2016, the CT’s with the highest effective dose (mSv) per exam were spine (8.8), cardiac (8.7), and abdomen and pelvis (7.7).
12/ NM
In the US, the annual number of NM procedures decreased by more than 20% due to the partial replacement of NM cardiac studies by stress echocardiograms and cardiac CT.
In the US, the annual number of NM procedures decreased by more than 20% due to the partial replacement of NM cardiac studies by stress echocardiograms and cardiac CT.
13/ In Conclusion
CT contributes to the largest share of medical radiation dose at a population level. Usage of CT exams continued to increase. However, the annual average effective dose per person from medical radiation overall has decreased.
CT contributes to the largest share of medical radiation dose at a population level. Usage of CT exams continued to increase. However, the annual average effective dose per person from medical radiation overall has decreased.
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