Radiation Dose from Computed Tomography in Patients with Necrotizing Pancreatitis: How Much Is Too Much?

Chad G. Ball, Camilo Correa-Gallego, Thomas Howard, Nicholas Zyromski, Michael House, Henry A. Pitt, Attila Nakeeb, C. Schmidt, M. Akisik, Keith D. Lillemoe

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objectives: Low-dose ionizing radiation from medical imaging has been indirectly linked with subsequent cancer. Computed tomography (CT) is the gold standard for defining pancreatic necrosis. The primary goal was to identify the frequency and effective radiation dose of CT imaging for patients with necrotizing pancreatitis. Methods: All patients with necrotizing pancreatitis (2003-2007) were retrospectively analyzed for CT-related radiation exposure. Results: Necrosis was identified in 18% (238/1290) of patients with acute pancreatitis (mean age = 53 years; hospital/ICU length of stay = 23/7 days; mortality = 9%). A median of five CTs/patient [interquartile range (IQR) = 4] were performed during a median 2.6-month interval. The average effective dose was 40 mSv per patient (equivalent to 2,000 chest X-rays; 13.2 years of background radiation; one out of 250 increased risk of fatal cancer). The actual effective dose was 63 mSv considering various scanner technologies. CTs were infrequently (20%) followed by direct intervention (199 interventional radiology, 118 operative, 12 endoscopic) (median = 1; IQR = 2). Magnetic resonance imaging did not have a CT-sparing effect. Mean direct hospital costs increased linearly with CT number (R = 0.7). Conclusions: The effective radiation dose received by patients with necrotizing pancreatitis is significant. Management changes infrequently follow CT imaging. The ubiquitous use of CT in necrotizing pancreatitis raises substantial public health concerns and mandates a careful reassessment of its utility.

Original languageEnglish
Pages (from-to)1529-1535
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume14
Issue number10
DOIs
StatePublished - 2010

Fingerprint

Pancreatitis
Tomography
Radiation
Necrosis
Background Radiation
Interventional Radiology
Hospital Costs
Diagnostic Imaging
Ionizing Radiation
Length of Stay
Neoplasms
Thorax
Public Health
Magnetic Resonance Imaging
X-Rays
Technology
Mortality

Keywords

  • Computed tomography
  • Necrotizing pancreatitis
  • Radiation

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Radiation Dose from Computed Tomography in Patients with Necrotizing Pancreatitis : How Much Is Too Much? / Ball, Chad G.; Correa-Gallego, Camilo; Howard, Thomas; Zyromski, Nicholas; House, Michael; Pitt, Henry A.; Nakeeb, Attila; Schmidt, C.; Akisik, M.; Lillemoe, Keith D.

In: Journal of Gastrointestinal Surgery, Vol. 14, No. 10, 2010, p. 1529-1535.

Research output: Contribution to journalArticle

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