David J Grand1,2, Adam Harris3, Jason Shapiro4, Edmund Wu3, Julie Giacalone5, Bruce E Sands5, Renee Bright6, Heather Moniz6, Meaghan Mallette6, Neal Leleiko3,4, Sylvan Wallenstein5, Zahid Samad7, Marjorie Merrick8, Samir A Shah3,6. 1. Alpert Medical School, Brown University, Providence, RI, USA. dgrand@lifespan.org. 2. Department of Diagnostic Imaging, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, 593 Eddy St., Providence, RI, 02906, USA. dgrand@lifespan.org. 3. Alpert Medical School, Brown University, Providence, RI, USA. 4. Hasbro Children's Hospital, Providence, RI, USA. 5. Icahn School of Medicine at Mount Sinai, New York, NY, USA. 6. Rhode Island Hospital, Providence, RI, USA. 7. National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. 8. Crohn's & Colitis Foundation of America, New York, NY, USA.
Abstract
PURPOSE: Patients with inflammatory bowel disease (IBD) may be exposed to high doses of diagnostic radiation. The purpose of this study is to identify subsets of this population at risk for significant radiation exposure. METHODS: This HIPAA compliant, IRB approved study consists of 336 patients (237 adult and 99 pediatric) within the Ocean State Crohn's & Colitis Area Registry (OSCCAR). All were newly diagnosed with IBD and prospectively enrolled between 1/2008 and 12/2012. Comprehensive chart review was performed. RESULTS: 207 (61.6%) patients were diagnosed with Crohn's disease (CD), 120 (35.7%) with ulcerative colitis (UC), and 9 (2.7%) with inflammatory bowel disease, type unspecified (IBDU). 192 (57.1%) patients were exposed to GI-specific radiation. Average GI-specific radiation dose for adult IBD patients was 14.1 mSV and was significantly greater among adult CD than adult UC patients (p = 0.01). Pediatric patients underwent fewer CT scans (p < 0.0001). Risk factors for increased radiation exposure include: GI surgery (p = 0.003), biologic therapy (p = 0.01), pain-predominant symptoms (as compared to diarrhea-predominant symptoms; p < 0.05), and isolated ileal disease (p = 0.02). Patients with stricturing or penetrating disease received higher radiation doses than patients with non-stricturing, non-penetrating disease (p < 0.0001). CONCLUSIONS: A variety of risk factors are associated with increased exposure to ionizing radiation after diagnosis of IBD. Knowledge of these risk factors can help physicians prospectively identify patients at risk for elevated radiation exposure and consider low-dose or radiation-free imaging.
PURPOSE:Patients with inflammatory bowel disease (IBD) may be exposed to high doses of diagnostic radiation. The purpose of this study is to identify subsets of this population at risk for significant radiation exposure. METHODS: This HIPAA compliant, IRB approved study consists of 336 patients (237 adult and 99 pediatric) within the Ocean State Crohn's & Colitis Area Registry (OSCCAR). All were newly diagnosed with IBD and prospectively enrolled between 1/2008 and 12/2012. Comprehensive chart review was performed. RESULTS: 207 (61.6%) patients were diagnosed with Crohn's disease (CD), 120 (35.7%) with ulcerative colitis (UC), and 9 (2.7%) with inflammatory bowel disease, type unspecified (IBDU). 192 (57.1%) patients were exposed to GI-specific radiation. Average GI-specific radiation dose for adult IBDpatients was 14.1 mSV and was significantly greater among adult CD than adult UC patients (p = 0.01). Pediatric patients underwent fewer CT scans (p < 0.0001). Risk factors for increased radiation exposure include: GI surgery (p = 0.003), biologic therapy (p = 0.01), pain-predominant symptoms (as compared to diarrhea-predominant symptoms; p < 0.05), and isolated ileal disease (p = 0.02). Patients with stricturing or penetrating disease received higher radiation doses than patients with non-stricturing, non-penetrating disease (p < 0.0001). CONCLUSIONS: A variety of risk factors are associated with increased exposure to ionizing radiation after diagnosis of IBD. Knowledge of these risk factors can help physicians prospectively identify patients at risk for elevated radiation exposure and consider low-dose or radiation-free imaging.
Authors: Richard G Kavanagh; John O'Grady; Brian W Carey; Patrick D McLaughlin; Siobhan B O'Neill; Michael M Maher; Owen J O'Connor Journal: Gastroenterol Res Pract Date: 2018-10-31 Impact factor: 2.260
Authors: Jonathan W Lischalk; Seth Blacksburg; Christopher Mendez; Michael Repka; Astrid Sanchez; Todd Carpenter; Matthew Witten; Jules E Garbus; Andrew Evans; Sean P Collins; Aaron Katz; Jonathan Haas Journal: Radiat Oncol Date: 2021-07-09 Impact factor: 3.481