Caterina Giannitto1, Mauro Campoleoni2, Sara Maccagnoni3, Alessio Salvatore Angileri3, Maria Carmela Grimaldi3, Nino Giannitto4, Francesca De Piano3, Eleonora Ancona3, Pietro Raimondo Biondetti5, Andrea Alessandro Esposito5. 1. Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy. caterina.giannitto@gmail.com. 2. Medical Phisic Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20121, Milan, Italy. 3. Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy. 4. Università di Messina, Via Consolare Valeria 1, 98125, Messina, Italy. 5. Department of Radiology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20121, Milan, Italy.
Abstract
PURPOSE: To determine the frequency of unindicated CT phases and the resultant excess of absorbed radiation doses to the uterus and ovaries in women of reproductive age who have undergone CT for non-traumatic abdomino-pelvic emergencies. MATERIALS AND METHODS: We reviewed all abdomino-pelvic CT examinations in women of reproductive age (40 years or less), between 1 June 2012 and 31 January 2015. We evaluated the appropriateness of each CT phase on the basis of clinical indications, according to ACR appropriateness criteria and evidence-based data from the literature. The doses to uterus and ovaries for each phase were calculated with the CTEXPO software, taking into consideration the size-specific dose estimate (SSDE) after measuring the size of every single patient. RESULTS: The final cohort was composed of 76 female patients with an average age of 30 (from 19 to 40 years). In total, 197 CT phases were performed with an average of 2.6 phases per patient. Out of these, 93 (47%) were unindicated with an average of 1.2 inappropriate phases per patient. Unindicated scans were most frequent for appendicitis and unlocalized abdominal pain. The excesses of mean radiation doses to the uterus and ovaries due to unindicated phases were, respectively, of 38 and 33 mSv per patient. CONCLUSION: In our experience, unindicated additional CT phases were numerous with a significant excess radiation dose without an associated clinical benefit. This excess of radiation could have been avoided by widespread adoption of the ACR appropriateness criteria and evidence-based data from the literature.
PURPOSE: To determine the frequency of unindicated CT phases and the resultant excess of absorbed radiation doses to the uterus and ovaries in women of reproductive age who have undergone CT for non-traumatic abdomino-pelvic emergencies. MATERIALS AND METHODS: We reviewed all abdomino-pelvic CT examinations in women of reproductive age (40 years or less), between 1 June 2012 and 31 January 2015. We evaluated the appropriateness of each CT phase on the basis of clinical indications, according to ACR appropriateness criteria and evidence-based data from the literature. The doses to uterus and ovaries for each phase were calculated with the CTEXPO software, taking into consideration the size-specific dose estimate (SSDE) after measuring the size of every single patient. RESULTS: The final cohort was composed of 76 female patients with an average age of 30 (from 19 to 40 years). In total, 197 CT phases were performed with an average of 2.6 phases per patient. Out of these, 93 (47%) were unindicated with an average of 1.2 inappropriate phases per patient. Unindicated scans were most frequent for appendicitis and unlocalized abdominal pain. The excesses of mean radiation doses to the uterus and ovaries due to unindicated phases were, respectively, of 38 and 33 mSv per patient. CONCLUSION: In our experience, unindicated additional CT phases were numerous with a significant excess radiation dose without an associated clinical benefit. This excess of radiation could have been avoided by widespread adoption of the ACR appropriateness criteria and evidence-based data from the literature.
Entities:
Keywords:
Computed tomography; Emergency; Radiation protection; Women
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