Imaging strategies to reduce the risk of radiation in CT studies, including selective substitution with MRI

Journal of Magnetic Resonance Imaging

Volumn 25, Issue 5, 2007, Pages 900-909

  Semelka, Richard C ^a   Armao, Diane M ^a   Elias Jr , Jorge ^a,b   Huda, Walter ^b  

^a UNIVERSITY OF NORTH CAROLINA SCHOOL OF MEDICINE   (United States)

^b UNIVERSITY OF SÃO PAULO   (Brazil)

Author keywords

Cancer risks; Computed tomography; Ionizing radiation; MRI; Patient safety

Indexed keywords

BODY SIZE; CANCER RISK; COMPUTER ASSISTED TOMOGRAPHY; CONTRAST ENHANCEMENT; DIGITAL RADIOGRAPHY; DNA STRAND BREAKAGE; HUMAN; IMAGE QUALITY; IONIZING RADIATION; NUCLEAR MAGNETIC RESONANCE IMAGING; PATIENT SAFETY; PRIORITY JOURNAL; RADIATION CATARACT; RADIATION DOSE; RADIATION HAZARD; RADIATION SAFETY; REVIEW; RISK REDUCTION;

HUMANS; MAGNETIC RESONANCE IMAGING; NEOPLASMS, RADIATION-INDUCED; RADIATION DOSAGE; RADIATION INJURIES; RISK FACTORS; TOMOGRAPHY, X-RAY COMPUTED;

EID: 34247881892     PISSN: 10531807     EISSN: 15222586     Source Type: Journal    
DOI: 10.1002/jmri.20895     Document Type: Review

References (110)

1. Hayashino Y, Goto M, Noguchi Y, Fukui T. Ventilation-perfusion scanning and helical CT in suspected pulmonary embolism: metaanalysis of diagnostic performance. Radiology 2005;234:740-748.
2. Lynch DA, Travis WD, Muller NL, et al. Idiopathic interstitial pneumonias: CT features. Radiology 2005;236:10-21.
3. Lee CI, Haims AH, Monico EP, Brink JA, Forman HP. Diagnostic CT scans: assessment of patient, physician, and radiologist awareness of radiation dose and possible risks. Radiology 2004;231:393-398.
4. Hall EJ. Radiobiology for the radiologist. Philadelphia, PA: Lippincott Williams & Wilkins: 2000. 588 p.
5. ICRP. 1990 recommendations of the International Commission on Radiological Protection. Ann ICRP 1991;21:1-201.
6. Committee on the Biological Effects of Ionizing Radiation (BEIR V) NRC. Health effects of exposure to low levels of ionizing radiation: BEIR V. Washington, DC: National Academy Press; 1990.
7. UNSCEAR 2000 Report to the General Assembly: United Nations Scientific Committee on the Effects of Atomic Radiation 2000.
8. Ulrich H. Incidence of leukemia in radiologists. N Engl J Med 1946;234:742-743.
9. Lewis EB. Leukemia and ionizing radiation. Science 1957;125:965-972.
10. Giles D, Hewitt D, Stewart A, Webb J. Malignant disease in childhood and diagnostic irradiation in utero. Lancet 1956;271:447.
11. Hewitt D. Some features of leukaemia mortality. Br J Prev Soc Med 1955;9:81-88.
12. Doll R, Wakeford R. Risk of childhood cancer from fetal irradiation. Br J Radiol 1997;70:130-139.
13. Morin Doody M, Lonstein JE, Stovall M, Hacker DG, Luckyanov N, Land CE. Breast cancer mortality after diagnostic radiography: findings from the U.S. Scoliosis Cohort Study. Spine 2000;25:2052-2063.
14. Infante-Rivard C, Mathonnet G, Sinnett D. Risk of childhood leukemia associated with diagnostic irradiation and polymorphisms in DNA repair genes. Environ Health Perspect 2000;108:495-498.
15. Brenner DJ, Doll R, Goodhead DT, et al. Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci USA 2003;100:13761-13766.
16. Preston DL, Shimizu Y, Pierce DA, Suyama A, Mabuchi K. Studies of mortality of atomic bomb survivors. Report 13: Solid cancer and noncancer disease mortality: 1950-1997. Radiat Res 2003;160:381-407.
17. Brenner DJ, Elliston CD. Estimated radiation risks potentially associated with full-body CT screening. Radiology 2004;232:735-738.
18. Brenner DJ, Hall EJ. Risk of cancer from diagnostic X-rays. Lancet 2004;363:2192; author reply 2192-2193.
19. Brenner DJ. Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative. Pediatr Radiol 2002;32:228-223; discussion 242-224.
20. Frush DP, Donnelly LF, Rosen NS. Computed tomography and radiation risks: what pediatric health care providers should know. Pediatrics 2003;112:951-957.
21. Parker MS, Hui FK, Camacho MA, Chung JK, Broga DW, Sethi NN. Female breast radiation exposure during CT pulmonary angiography. AJR Am J Roentgenol 2005;185:1228-1233.
22. Katz SI, Saluja S, Brink JA, Forman HP. Radiation dose associated with unenhanced CT for suspected renal colic: impact of repetitive studies. AJR Am J Roentgenol 2006;186:1120-1124.
23. Lobrich M, Rief N, Kuhne M, et al. In vivo formation and repair of DNA double-strand breaks after computed tomography examinations. Proc Natl Acad Sci USA 2005;102:8984-8989.
24. Huda W. Radiation dosimetry in diagnostic radiology. AJR Am J Roentgenol 1997;169:1487-1488.
25. Bae KT, Hong C, Whiting BR. Radiation dose in multidetector row computed tomography cardiac imaging. J Magn Reson Imaging 2004;19:859-863.
26. Huda W. Dose and image quality in CT. Pediatr Radiol 2002;32:709-713; discussion 751-704.
27. Dixon AK, Dendy P. Spiral CT: how much does radiation dose matter? Lancet 1998;352:1082-1083.
28. Imaizumi M, Usa T, Toininaga T, et al. Radiation dose-response relationships for thyroid nodules and autoimmune thyroid diseases in Hiroshima and Nagasaki atomic bomb survivors 55-58 years after radiation exposure. JAMA 2006;295:1011-1022.
29. Huda W. Effective doses to adult and pediatric patients. Pediatr Radiol 2002;32:272-279.
30. Anderson Hospital and Tumor Institute: Cellular Radiation Biology. Eighteenth Symposium on Fundamental Cancer Research, Houston, 1964. Baltimore: Williams and Wilkins Co.; 1965.
31. Pierce DA, Shimizu Y, Preston DL, Vaeth M, Mabuchi K. Studies of the mortality of atomic bomb survivors. Report 12, Part 1. Cancer: 1950-1990. Radiat Res 1996;146:1-27.
32. Brenner D, Elliston C, Hall E, Berdon W. Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol 2001;176:289-296.
33. Executive Summary. Board on Radiation Effects Research - Division on Earth and Life Studies editor Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII - Phase 2. Washington, DC: National Academy Press; 2005.
34. Panel discussion. Pediatr Radiol 2002;32:242-244.
35. Huda W, Chamberlain CC, Rosenbaum AE, Garrisi W. Radiation doses to infants and adults undergoing head CT examinations. Med Phys 2001;28:393-399.
36. Huda W, Scalzetti EM, Roskopf M. Effective doses to patients undergoing thoracic computed tomography examinations. Med Phys 2000;27:838-844.
37. Mettler FA, Jr., Wiest PW, Locken JA, Kelsey CA. CT scanning: patterns of use and dose. J Radiol Prot 2000;20:353-359.
38. Ware DE, Huda W, Mergo PJ, Litwiller AL. Radiation effective doses to patients undergoing abdominal CT examinations. Radiology 1999;210:645-650.
39. Paterson A, Frush DP, Donnelly LF. Helical CT of the body: are settings adjusted for pediatric patients? AJR Am J Roentgenol 2001;176:297-301.
40. Prokop M. Cancer screening with CT: dose controversy. Eur Radiol 2005;15(Suppl 4):D55-D61.
41. What are the radiation risks from CT? U.S. Food and Drug Administration. http://www.fda.gov/cdrh/ct/risks.html; 2005.
42. de Gonzalez BA, Darby S. Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries. Lancet 2004;363:345-351.
43. Union OW, Mettler Jr FA. National conference on dose reduction in CT, with an emphasis on pediatric patients. AJR Am J Roentgenol 2003;181:321-329.
44. Levatter RE, Brenner DJ, Elliston CD. Radiation risk of body CT: what to tell our patients and other questions. Drs. Brenner and Elliston respond. Radiology 2005;234:968-970.
45. Jacob K, Vivian G, Steel JR. X-ray dose training: are we exposed to enough? Clin Radiol 2004;59:928-934; discussion 926-927.
46. Mulshine JL, Sullivan DC. Clinical practice. Lung cancer screening. N Engl J Med 2005;352:2714-2720.
47. National Toxicology Program. 11th report on carcinogens. Research Triangle Park. NC: Department, of Health and Human Services; 2005.
48. Evaluation of the linear-nonthreshold dose-response model for ionizing radiation. Report 136. National Council on Radiation Protection and Measurements (NCRP); 2001.
49. Cardis E, Vrijheid M, Blettner M, et al. Risk of cancer after low doses of ionising radiation: retrospective cohort study in 15 countries. BMJ 2005;331:77.
50. Uncertainties in fatal cancer risk estimates used in radiation protection. Report 126. National Council on Radiation Protection and Measurements; 1997.
51. Cohen BL. Cancer risk from low-level radiation. AJR Am J Roentgenol 2002;179:1137-1143.
52. Romerio F. Which paradigm for managing the risk of ionizing radiation? Risk Anal 2002;22:59-66.
53. Rossi HH, Zaider M. Radiogenic lung cancer: the effects of low doses of low linear energy transfer (LET) radiation. Radiat Environ Biophys 1997;36:85-88.
54. Sagan LA. What is hormesis and why haven't we heard about it before? Health Phys 1987;52:517-680.
55. Cameron JR, Moulder JE. Proposition: radiation hormesis should be elevated to a position of scientific respectability. Med Phys 1998;25:1407-1410.
56. Gofman JW. Radiation and human health. San Francisco: Sierra Club Books; 1981.
57. Kneale GW, Stewart AM. Reanalysis of Hanford data: 1944-1986 deaths. Am J Ind Med 1993;23:371-389.
58. Ehrle LH. Ionising radiation in infancy and adult cognitive function: much research on low dose radiation remains hidden. BMJ 2004;328:582; author reply 582.
59. Brunk CG, Haworth L, Lee B. Value assumptions in risk assessment. Brunk CG, Haworth L, Lee B, editors. Waterloo, Canada: Wilfrid Laurier University Press; 1991.
60. Rofsky NM, Weinreb JC, Bosniak MA, Libes RB, Birnbaum BA. Renal lesion characterization with gadolinium-enhanced MR imaging: efficacy and safety in patients with renal insufficiency. Radiology 1991;180:85-89.
61. Kaur H, Loyer E, Lano I. Pancreatic cancer. In: Evans D, Abruzzese JL, Pisters PWT, editors. Pancreatic cancer: radiology staging. New York: Springer-Verlag. 2002: 85-95.
62. Noone TC, Semelka RC, Chaney DM, Reinhold C. Abdominal imaging studies: comparison of diagnostic accuracies resulting from ultrasound, computed tomography, and magnetic resonance imaging in the same individual. Magn Reson Imaging 2004;22:19-24.
63. Semelka RC, Maycher B, Shoenut JP, Kroeker R, Griffin P, Lertzman M. Dynamic Gd-DTPA enhanced Breath-hold 1.5 T MRI of normal lungs and patients with interstitial lung disease and pulmonary nodules: preliminary results. Eur Radiol 1992;2:576-582.
64. Willis CE, Slovis TL. The ALARA concept in pediatric CR and DR: dose reduction in pediatric radiographic exams-a white paper conference executive summary. Pediatr Radiol 2004;34(Suppl 3):S162-S164.
65. Chapman BE, Yankelevitz DP, Henschke CI, Gur D. Lung cancer screening: simulations of effects of imperfect detection on temporal dynamics. Radiology 2005;234:582-590.
66. Low RN, Semelka RC, Worawattanakul S, Alzate GD, Sigeti JS. Extrahepatic abdominal imaging in patients with malignancy: comparison of MR imaging and helical CT, with subsequent surgical correlation. Radiology 1999;210:625-632.
67. Memarsadeghi M, Heinz-Peer G, Helbich TH, et al. Unenhanced multi-detector row CT in patients suspected of having urinary stone disease: effect of section width on diagnosis. Radiology 2005;235:530-536.
68. Kanal E, Borgstede JP, Barkovich AJ, et al. American College of Radiology white paper on MR safety. AJR Am J Roentgenol 2002;178:1335-1347.
69. Klucznik RP, Carrier DA, Pyka R, Haid RW. Placement of a ferromagnetic intracerebral aneurysm clip in a magnetic field with a fatal outcome. Radiology 1993;187:855-856.
70. Grobner T. Gadolinium-a specific trigger for the development of nephrogenic fibrosing dermopathy and nephrogenic systemic fibrosis? Nephrol Dial Transplant 2006;21:1104-1108.
71. Marckmann P, Skov L, Rossen K, et al. Nephrogenic systemic fibrosis: suspected causative role of gadodiamide used for contrast-enhanced magnetic resonance imaging. J Am Soc Nephrol 2006;17:2359-2362.
72. Birchard KR, Semelka RC, Hyslop WB, et al. Suspected pancreatic cancer: evaluation by dynamic gadolinium-enhanced 3D gradient-echo MRI. AJR Am J Roentgenol 2005;185:700-703.
73. Gabata T, Matsui O, Kadoya M, et al. Small pancreatic adenocarcinomas: efficacy of MR imaging with fat suppression and gadolinium enhancement. Radiology 1994;193:683-688.
74. Semelka RC, Kelekis NL, Molina PL, Sharp TJ, Calvo B. Pancreatic masses with inconclusive findings on spiral CT: is there a role for MRI? J Magn Reson Imaging 1996;6:585-588.
75. Outwater EK, Siegelman ES, Huang AB, Birnbaum BA. Adrenal masses: correlation between CT attenuation value and chemical shift ratio at MR imaging with in-phase and opposed-phase sequences. Radiology 1996;200:749-752.
76. Semelka RC, Shoenut JP, Kroeker MA, MacMahon RG, Greenberg HM. Renal lesions: controlled comparison between CT and 1.5-T MR imaging with nonenhanced and gadolinium-enhanced fat-suppressed spin-echo and breath-hold FLASH techniques. Radiology 1992;182:425-430.
77. Semelka RC, Shoenut JP, Ascher SM, et al. Solitary hepatic metastasis: comparison of dynamic contrast-enhanced CT and MR imaging with fat-suppressed T2-weighted. breath-hold T1-weighted FLASH, and dynamic gadolinium-enhanced FLASH sequences. J Magn Reson Imaging 1994;4:319-323.
78. Semelka RC, Martin DR, Balci C, Lance T. Focal liver lesions: comparison of dual-phase CT and multisequence multiplanar MR imaging including dynamic gadolinium enhancement. J Magn Reson Imaging 2001;13:397-401.
79. Vassiliades VG, Foley WD, Alarcon J, et al. Hepatic metastases: CT versus MR imaging at 1.5T. Gastrointest Radiol 1991;16:159-163.
80. Larson RE, Semelka RC, Bagley AS, Molina PL, Brown ED, Lee JK. Hypervascular malignant liver lesions: comparison of various MR imaging pulse sequences and dynamic CT. Radiology 1994;192:393-399.
81. Low RN, Semelka RC, Worawattanakul S, Alzate GD. Extrahepatic abdominal imaging in patients with malignancy: comparison of MR imaging and helical CT in 164 patients. J Magn Reson Imaging 2000;12:269-277.
82. Lauenstein TC, Goehde SC, Herborn CU, et al. Whole-body MR imaging: evaluation of patients for metastases. Radiology 2004;233:139-148.
83. Semelka RC. Abdominal pelvic MRI. New York: Wiley-Liss; 2006.
84. Bell RA. Magnetic resonance in medicine in 2020. Decisions in imaging echonomics 2004:December 23-33.
85. Donnelly LF. Reducing radiation dose associated with pediatric CT by decreasing unnecessary examinations. AJR Am J Roentgenol 2005;184:655-657.
86. Partrick DA, Janik JE, Janik JS, Bensard DD, Karrer FM. Increased CT scan utilization does not improve the diagnostic accuracy of appendicitis in children. J Pediatr Surg 2003;38:659-662.
87. Brenner DJ. Radiation risks potentially associated with low-dose CT screening of adult, smokers for lung cancer. Radiology 2004;231:440-445.
88. Illes J, Kann D, Karetsky K, et al. Advertising, patient decision making, and self-referral for computed tomographic and magnetic resonance imaging. Arch Intern Med 2004;164:2415-2419.
89. Amen Clinics Inc., A Medical Corporation. Volume 2005: 2005. amenclinics.com.
90. Martin DR, Semelka RC. Health effects of ionising radiation from diagnostic CT. Lancet 2006;367:1712-1714.
91. Ravenel JG, Scalzelti EM, Huda W, Garrisi W. Radiation exposure and image quality in chest CT examinations. AJR Am J Roentgenol 2001;177:279-284.
92. Freedman M, Pe E, Mun SK, Lo SCB, Nelson M. The potential for unnecessary patient exposure from the use of storage phosphor imaging systems. SPIE Med Imaging 1993;1897:472-479.
93. Seibert JA, Shelton DK, Moore EH. Computed radiography X-ray exposure trends. Acad Radiol 1996;3:313-318.
94. Kalra MK, Maher MM, Toth TL, et al. Strategics for CT radiation dose optimization. Radiology 2004;230:619-628.
95. Hilda W, Scalzetti EM, Levin G. Technique factors and image quality as functions of patient weight at abdominal CT. Radiology 2000;217:430-435.
96. Ogden K, Huda W, Scalzetti EM, Roskopf ML. Patient size and x-ray transmission in body CT. Health Phys 2004;86:397-405.
97. Brody AS. Thoracic: CT technique in children. J Thorac Imaging 2001;16:259-268.
98. Donnelly LF, Emery KH, Brody AS, et al. Minimizing radiation dose for pediatric body applications of single-detector helical CT: strategies at a large children's hospital. AJR Am J Roentgenol 2001;176:303-306.
99. Slovis TL. CT and computed radiography: the pictures are great, but is the radiation dose greater than required? AJR Am J Roentgenol 2002;179:39-41.
100. McCollough CH, Bruesewitz MR, McNitt-Gray MF, et al. The phantom portion of the American College of Radiology (ACR) computed tomography (CT) accreditation program: practical lips, artifact examples, and pitfalls to avoid. Med Phys 2004;31:2423-2442.
101. Berdon WE, Slovis TL. Where we are since ALARA and the series of articles on CT dose in children and risk of long-term cancers: what has changed? Pediatr Radiol 2002;32:699.
102. Medical imaging - the assessment of image quality. Report 54: International Commission on Radiation Units and Measurements. Inc.; 1996.
103. Wintermark M, Maeder P, Verdun FR, et al. Using 80 kVp versus 120 kVp in perfusion CT measurement of regional cerebral blood flow. AJNR Am J Neuroradiol 2000;21:1881-1884.
104. Hilda W, Lieberman KA, Chang J, Roskopf ML. Patient size and x-ray technique factors in head computed tomography examinations. II. Image quality. Med Phys 2004;31:595-601.
105. Garnier S, Bertrand P, Chapiron C, Asquier E, Rouleau P, Brunereau L. [Low dose helical CT pelvimetry; evaluation of radiation dose and image processing]. J Radiol 2004;85(6 Pt 1):747-753.
106. Buthiau D. [Computerized tomography pelvimetry: recent advances]. Gynecol Obstet Fertil 2003;31:465-470.
107. Swensen SJ, Jell JR, Hartman TE, et al. CT screening for lung cancer: five-year prospective experience. Radiology 2005;235:259-265.
108. Oguchi K, Sone S, Kiyono K, et al. Optimal lube current for lung cancer screening with low-dose spiral CT. Acta Radiol 2000;41:352-356.
109. Tack D, De Maertelaer V, Petit W, et al. Multi-detector row CT pulmonary angiography: comparison of standard-dose and simulated low-dose techniques. Radiology 2005;236:318-325.
110. Flohr TG, McCollough CH, Bruder H, et al. First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 2006;16:256-268.