Assessing trends in patients undergoing recurrent CT examinations and cumulative doses

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-04-05 DOI:10.1016/j.ejrad.2025.112099

Andrew E. Ferretti, Nathaniel D. Mercaldo, Xinhua Li, Madan M. Rehani

{"title":"Assessing trends in patients undergoing recurrent CT examinations and cumulative doses","authors":"Andrew E. Ferretti, Nathaniel D. Mercaldo, Xinhua Li, Madan M. Rehani","doi":"10.1016/j.ejrad.2025.112099","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Recent research has enhanced our understanding of the number of patients receiving relatively high radiation doses (≥100 mSv) through recurrent CT examinations. However, there is a paucity of information on temporal trends. This study elucidates these trends over the past 11 years.</div></div><div><h3>Methods</h3><div>We retrieved data on CT exams conducted from 2013 to 2023 from our hospital’s dose-management system. We analyzed the number of patients undergoing recurrent CT examinations, calculated the median cumulative effective dose (CED), and assessed the frequency of patients receiving doses of ≥ 50 mSv and ≥ 100 mSv. Generalized linear models that accounted for autocorrelation via Newey-West covariance estimates and non-linearities due to the COVID-19 pandemic were employed to quantify temporal trends.</div></div><div><h3>Results</h3><div>Among 403,997 patients in 11 years, 46.3 % had 1 CT exam, 53.7 % received ≥ 2 exams, 20.3 % received ≥ 5 exams, and 8.3 % had ≥ 10 exams, with 6.6 % having CEDs ≥ 100 mSv. The rate of recurrent exams decreased post-2020 (incident rate ratio, IRR: 1.029, 95 % CI 1.025, 1.033). The median CED increased post-2020 relative to pre-2020 (difference in annual changes: −0.102, 95 % CI −0.119, −0.085). Patients with new annual doses ≥ 100 mSv decreased post-pandemic (IRR: 0.976, 95 % CI 0.955, 0.997).</div></div><div><h3>Conclusions</h3><div>In this study examining temporal trends, the percentage of patients undergoing multiple CT examinations has changed since 2020, with a shift from an increasing to a decreasing trend in those receiving cumulative doses ≥ 100 mSv per year. This suggests an alteration in imaging practices or patient demographics since 2020, providing valuable insights to inform policymaking.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"187 ","pages":"Article 112099"},"PeriodicalIF":3.2000,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0720048X25001858","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Recent research has enhanced our understanding of the number of patients receiving relatively high radiation doses (≥100 mSv) through recurrent CT examinations. However, there is a paucity of information on temporal trends. This study elucidates these trends over the past 11 years.

Methods

We retrieved data on CT exams conducted from 2013 to 2023 from our hospital’s dose-management system. We analyzed the number of patients undergoing recurrent CT examinations, calculated the median cumulative effective dose (CED), and assessed the frequency of patients receiving doses of ≥ 50 mSv and ≥ 100 mSv. Generalized linear models that accounted for autocorrelation via Newey-West covariance estimates and non-linearities due to the COVID-19 pandemic were employed to quantify temporal trends.

Results

Among 403,997 patients in 11 years, 46.3 % had 1 CT exam, 53.7 % received ≥ 2 exams, 20.3 % received ≥ 5 exams, and 8.3 % had ≥ 10 exams, with 6.6 % having CEDs ≥ 100 mSv. The rate of recurrent exams decreased post-2020 (incident rate ratio, IRR: 1.029, 95 % CI 1.025, 1.033). The median CED increased post-2020 relative to pre-2020 (difference in annual changes: −0.102, 95 % CI −0.119, −0.085). Patients with new annual doses ≥ 100 mSv decreased post-pandemic (IRR: 0.976, 95 % CI 0.955, 0.997).

Conclusions

In this study examining temporal trends, the percentage of patients undergoing multiple CT examinations has changed since 2020, with a shift from an increasing to a decreasing trend in those receiving cumulative doses ≥ 100 mSv per year. This suggests an alteration in imaging practices or patient demographics since 2020, providing valuable insights to inform policymaking.

查看原文本刊更多论文

评估反复CT检查患者的趋势和累积剂量

最近的研究通过反复的CT检查增强了我们对接受相对高辐射剂量（≥100毫西弗）的患者数量的了解。但是，关于时间趋势的资料很少。这项研究阐明了过去11年来的这些趋势。方法从我院剂量管理系统中检索2013 - 2023年CT检查数据。我们分析了接受复发性CT检查的患者数量，计算了中位累积有效剂量（CED），并评估了接受剂量≥50毫西弗和≥100毫西弗的患者的频率。采用广义线性模型，通过新西部协方差估计和COVID-19大流行引起的非线性来解释自相关，以量化时间趋势。结果11年403,997例患者中，46.3%接受1次CT检查，53.7%接受≥2次CT检查，20.3%接受≥5次CT检查，8.3%接受≥10次CT检查，其中6.6%的患者CEDs≥100 mSv。2020年后复查率下降（IRR: 1.029, 95% CI: 1.025, 1.033）。中位CED在2020年后相对于2020年前增加（年变化差异：- 0.102,95% CI - 0.119, - 0.085）。年新剂量≥100 mSv的患者在大流行后减少（IRR: 0.976, 95% CI 0.955, 0.997）。本研究考察了时间趋势，自2020年以来，接受多次CT检查的患者百分比发生了变化，在每年累计剂量≥100 mSv的患者中，从增加趋势转变为减少趋势。这表明自2020年以来，成像实践或患者人口统计学发生了变化，为决策提供了有价值的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.