scholarly journals Utilization of Diagnostic Imaging and Ionizing Radiation Exposure—Has the Tide Already Turned?

2019 ◽  
Vol 26 (6) ◽  
pp. 907-908
Author(s):  
Sebastian Zundler
Keyword(s):  
Ionizing Radiation ◽  
Diagnostic Imaging ◽  
Radiation Exposure ◽  
Case Control Study ◽  
Management Of Complications ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Ionizing Radiation Exposure ◽  
Control Study

Abstract Inflammatory bowel diseases require repetitive abdominal imaging for diagnosis, follow-up, or management of complications. This editorial comments on the large incident-based case–control study on utilization of diagnostic imaging and ionizing radiation exposure by Nguyen and colleagues published in this issue.

scholarly journals Utilization of Diagnostic Imaging and Ionization Radiation Exposure Among an Inflammatory Bowel Disease Inception Cohort

2019 ◽  
Vol 26 (6) ◽  
pp. 898-906
Author(s):  
Geoffrey C Nguyen ◽  
Daniel Low ◽  
Rachel Y Chong ◽  
Christina Diong ◽  
Tanya Chawla
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Ionizing Radiation ◽  
Diagnostic Imaging ◽  
Radiation Exposure ◽  
High Exposure ◽  
Abdominal Mri ◽  
Inflammatory Bowel ◽  
Ionizing Radiation Exposure

Abstract Background Abdominal imaging is important in managing inflammatory bowel disease (IBD). We characterized utilization of imaging and exposure to ionizing radiation. Methods We enumerated abdominal diagnostic imaging in a population-based cohort of IBD patients between 1994 and 2016. Trends in utilization of abdominal computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound were characterized. Cumulative doses of ionizing radiation were compared between IBD patients and non-IBD controls and between Crohn’s disease (CD) and ulcerative colitis (UC) patients. Regression models were constructed to assess predictors of high ionizing radiation exposure. Results There were 72,933 incident cases of IBD. During the first 5 years of diagnosis, IBD patients were exposed to nearly 6-fold higher exposure to cumulative ionizing radiation attributable to abdominal imaging compared with non-IBD controls (18.6 mSv vs 2.9 mSv). Cumulative ionizing radiation exposure was higher in CD than UC (26.0 mSv vs 12.0 mSv; P < 0.001). Crohn’s disease patients were more than twice as likely as UC patients to exceed 50 mSv (15.6% vs 6.2%; P < 0.001) and 100 mSV (5.0% vs 2.1%; P < 0.001). There was geographic variation in ionizing radiation exposure, and individuals of lower income were more likely to have high exposure. Utilization of abdominal MRI has increased substantially, peaking between 2007 and 2012 and increasing annually at 34%, which coincided with an annual 2% decline in the use of abdominal CT. Conclusions Crohn’s disease patients are at highest risk for high exposure to ionizing radiation, with a subgroup receiving potentially harmful levels. Increasing utilization and access to abdominal MRI may alleviate exposure.

scholarly journals Diagnostic Ionizing Radiation Exposure in a Population-Based Sample of Children With Inflammatory Bowel Diseases

2009 ◽  
Vol 104 (11) ◽  
pp. 2816-2823 ◽  
Author(s):  
Lena Palmer ◽  
Hans Herfarth ◽  
Carol Q Porter ◽  
Lynn A Fordham ◽  
Robert S Sandler ◽  
...  
Keyword(s):  
Ionizing Radiation ◽  
Radiation Exposure ◽  
Inflammatory Bowel Diseases ◽  
Population Based ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Ionizing Radiation Exposure

A Nested Case-Control Study of Lung Cancer Risk and Ionizing Radiation Exposure at the Portsmouth Naval Shipyard

2007 ◽  
Vol 168 (3) ◽  
pp. 341-348 ◽  
Author(s):  
James H. Yiin ◽  
Sharon R. Silver ◽  
Robert D. Daniels ◽  
Dennis D. Zaebst ◽  
Evelyn A. Seel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Risk ◽  
Ionizing Radiation ◽  
Radiation Exposure ◽  
Case Control Study ◽  
Lung Cancer Risk ◽  
Case Control ◽  
Ionizing Radiation Exposure ◽  
Nested Case Control ◽  
Control Study

scholarly journals Diagnostic Ionizing Radiation Exposure in a Population-Based Cohort of Patients with Inflammatory Bowel Disease

2008 ◽  
Vol 103 (8) ◽  
pp. 2015-2022 ◽  
Author(s):  
Joanna M. Peloquin ◽  
Darrell S. Pardi ◽  
William J. Sandborn ◽  
Joel G. Fletcher ◽  
Cynthia H. McCollough ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Ionizing Radiation ◽  
Radiation Exposure ◽  
Bowel Disease ◽  
Population Based ◽  
Inflammatory Bowel ◽  
Ionizing Radiation Exposure

Case-control Study on Dactylitis, Enthesitis, and Anterior Uveitis in Spondyloarthritis Associated with Inflammatory Bowel Diseases: Role of Coexistent Psoriasis

2017 ◽  
Vol 44 (9) ◽  
pp. 1341-1346 ◽  
Author(s):  
Fabrizio Cantini ◽  
Laura Niccoli ◽  
Carlotta Nannini ◽  
Emanuele Cassarà ◽  
Olga Kaloudi ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Anterior Uveitis ◽  
Skin Disease ◽  
Case Control Study ◽  
Case Control ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Control Study

Objective.To evaluate the frequency of dactylitis, enthesitis, and anterior uveitis (AU) in spondyloarthritis (SpA) associated with inflammatory bowel disease (IBD-SpA) compared with other SpA, and to assess the role of associated psoriasis in the occurrence of dactylitis and enthesitis.Methods.In a 12-month case-control study, the frequency of dactylitis and enthesitis in 29 patients with ulcerative colitis (UC) and 59 with Crohn disease (CD) who satisfied the Spondyloarthritis international Society criteria for axial or peripheral SpA was compared with 176 controls, including 97 (55.1%) with psoriatic arthritis (PsA), 47 (26.7%) with ankylosing spondylitis (AS), and 32 (18.2%) with nonradiographic axial SpA (nr-axSpA). The occurrence of these features in IBD-SpA with and without psoriasis was also evaluated.Results.Axial, peripheral, or mixed involvement was observed in 46 (52%), 29 (33%), and 13 (15%) patients, respectively; and 14/88 (16%) had psoriasis. Dactylitis was recorded in 4/88 patients (4.5%) with IBD-SpA and in 30 controls (17.4%; p = 0.008), enthesitis in 16 cases (18.1%) and in 78/176 controls (44.3%; p < 0.001), and AU in 3 patients (3.4%) with IBD-SpA and in 26 controls (14.7%; p = 0.01). No significant differences were found between patients with UC-SpA and those with CD-SpA. Dactylitis and enthesitis were significantly more common in patients with IBD-SpA who also had psoriasis compared to those without skin disease (p = 0.009 and 0.003, respectively).Conclusion.Dactylitis, enthesitis, and AU are significantly less frequent in IBD-SpA compared with other types of SpA. Given the frequent association of psoriasis and IBD, overlooking coexistent skin disease may lead to overestimating the frequency of these features.

Ionizing radiation exposure in patients with inflammatory bowel disease: Are we overexposing our patients?

2015 ◽  
Vol 16 (2) ◽  
pp. 83-89 ◽  
Author(s):  
Camila Estay ◽  
Daniela Simian ◽  
Jaime Lubascher ◽  
Carolina Figueroa ◽  
Andrés O'Brien ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Ionizing Radiation ◽  
Radiation Exposure ◽  
Bowel Disease ◽  
Inflammatory Bowel ◽  
Ionizing Radiation Exposure

scholarly journals Helicobacter Pylori Eradication Therapy is Not Associated with the Onset of Inflammatory Bowel Diseases. A Case-Control Study

2018 ◽  
Vol 27 (2) ◽  
pp. 119-125 ◽  
Author(s):  
Rosa Rosania ◽  
Ulrike Von Arnim ◽  
Alexander Link ◽  
Mirjana Rajilic-Stojanovic ◽  
Caspar Franck ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Reports ◽  
Eradication Therapy ◽  
Case Control ◽  
Control Group ◽  
Serum Samples ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
H Pylori ◽  
Control Study

Background & Aims: A negative association between H. pylori and inflammatory bowel disease (IBD) has been previously reported. There were also case reports suggesting a new onset of IBD 6-12 months after H. pylori eradication therapy. In a case-control study we investigated whether previous H. pylori eradication therapy was associated with the risk of developing IBD.Methods: IBD outpatients with both Crohn´s disease (CD) and ulcerative colitis (UC) were enrolled. Age- and sex-matched blood donors served as controls in a 1:2 fashion. Information on demographics, medical history, previous H. pylori infection and eradication therapy was recorded. Serum samples for H. pylori serology testing (anti-H. pylori-IgG and anti-CagA-IgG) were obtained. Controls that received H. pylori eradication therapy during the 12 months previous to enrollment were excluded.Results: Overall, 127 IBD patients (CD N= 90; UC N= 37) and 254 controls were enrolled. The prevalence of H. pylori infection (positive H. pylori serology and/or previous eradication) in IBD patients and controls was 11% and 23%, respectively (OR 0.4, 95% CI 0.21-0.74, p<0.003). Four patients (3%) developed IBD (3 MC and 1 CU) after receiving successful H. pylori eradication (latency 6-12 months). The rate of previous H. pylori eradication therapy in patents who successively developed IBD was lower but not statistically different from that observed in the control group (OR 0.43, 95% CI 0.14-1.29, p=0.16).Conclusions: In our study previous H. pylori eradication therapy was not associated with the onset of IBD.Whether in a subgroup of patients, H. pylori eradication therapy may trigger a latent IBD, cannot be excluded.

Radiation Exposure From Diagnostic Imaging in Patients with Lymphoma - The Cost Of The Cure?

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 557-557
Author(s):  
Maeve P Crowley ◽  
Siobhan B O'Neill ◽  
Damien C O'Neill ◽  
Joesph A Eustace ◽  
Brian R Healey Bird ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Ionizing Radiation ◽  
Diagnostic Imaging ◽  
Radiation Exposure ◽  
Hodgkin Lymphoma ◽  
B Cell Lymphoma ◽  
Cumulative Exposure ◽  
Pet Ct ◽  
Radiological Procedures

Abstract Introduction The American Cancer Society anticipates the diagnosis of 80,000 new cases of lymphoma in the US in 2013. Cancer Research UK estimates that more than 80% of Hodgkin Lymphoma (HL) patients and more than 60% of Non-Hodgkin Lymphoma (NHL) patients will be alive 5 or more years after diagnosis. As survival rates improve, focus shifts to ensuring quality of life in survivors and decreasing potential toxicity. Radiological procedures play a prominent role in diagnosis, staging and assessment of treatment response. Exposure to ionizing radiation has been linked to an increased risk of malignancy (Pearce et al 2012, Miglioretti et al 2013, Mathews et al 2013). Cumulative exposure in excess of 75mSv has been estimated to increase cancer mortality by 7.3% (Cardis et al 2007). There is a paucity of data in the literature regarding cumulative radiation exposure in patients with lymphoma. In cancer treatment, the aim is individualized management strategies. This should also be the goal for diagnostic procedures (O' Neill et al 2011, Fletcher et al 2012). Methods A retrospective review of all patients on a prospectively maintained database with biopsy proven HL or NHL between January 2009 and July 2012 was conducted in a University hospital group. The cumulative effective radiation dose (CED) was calculated using standardized procedure-specific radiation dose levels. Results Four hundred and eighty six patients were included in the study. Mean (SD) age at diagnosis was 59 (17) years and 15% were aged < 40. Fifty-nine percent were men. Sixteen percent had HL; 84% had NHL. There were a total of 1127 patient-years of follow-up, with 15% having <1 year and 10% having 5 or more years of follow-up. Ninety-nine per cent of patients had diagnostic imaging. A total of 5748 radiological procedures were performed, equivalent to one procedure every 70 patient days of follow-up. The median estimated total CED ( IQR) per subject was 69mSv (42-118). Forty- six percent had a total CED >75mSv and 14% had a total CED >150mSv – SeeFigure 1. CT contributed 89% of the radiation dose and PET-CT contributed 8%. Patients aged <40 had a median CED (IQR) of 89mSv (55-124). Seventy-five per cent of these patients had a potentially curable malignancy (66% had HL; 5% had Diffuse Large B Cell Lymphoma; 4% had Burkitt Lymphoma). Patients who underwent stem cell transplantation had a median CED (IQR) of 162mSv (135-225) with 59% having radiotherapy as part of their management. Univariate analysis showed that age (p<0.001), duration of lymphoma (p<0.001) and stage (<0.001) were associated with CED. Discussion This study highlights the considerable ionizing radiation exposure from diagnostic imaging in patients with lymphoma. This is especially relevant in young people who would be considered the most radiosensitive and at highest risk for secondary malignancies. Low grade lymphomas are relapsing and remitting in nature and frequently require re-staging imaging over many years. Longer follow-up will be required here to potentially explain the non-significant trend between histological subtype and different CED. The American College of Radiology stated in 2013 that when used appropriately, the benefits of ionizing radiation far outweigh the risks. However, to minimize risk, institutions should participate in national dose registries. With the widespread use of Picture Archiving and Communication System (PACS), this will be feasible. Low dose CT imaging has emerged as a mechanism for minimizing CED. Dose reduction strategies incorporating patient-specific information would optimize imaging while minimizing the harmful effects (Shah et al 2012). Novel CT reconstruction algorithms allow diagnostic quality imaging to be obtained at reduced radiation doses without the prohibitive noise that would otherwise be present (Prakash et al 2010). Procedures which do not involve ionizing radiation such as MRI and ultrasound are becoming increasingly popular. There is growing interest in PET-MRI for staging of malignancies (Appenzeller 2013) but as yet, PET-CT remains superior. For patients with potentially curable lymphoma, particularly young patients with higher CED, consideration should be given to these strategies. Disclosures: No relevant conflicts of interest to declare.

Effect of Rural Living on the Development of the Inflammatory Bowel Diseases: A Nested Case-control Study

2011 ◽  
Vol 106 ◽  
pp. S474-S475 ◽  
Author(s):  
Alexandra Frolkis ◽  
James Hubbard ◽  
Jennifer Debruyn ◽  
Nathalie Jette ◽  
Cynthia Seow ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Case Control Study ◽  
Case Control ◽  
Rural Living ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Nested Case Control ◽  
Control Study
Sign in / Sign up

Export Citation Format

Share Document