Radiation doses from small-bowel follow-through and abdominopelvic MDCT in Crohn's disease.
OBJECTIVE
The purpose of our study was to compare organ and effective doses for small-bowel follow-through (SBFT) and abdominopelvic MDCT in adults with Crohn's disease, to retrospectively evaluate the number of radiographic examinations performed for Crohn's disease indications, and to identify those patients undergoing serial examinations to better delineate the use of radiology in the diagnosis and clinical management of Crohn's disease.


METHODS
Using an anthropomorphic phantom and metal-oxide semiconductor field-effect transistor (MOSFET) dosimeters, specific organ doses were measured for 5 minutes of continuous fluoroscopy (kVp, 120; mA, 0.6) of each of the following: right lower quadrant, central abdomen, and pelvis. Effective doses were determined based on International Commission on Radiological Protection (ICRP) 60 weighting factors. Organ and effective doses were determined for abdominal and pelvic 16-MDCT: detector configuration, 16 x 0.625 mm; pitch, 1.75; 17.5 mm per rotation; rotation time, 0.5 second; 140 kVp; 340 mA. Electronic records were reviewed to determine the number of patients imaged for Crohn's disease indications and the number of studies per patient.


RESULTS
The highest fluoroscopic organ doses were as follows: in the right lower quadrant, right kidney (0.78 cGy) and marrow (0.66 cGy); in the central abdomen, kidneys (1.5 and 1.6 cGy) and marrow (0.76 cGy); and in the pelvis, marrow (0.67-0.95 cGy). Effective doses for the right lower quadrant, central abdomen, and pelvis were 1.37, 2.02, and 3.83 mSv, respectively. For MDCT, the highest organ doses were to the liver (2.95-3.33 cGy). The effective dose for abdominopelvic MDCT was 16.1 mSv. Three hundred seventy-three patients underwent imaging for Crohn's disease. The average number of SBFT and CT examinations was 1.8 and 2.3, respectively. Thirty-four (9%) of 373 patients underwent more than five CT examinations and 11 (3%) had more than 10.


CONCLUSIONS
Organ and effective doses are up to five times higher with MDCT than with SBFT. Crohn's disease is more frequently imaged with CT. For a subset of patients who undergo numerous CT examinations, efforts should be made to minimize the number of CT examinations, decrease the CT dose, or consider MR enterography.
Jaffe
Tracy A
TA
Department of Radiology, Duke University Medical Center, Erwin Rd., Box 3808, Durham, NC 27710, USA.
Gaca
Ana Maria
AM
Delaney
Susan
S
Yoshizumi
Terry T
TT
Toncheva
Greta
G
Nguyen
Giao
G
Frush
Donald P
DP
D001822:Body Burden; D003424:Crohn Disease / Q000000981:diagnostic imaging*; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011860:Radiography, Abdominal / Q000379:methods*; D011874:Radiometry / Q000379:methods*; D012062:Relative Biological Effectiveness; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed