title: Quantifying exposure to diagnostic radiation and factors associated with exposure to high levels of radiation in Korean patients with inflammatory bowel disease.
abstract: BACKGROUND
  Several recent studies have revealed that diagnostic imaging can result in exposure to potentially harmful levels of ionizing radiation in patients with inflammatory bowel disease (IBD). However, these studies have been conducted exclusively in Western countries, and no data are available in Asian populations. The aim of this study was to estimate the diagnostic radiation exposure in Korean patients with IBD and to determine the factors associated with high radiation exposure.
  
  
  METHODS
  Patients with an established diagnosis of IBD between July 1987 and January 2012 were investigated in 13 university hospitals in Korea. The cumulative effective dose (CED) was calculated retrospectively from standard tables.
  
  
  RESULTS
  A total of 777 patients with Crohn's disease (CD) and 1422 patients with ulcerative colitis (UC) were included in the study. The mean CED for CD and UC were 53.6 and 16.4 mSv, respectively (P < 0.001). CTof CD and UC accounted for 81.6% and 71.2% of total effective dose, respectively. Importantly, 34.7% of patients with CD and 8.4% of patients with UC were exposed to high levels of radiation (CED > 50 mSv) (P < 0.001). High radiation exposure was associated with long disease duration, ileocolonic disease, upper gastrointestinal tract involvement, surgical intervention, hospitalization, and the requirement for oral steroids in CD, and with surgical intervention, hospitalization, and the requirement for infliximab in UC.
  
  
  CONCLUSIONS
  A substantial proportion of patients with IBD, especially patients with CD, were exposed to significantly harmful amounts of diagnostic radiation, mainly as a result of CT examination. Given that IBD is a life-long illness, strategies to reduce radiation exposure from diagnostic imaging need to be considered.
authors.affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Yoon Suk
authors.initials: YS
authors.lastname: Jung
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Park
authors.forename: Eun Ran
authors.initials: ER
authors.lastname: Kim
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Kim
authors.forename: Chang Kyun
authors.initials: CK
authors.lastname: Lee
authors.forename: Suck Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Jae Hak
authors.initials: JH
authors.lastname: Kim
authors.forename: Kyu
authors.initials: K
authors.lastname: Chan Huh
authors.forename: Sung-Ae
authors.initials: SA
authors.lastname: Jung
authors.forename: Soon Man
authors.initials: SM
authors.lastname: Yoon
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Song
authors.forename: Sun-Jin
authors.initials: SJ
authors.lastname: Boo
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Jang
authors.forename: You Sun
authors.initials: YS
authors.lastname: Kim
authors.forename: Kang-Moon
authors.initials: KM
authors.lastname: Lee
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Shin
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000150:complications / Q000000981:diagnostic imaging*; D003424:Crohn Disease / Q000150:complications / Q000000981:diagnostic imaging*; D003952:Diagnostic Imaging / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology*; D011839:Radiation, Ionizing; D011859:Radiography; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors