Cumulative radiation exposure estimates of hospitalized patients from radiological imaging.
OBJECTIVE
To examine the use of inpatient diagnostic imaging and image-guided procedures to estimate cumulative radiation exposure, radiation exposure based on imaging modality, and compare estimated doses based on patient demographics including age, gender, and diagnoses.


METHODS
Two hundred consecutive hospitalized adult patients who underwent diagnostic imaging studies at 2 large, affiliated hospitals were identified, and every study in each patient's electronic record that took place during a single hospitalization was reviewed. Dose estimates were calculated for each CT, fluoroscopy, nuclear medicine, plain film, and interventional radiology study or procedure based on reported dose length product, published reference values, and conversion factors. Medical records were reviewed to determine patient gender, age, diagnoses, length of stay, admitting service, and time in an intensive care unit (ICU).


RESULTS
Two hundred inpatients (46.5% male; mean age, 60.4 years) underwent 2,751 imaging studies (79.3% radiographs, 9.7% CT, 6.1% ultrasound, 2.5% interventional radiology, 2.2% MRI, 0.4% nuclear medicine). The mean dose estimate per patient was 14.8 milliSieverts (mSv) and the range was 0 mSv to 130.5 mSv. Mean cumulative dose estimates were significantly higher for patients whose hospitalizations included time in an ICU (17.9 mSv versus 11.3 mSv [P = .01]). CT examinations accounted for 82.1% of the total radiation dose estimate. Eleven patients (5.5%) received radiation dose estimates ≥ 50 mSv, including 2 ≥ 100 mSv.


CONCLUSIONS
Of imaged inpatients, 62% underwent at least 1 CT and the majority (82.1%) of inpatient radiation exposure was attributable to CT examinations. Mean dose estimate was 14.8 mSv per patient; 5.5% of patients experienced estimated doses ≥ 50 mSv.
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia. Electronic address: alutter@emory.edu.
Arielle C
AC
Lutterman
Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
Courtney C
CC
Moreno
Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
Pardeep K
PK
Mittal
Department of Biostatistics, Rollins School of Public Health, Atlanta, Georgia.
Jian
J
Kang
Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
Kimberly E
KE
Applegate
D001822:Body Burden; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D005260:Female; D005845:Georgia; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D011874:Radiometry / Q000706:statistics & numerical data*
CT; Imaging utilization; cumulative; hospitalization; inpatients; radiation exposure