title: Risk factors for radiation exposure in newly diagnosed IBD patients.
abstract: Patients with inflammatory bowel disease (IBD) may be exposed to high doses of diagnostic radiation. The purpose of this study is to identify subsets of this population at risk for significant radiation exposure.
  
  
  
  This HIPAA compliant, IRB approved study consists of 336 patients (237 adult and 99 pediatric) within the Ocean State Crohn's & Colitis Area Registry (OSCCAR). All were newly diagnosed with IBD and prospectively enrolled between 1/2008 and 12/2012. Comprehensive chart review was performed.
  
  
  
  207 (61.6%) patients were diagnosed with Crohn's disease (CD), 120 (35.7%) with ulcerative colitis (UC), and 9 (2.7%) with inflammatory bowel disease, type unspecified (IBDU). 192 (57.1%) patients were exposed to GI-specific radiation. Average GI-specific radiation dose for adult IBD patients was 14.1 mSV and was significantly greater among adult CD than adult UC patients (p = 0.01). Pediatric patients underwent fewer CT scans (p < 0.0001). Risk factors for increased radiation exposure include: GI surgery (p = 0.003), biologic therapy (p = 0.01), pain-predominant symptoms (as compared to diarrhea-predominant symptoms; p < 0.05), and isolated ileal disease (p = 0.02). Patients with stricturing or penetrating disease received higher radiation doses than patients with non-stricturing, non-penetrating disease (p < 0.0001).
  
  
  
  A variety of risk factors are associated with increased exposure to ionizing radiation after diagnosis of IBD. Knowledge of these risk factors can help physicians prospectively identify patients at risk for elevated radiation exposure and consider low-dose or radiation-free imaging.
authors.affiliation: Alpert Medical School, Brown University, Providence, RI, USA. dgrand@lifespan.org.|Department of Diagnostic Imaging, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, 593 Eddy St., Providence, RI, 02906, USA. dgrand@lifespan.org.
authors.forename: David J
authors.initials: DJ
authors.lastname: Grand
authors.affiliation: Alpert Medical School, Brown University, Providence, RI, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Harris
authors.affiliation: Hasbro Children's Hospital, Providence, RI, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Shapiro
authors.affiliation: Alpert Medical School, Brown University, Providence, RI, USA.
authors.forename: Edmund
authors.initials: E
authors.lastname: Wu
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Giacalone
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Sands
authors.affiliation: Rhode Island Hospital, Providence, RI, USA.
authors.forename: Renee
authors.initials: R
authors.lastname: Bright
authors.affiliation: Rhode Island Hospital, Providence, RI, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Moniz
authors.affiliation: Rhode Island Hospital, Providence, RI, USA.
authors.forename: Meaghan
authors.initials: M
authors.lastname: Mallette
authors.affiliation: Alpert Medical School, Brown University, Providence, RI, USA.|Hasbro Children's Hospital, Providence, RI, USA.
authors.forename: Neal
authors.initials: N
authors.lastname: Leleiko
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Sylvan
authors.initials: S
authors.lastname: Wallenstein
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Zahid
authors.initials: Z
authors.lastname: Samad
authors.affiliation: Crohn's & Colitis Foundation of America, New York, NY, USA.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Merrick
authors.affiliation: Alpert Medical School, Brown University, Providence, RI, USA.|Rhode Island Hospital, Providence, RI, USA.
authors.forename: Samir A
authors.initials: SA
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000000981:diagnostic imaging*; D008297:Male; D011446:Prospective Studies; D000069079:Radiation Exposure; D012042:Registries; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
keywords: CT; Crohn’s disease; Inflammatory bowel disease; Radiation; Ulcerative colitis