Skip to main content
Log in

Radiation dose from computed tomography in patients with acute pancreatitis: an audit from a tertiary care referral hospital

  • Pancreas
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Background

There is a limited data on the radiation dose from computed tomography (CT) in patients with acute pancreatitis (AP). The present study evaluated the radiation dose from CT scans in patients with AP.

Material

A retrospective review of CT reports of patients with AP was conducted. The type of CT scan (non-contrast vs. single-phase vs. biphasic CT) was recorded. The mean number of CT scans and cumulative radiation dose was calculated. The indications and abnormalities on biphasic CT scans were recorded. The radiation doses between different types of the scan were compared.

Results

495 CT studies in 351 patients were evaluated. In patients (n = 78, 22.2%) undergoing multiple CT scans, mean number of CT scans per patient and mean radiation dose were 2.64 ± 1.18 (range 2–9) and 24 ± 15 mSv (range 8.3–79.8 mSv), respectively. The mean radiation dose was significantly greater in patients with modified CT severity index ≥ 8 (n = 63) [25.08 mSv vs. 18.96 mSv, (P = 0.048)]. 61 (12.32%) biphasic scans were performed. A definite indication for a biphasic CT scan was identified in 20 (32.7%) patients. Arterial abnormalities were detected in 6 (9.8%) patients undergoing CT for defined indication. Mean radiation dose in this group was 13.26 ± 7.64 mSv (range 3.42–38.27 mSv) which was significantly greater than the single venous phase scan (7.96 ± 3.48 mSv, P < 0.001).

Conclusion

There is a potential for substantial radiation exposure from CT scans to patients with AP. Patients with severe AP and those undergoing biphasic scans have significantly higher radiation exposure. Hence, routine arterial phase acquisition should be avoided.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Yadav D, Lowenfels AB. Trends in the Epidemiology of the First Attack of Acute Pancreatitis: A Systematic Review. Pancreas. 2006;33(4):323–30.

    Article  Google Scholar 

  2. Goldacre MJ, Roberts SE. Hospital admission for acute pancreatitis in an English population, 1963-98: database study of incidence and mortality. BMJ. 2004;328(7454):1466–9.

    Article  Google Scholar 

  3. Spanier BM, Bruno MJ, Dijkgraaf MG. Incidence and mortality of acute and chronic pancreatitis in the Netherlands: A nationwide record-linked cohort study for the years 1995-2005. World J Gastroenterol. 2013;19(20):3018–26.

    Article  Google Scholar 

  4. Floyd A, Pedersen L, Nielsen GL, Thorladcius-Ussing O, Sorensen HT. Secular trends in incidence and 30-day case fatality of acute pancreatitis in North Jutland County, Denmark: a register-based study from 1981-2000. Scand J Gastroenterol. 2002;37(12):1461–5.

    Article  CAS  Google Scholar 

  5. Lindkvist B, Appelros S, Manjer J, Borgström A. Trends in incidence of acute pancreatitis in a Swedish population: is there really an increase? Clin Gastroenterol Hepatol. 2004;2(9):831-7.

    Article  Google Scholar 

  6. Fagenholz PJ, Fernández-del Castillo C, Harris NS, Pelletier AJ, Camargo CA Jr. National study of United States emergency department visits for acute pancreatitis, 1993-2003. BMC Emerg Med. 2007;7:1.

    Article  Google Scholar 

  7. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–11.

    Article  Google Scholar 

  8. Bansal A, Gupta P, Singh H, et al. Gastrointestinal complications in acute and chronic pancreatitis. JGH Open. 2019;3(6):450–5.

    Article  Google Scholar 

  9. Kumar P, Gupta P, Rana S. Thoracic complications of pancreatitis. JGH Open. 2018;3(1):71–9.

    Article  Google Scholar 

  10. Hall EJ, Brenner DJ. Cancer risks from diagnostic radiology. Br J Radiol. 2008;81(965):362–78.

    Article  CAS  Google Scholar 

  11. Griffey RT, Sodickson A. Cumulative radiation exposure and cancer risk estimates in emergency department patients undergoing repeat or multiple CT. AJR Am J Roentgenol. 2009;192(4):887-92.

    Article  Google Scholar 

  12. Dixon AK, Dendy P. Spiral CT: how much does radiation dose matter? Lancet Lond Engl. 1998;352(9134):1082–3.

    Article  CAS  Google Scholar 

  13. Brenner DJ, Elliston CD. Estimated radiation risks potentially associated with full-body CT screening. Radiology. 2004;232(3):735–8.

    Article  Google Scholar 

  14. Journy NMY, Lee C, Harbron RW, McHugh K, Pearce MS, Berrington de González A. Projected cancer risks potentially related to past, current, and future practices in paediatric CT in the United Kingdom, 1990–2020. Br J Cancer. 2017;116(1):109–16.

  15. Sodickson A, Baeyens PF, Andriole KP, et al. Recurrent CT, cumulative radiation exposure, and associated radiation-induced cancer risks from CT of adults. Radiology. 2009;251(1):175-84.

    Article  Google Scholar 

  16. Frush DP. Review of radiation issues for computed tomography. Semin Ultrasound CT MR. 2004;25:17–24.

    Article  Google Scholar 

  17. Mortele KJ, Wiesner W, Intriere L, Shankar S, Zou KH, Kalantari BN, et al. A Modified CT Severity Index for Evaluating Acute Pancreatitis: Improved Correlation with Patient Outcome. Am J Roentgenol. 2004;183(5):1261–5.

    Article  Google Scholar 

  18. Gupta P, Rana P, Bellam BL, et al. Site and size of extrapancreatic necrosis are associated with clinical outcomes in patients with acute necrotizing pancreatitis. Pancreatology. 2019 Nov 20. pii: S1424-3903(19)30791-4.

  19. Morgan DE, Ragheb CM, Lockhart ME, Cary B, Fineberg NS, Berland LL. Acute pancreatitis: computed tomography utilization and radiation exposure are related to severity but not patient age. Clin Gastroenterol Hepatol. 2010;8(3):303-8

    Article  Google Scholar 

  20. Ball CG, Correa-Gallego C, Howard TJ, et al. Radiation dose from computed tomography in patients with necrotizing pancreatitis: how much is too much? J Gastrointest Surg. 2010;14(10):1529-35.

    Article  Google Scholar 

  21. Singhal M, Gupta P, Singh S, Khandelwal N. Computed tomography coronary angiography is the way forward for evaluation of children with Kawasaki disease. Glob Cardiol Sci Pract. 2017;2017(3):e201728.

    PubMed  PubMed Central  Google Scholar 

  22. Kothari S, Kalinowski M, Kobeszko M, Almouradi T. Computed tomography scan imaging in diagnosing acute uncomplicated pancreatitis: Usefulness vs cost. World J Gastroenterol. 2019;25(9):1080-1087.

    Article  Google Scholar 

  23. Kwon Y, Park HS, Kim YJ, Jung SI, Jeon HJ. Multidetector row computed tomography of acute pancreatitis: Utility of single portal phase CT scan in short-term follow up. Eur J Radiol. 2012;81(8):1728-34.

    Article  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pankaj Gupta.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gupta, P., Jain, R., Koshi, S. et al. Radiation dose from computed tomography in patients with acute pancreatitis: an audit from a tertiary care referral hospital. Abdom Radiol 45, 1517–1523 (2020). https://doi.org/10.1007/s00261-020-02408-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-020-02408-7

Navigation