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Computed tomography use in a large Italian region: trend analysis 2004-2014 of emergency and outpatient CT examinations in children and adults

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Abstract

Objectives

To analyse CT use in recent years in a high-density Italian area (±10 million inhabitants, including 1 million children), focusing on developing age.

Methods

Retrospective analysis of records from HealthCare IT System, covering >400 hospitals and clinics. Description of CT use between 2004–2014 in emergency and outpatient care and assessment of radiation exposure trend.

Results

Over 9 million scans were performed. Emergency procedures showed a global increase of 230 %, mainly head examinations. In the global outpatient setting, the annual number of CT scans/person increased ±19 %. A moderate increase in CT examinations was observed in the developing age population, while a remarkable increase in dental, chest and abdominal procedures occurred for the 10- to 30-year age range. The increase in mean annual dose/capita in the global patient pool was approximately 42 %, increasing from 0.72–1.03 mSv. The population rate receiving an annual CT radiation dose/capita higher than 1 mSv tripled in the 11-year interval, increasing from 16–48 %.

Conclusions

The remarkable increase in radiation exposure raises a special concern for teenagers and young adults, whose risk tends to be underestimated. The fivefold increase in dental CTs in the younger age groups requires further investigations.

Key Points

• Literature highlights a remarkable increase in CT use over the last decades.

• The paediatric age had higher exposure to X-ray risk.

• A detailed retrospective analysis of more than 9 million scans was performed.

• Dental, chest, abdominal procedures increased remarkably in 10- to 30-year age range.

• This study raises concern about exposure for teenagers and young adults.

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Abbreviations

CBCT:

Cone beam computed tomography

CT:

Computed tomography

DLP:

Dose length product

RHCS:

Regional Health Care System

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Acknowledgements

We thank Dr. Maurizio Bersani from Direzione Generale Sanità, Regione Lombardia, who kindly helped and supported us during the data selection and collection.

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Correspondence to Andrea Pola.

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Guarantor

The scientific guarantor of this publication is Andrea Pola.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

This study has received funding by Direzione Generale Sanità, Regione Lombardia, Call per la ricerca indipendente 2010-2013.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was not required for this study because no human subjects were involved in this study.

Ethical approval

Institutional Review Board approval was not required for this study because no human subjects were involved in this study.

Methodology

retrospective

multicentre study

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Pola, A., Corbella, D., Righini, A. et al. Computed tomography use in a large Italian region: trend analysis 2004-2014 of emergency and outpatient CT examinations in children and adults. Eur Radiol 28, 2308–2318 (2018). https://doi.org/10.1007/s00330-017-5225-x

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  • DOI: https://doi.org/10.1007/s00330-017-5225-x

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