Computed Tomography Radiation
Hello, doctor.
In September 2018, I was diagnosed with a salivary gland tumor and underwent a CT scan of the head and neck with contrast, as well as a chest X-ray, in preparation for surgery.
On December 31, 2018, I had another CT scan of the head and neck with contrast.
Then, on March 7, 2019, I had yet another CT scan of the head and neck with contrast.
Could you please let me know if this frequency of imaging exceeds the standard recommendations? Thank you!
Fanqie, 40~49 year old female. Ask Date: 2019/03/07
Dr. Wang Yifen reply Radiology
Hello, according to the information from the American Society of Radiologic Technologists, the radiation dose for a single CT scan of the head and neck is approximately 8 millisieverts, and the total dose for three scans is about 24 millisieverts.
A single chest X-ray (both frontal and lateral views) is about 0.1 millisieverts.
The International Commission on Radiological Protection (ICRP) report 103 states that doses below 100 millisieverts (whether single or multiple) do not cause clinically significant functional impairment.
However, the interval between your CT scans is less than three months, which is considered too frequent according to standard medical practice.
Additionally, since radiation effects are cumulative, it is essential to discuss the necessity of the examination with your physician before proceeding, especially if there are alternative imaging options available.
Evaluate whether the benefits of the examination outweigh the risks.
Wishing you safety and good health.
Reply Date: 2019/03/07
More Info
When considering the safety of radiation exposure from CT scans, it is essential to understand the context of the medical necessity for these procedures, the cumulative radiation doses involved, and the associated risks.
In your case, you have undergone multiple CT scans of the head and neck, along with chest X-rays, within a relatively short time frame. Each CT scan typically exposes a patient to a significant amount of radiation. For example, a standard head CT scan can deliver an effective dose of approximately 2 mSv, while a chest X-ray usually delivers about 0.1 mSv. When you undergo multiple scans, the cumulative dose can add up quickly.
To evaluate whether your radiation exposure exceeds safe limits, we can look at the cumulative doses from your scans. Based on the information provided, if we assume each head CT scan delivered around 2 mSv and you had three of them, that totals approximately 6 mSv. Adding the chest X-ray's dose of 0.1 mSv brings your total to about 6.1 mSv.
According to guidelines from organizations such as the American College of Radiology and the Radiological Society of North America, radiation doses below 10 mSv are generally considered low risk. The International Commission on Radiological Protection (ICRP) states that doses below 100 mSv do not result in observable health effects in the general population. Therefore, your cumulative exposure of approximately 6.1 mSv is below the threshold where significant health risks are expected.
However, it is crucial to consider the context of these scans. If they were performed to diagnose or monitor a serious condition, such as a tumor, the benefits of obtaining critical diagnostic information often outweigh the risks associated with radiation exposure. The principle of "justification" in radiology emphasizes that any medical imaging involving radiation should be justified by the potential health benefits.
Moreover, if you have concerns about the frequency of your scans or the cumulative radiation dose, it is advisable to discuss these with your healthcare provider. They can provide insights into the necessity of each scan and whether alternative imaging modalities, such as ultrasound or MRI, which do not involve ionizing radiation, could be considered for future evaluations.
In summary, while your cumulative radiation exposure from the CT scans and X-rays is within generally accepted safety limits, it is essential to maintain open communication with your healthcare provider regarding the necessity of these imaging studies and any potential alternatives. Your health and safety are paramount, and your medical team can help ensure that any imaging performed is both necessary and appropriate for your condition.
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