Radiation Exposure: Concerns for Patients with Multiple Imaging Tests

Radiation issues

Hello doctor, I am a health anxiety patient.
Due to autonomic nervous system dysregulation, I have undergone the following examinations in 2018, 2019, and this year: one head computed tomography (CT), one head magnetic resonance imaging (MRI), approximately 18 chest X-rays (due to chest pain, I frequently visited the emergency room), one cardiac CT, one abdominal CT, two abdominal X-rays, a neck ultrasound, a cardiac ultrasound, a breast ultrasound, an upper gastrointestinal endoscopy, an abdominal ultrasound, and a colonoscopy.
I am very anxious about whether the radiation exposure is excessive and if the current radiation levels could lead to additional diseases or cancer.

Lübing Huanzhe, 30~39 year old female. Ask Date: 2020/04/02

Dr. Wang Yifen reply Radiology

According to the data from the American Society of Radiologic Technologists, the radiation dose for a 30-year-old female undergoing a head CT scan (1 time) is approximately 2 millisieverts (mSv), for a chest X-ray (about 18 times) it is approximately 1.8 mSv, for a cardiac CT (1 time) it is approximately 16 mSv, for an abdominal CT (1 time) it is approximately 14 mSv, and for abdominal X-rays (2 times) it is approximately 1.4 mSv.
The total radiation dose from these procedures is about 35.2 mSv, which corresponds to an increased risk of cancer of approximately 0.5%.
In contrast, procedures such as head MRI, ultrasound, gastroscopy, and colonoscopy do not involve radiation.
According to the International Commission on Radiological Protection (ICRP) report 103, doses below 100 mSv (whether single or multiple exposures) do not cause clinically significant functional damage.
The use of radiation in the medical field is increasing, and to achieve diagnostic or therapeutic purposes while providing necessary information for physicians, it is advisable to follow medical recommendations for radiation-related examinations or treatments, as the health benefits outweigh the risks of radiation exposure.
If there are any concerns, it is recommended to communicate with the physician before proceeding with the examination.
Wishing you safety and health.

Reply Date: 2020/04/02

More Info

Dear Patient,
Thank you for sharing your concerns regarding radiation exposure from multiple imaging tests. It’s understandable to feel anxious about the cumulative effects of radiation, especially with the frequency of your imaging studies. Let’s break down your situation and provide some clarity.

Understanding Radiation Exposure
Radiation exposure from medical imaging is a valid concern, particularly with modalities like CT scans and X-rays, which utilize ionizing radiation. Each imaging test has a specific radiation dose associated with it, measured in millisieverts (mSv). Here’s a general idea of the radiation doses for the tests you mentioned:
- Head CT: Approximately 2 mSv
- Chest X-ray: About 0.1 mSv per image
- Cardiac CT: Ranges from 5 to 15 mSv, depending on the type of scan
- Abdominal CT: Roughly 10 to 15 mSv
- Abdominal X-ray: Approximately 0.7 mSv
- MRI and Ultrasound: These modalities do not use ionizing radiation, so they do not contribute to your cumulative radiation dose.

Cumulative Radiation Dose
Based on your reported imaging tests, let’s estimate your cumulative radiation exposure:
- Head CT: 2 mSv
- Chest X-rays: 18 X 0.1 mSv = 1.8 mSv
- Cardiac CT: Assuming an average of 10 mSv
- Abdominal CT: 10 mSv
- Abdominal X-rays: 2 X 0.7 mSv = 1.4 mSv
Adding these together gives you an approximate cumulative dose of 25.2 mSv.

Risk Assessment
The International Commission on Radiological Protection (ICRP) states that doses below 100 mSv are generally considered to have a negligible risk of causing cancer. Your cumulative exposure of 25.2 mSv is below this threshold. However, it is essential to remember that the risk of radiation-induced cancer is cumulative over a lifetime, and repeated exposure can increase risk, albeit slightly.

Recommendations
1. Discuss with Your Physician: It’s crucial to have an open dialogue with your healthcare provider about your imaging needs. They can help assess whether further imaging is necessary or if alternative methods (like MRI or ultrasound) can be utilized, especially since these do not involve radiation.

2. Monitor Your Health: If you have concerns about your health or symptoms, continue to communicate with your healthcare team. They can provide guidance on the necessity of further imaging based on your clinical situation.

3. Stay Informed: Educate yourself about the risks and benefits of imaging tests. Understanding the rationale behind each test can help alleviate anxiety.

4. Consider Alternatives: If you feel that your imaging frequency is excessive, discuss the possibility of alternative imaging modalities that do not involve radiation, especially for follow-up assessments.

Conclusion
While it’s natural to worry about radiation exposure, your current cumulative dose is within a range that is generally considered safe. The benefits of imaging, particularly in diagnosing and managing health conditions, often outweigh the risks associated with radiation exposure. Always prioritize communication with your healthcare provider to ensure that your imaging needs are met safely and effectively.

Wishing you good health and peace of mind.

Best regards.

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