the Impact of Cumulative Radiation Exposure from X-rays and CT Scans - Radiology

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Is the impact of radiation accumulation significant?


Hello, doctor.
I had chest X-rays in July, August, and on September 20th, and no issues were found.
Since the cause of my chest pain and tightness remains unclear, I am now planning to undergo a low-dose computed tomography (CT) scan of my lungs at my own expense.
The technician mentioned that if I have concerns, I could wait three to six months before having the low-dose CT scan, as the dates are too close together.
However, I am worried about missing the opportunity to detect any potential issues, but I am also afraid that having too many scans could increase my risk of cancer due to radiation exposure.
Could you please clarify how significant the cumulative radiation effect would be from having multiple X-rays and a low-dose CT scan in the same area? Thank you for your guidance.

Mr. Huang, 40~49 year old female. Ask Date: 2023/09/25

Dr. Wang Yifen reply Radiology


Hello, a chest X-ray has a radiation dose of approximately 0.02 millisieverts, while a single low-dose computed tomography (CT) scan has a radiation dose of about 2 millisieverts.
According to the International Commission on Radiological Protection (ICRP) report 103, doses below 100 millisieverts (whether single or multiple) do not cause clinically significant functional impairment.
Following your doctor's advice to undergo radiation-related examinations is based on the consideration that the health benefits outweigh the risks of radiation exposure.
If you have concerns, it is recommended to discuss them further with your physician before proceeding with the examination.
Do not avoid tests out of fear of radiation, as this could result in missing critical treatment opportunities for diseases.
Please take this into consideration, and I wish you safety and good health.

Reply Date: 2023/09/25

More Info


The concern regarding cumulative radiation exposure from X-rays and CT scans is a valid one, especially in light of the increasing use of these imaging modalities in medical diagnostics. Understanding the potential risks associated with radiation exposure is crucial for making informed decisions about your health.

To begin with, let's break down the radiation doses associated with the imaging procedures you've undergone. A standard chest X-ray typically delivers a dose of about 0.1 millisieverts (mSv). In your case, if you had multiple chest X-rays in July, August, and September, the cumulative dose could be calculated based on the number of X-rays taken. For example, if you had three chest X-rays, that would amount to approximately 0.3 mSv.

Now, regarding the low-dose CT scan of the lungs, the radiation dose is generally around 1 to 2 mSv, depending on the specific protocol used. If we consider the higher end of that range, let's say 2 mSv for your upcoming scan, the total cumulative radiation dose from your chest X-rays and the low-dose CT would be approximately 2.3 mSv (0.3 mSv from X-rays + 2 mSv from the CT scan).

It's important to note that according to the International Commission on Radiological Protection (ICRP), doses below 100 mSv are not associated with any clinically significant harm. The risk of developing cancer from radiation exposure is generally considered to be very low at these levels. For context, the average person is exposed to about 3 mSv of natural background radiation each year from sources such as cosmic rays, radon gas, and terrestrial radiation.

When considering the cumulative effects of radiation exposure, it's also essential to weigh the benefits of the imaging studies against the potential risks. In your case, the chest X-rays were performed to investigate symptoms of chest pain and discomfort, which could indicate underlying health issues. The low-dose CT scan is a valuable tool for further evaluation, particularly if there are concerns about lung conditions.

If you are feeling apprehensive about the frequency of your imaging studies, it is advisable to have an open discussion with your healthcare provider. They can help you assess the necessity of the upcoming CT scan in light of your symptoms and previous imaging results. If the healthcare provider believes that the benefits of the CT scan outweigh the risks, it may be appropriate to proceed with the examination.

In terms of reducing radiation exposure, there are a few strategies that can be employed. First, ensure that all imaging studies are medically justified and that alternative methods (such as ultrasound or MRI) are considered when appropriate. Second, if multiple imaging studies are required, spacing them out over time can help minimize cumulative exposure. Lastly, always communicate any concerns you have with your healthcare provider, as they can provide guidance tailored to your specific situation.

In conclusion, while it is essential to be mindful of cumulative radiation exposure from X-rays and CT scans, the doses you have described are relatively low and within safe limits according to current medical guidelines. The key is to maintain open communication with your healthcare provider to ensure that any imaging studies performed are necessary and beneficial for your health. Remember, the goal of these diagnostic tools is to provide critical information that can lead to timely and effective treatment, ultimately improving your health outcomes.

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