Is My Radiation Exposure Too High? Safety Standards and Next Steps - Radiology

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Is the radiation excessive?


Hello Dr.
Wang, I underwent myocardial perfusion imaging in March 2023 and a cardiac catheterization in April 2023 (during which one stent was placed) due to chest discomfort.
I had another myocardial perfusion imaging in November 2023 and a subsequent cardiac catheterization in December 2023 (without stent placement).
Later, I experienced cervical spine compression and visited different hospitals (orthopedics and neurosurgery) from November 2023 to January 2024, where I had approximately 20 cervical spine X-rays taken.
I am concerned whether this level of radiation exposure exceeds safety standards.
What should I do? I am really worried and would like to know which specialty I should consult for follow-up or what kind of examinations I should undergo.
I appreciate your advice.
Thank you.

Wei Cheng, 40~49 year old female. Ask Date: 2024/01/11

Dr. Wang Yifen reply Radiology


Hello, the necessity of X-ray radiation examinations is considered without limiting the radiation dose or the number of examinations.
If you are unsure which specialty to consult regarding your symptoms, it is recommended to first make an appointment with a family medicine physician or a specialist you have previously seen.
Following your doctor's instructions to undergo radiation-related examinations is based on the assessment that the health benefits outweigh the effects of radiation.
If you have concerns, it is advisable to communicate with your physician before proceeding with the examination.
Do not avoid examinations out of fear of radiation, as this may lead to missing critical treatment opportunities for your condition.
Please take this into consideration, and I wish you peace and good health.

Reply Date: 2024/01/11

More Info


When it comes to understanding radiation exposure from medical imaging, it’s essential to put things into perspective. Your concerns about radiation exposure are valid, especially given the number of procedures you've undergone in a relatively short period. However, it's important to understand the context of these exposures and the associated risks.

First, let's break down the radiation doses associated with the procedures you've mentioned. A myocardial perfusion scan typically exposes a patient to about 5-20 millisieverts (mSv), depending on the specific protocol and the radiopharmaceutical used. A cardiac catheterization procedure can expose you to approximately 7-15 mSv, depending on the complexity of the procedure and the duration of fluoroscopy. X-rays, including those for cervical spine imaging, generally expose patients to much lower doses, around 0.1 mSv per X-ray.

Now, let's calculate your total exposure based on the procedures you've mentioned. If we assume an average exposure of 15 mSv for each myocardial perfusion scan and 10 mSv for each cardiac catheterization, along with an average of 0.1 mSv per X-ray for 20 cervical spine X-rays, your total exposure could be estimated as follows:
- Myocardial perfusion scans: 2 scans x 15 mSv = 30 mSv
- Cardiac catheterizations: 2 procedures x 10 mSv = 20 mSv
- Cervical spine X-rays: 20 X-rays x 0.1 mSv = 2 mSv
Adding these together gives you a total estimated exposure of approximately 52 mSv.
To put this into perspective, the average person is exposed to about 3 mSv per year from natural background radiation. The threshold for increased cancer risk from radiation exposure is generally considered to be around 100 mSv over a lifetime, with lower doses posing a much smaller risk. Your total exposure of 52 mSv, while higher than average, is still below the threshold where significant risk is expected.

However, your anxiety regarding this exposure is understandable. It’s crucial to maintain open communication with your healthcare providers. If you have concerns about your radiation exposure, consider discussing them with your primary care physician or a specialist in radiation safety. They can help you assess your risk based on your medical history and the specific procedures you've undergone.

In terms of next steps, here are some recommendations:
1. Consult a Specialist: If you're particularly worried about the effects of radiation, consider seeing a specialist in radiation oncology or a medical physicist who can provide detailed insights into your exposure and its implications.

2. Regular Monitoring: While there’s no specific test for radiation exposure, regular health check-ups can help monitor any potential long-term effects. Discuss with your doctor what kind of follow-up care might be appropriate based on your medical history.

3. Lifestyle Factors: Focus on maintaining a healthy lifestyle, as many factors contribute to cancer risk, including diet, exercise, and smoking. Reducing these risks can be beneficial regardless of your radiation exposure.

4. Mental Health: If your anxiety about radiation exposure is affecting your quality of life, consider speaking with a mental health professional. They can help you develop coping strategies to manage your concerns.

In summary, while your radiation exposure from medical imaging is higher than average, it remains below levels typically associated with significant risk. Open communication with your healthcare providers and focusing on overall health can help alleviate your concerns. Remember, the benefits of necessary medical imaging often outweigh the risks, especially when it comes to diagnosing and treating serious health conditions.

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