Cervical and lumbar spine imaging after traffic and occupational accidents: Evaluation of the use of imaging techniques, cumulative radiation dose and associated lifetime cancer risk. Issue 151 (June 2022)

• Record Type: Journal Article
• Authors: De Roo, Bieke; Bacher, Klaus; Verstraete, Koenraad
• Is Part Of: European journal of radiology. Issue 151(2022)
• Publication Date: 2022-06
• Subjects: Cervical spine -- Lumbar spine -- Traffic accident -- Occupational accident -- Radiation exposure -- Radiation-induced risk; AIS Abbreviated Injury Scale -- CED cumulative effective dose -- mSv millisieverts -- CT computed tomography -- MRI magnetic resonance imaging -- PI principal investigator -- CS cervical spine -- LS lumbar spine -- E effective dose -- ESD entrance surface dose, DAP, dose-area product -- DLP dose-length product -- CI confidence interval -- LNT linear no-threshold; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2022.110293
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Repeated imaging is common for those who were in a traffic or occupational accident. In this study, no patient had a cumulative dose higher than 100 mSv. Some patients have moderate risk of developing radiation-induced cancer. Abstract: Purpose: To study number and type of imaging techniques, cumulative radiation exposure and radiation-induced risk from repeated imaging of cervical and lumbar spine attained after traffic or occupational accident. Method: The study cohort comprised of 500 patients after traffic or occupational accident. Amount of radiography, CT and MRI procedures and injury severity were tallied for each patient. Cumulative effective dose (CED), expressed in millisieverts (mSv), was estimated by summing up typical effective dose values. Total lifetime cancer risks and associated risk category were estimated by using risk coefficients, specified according to sex, age at exposure and exposed region. Results: A total of 2, 107 imaging procedures were performed of which 30% were radiographs (n = 631), 21% were CT (n = 438) and 49% were MRI (n = 1, 038). Abbreviated Injury Scale was low (1–2) in all cases (except one). The cohort included 352 patients after traffic accident and 148 after occupational accident. Mean CED of these two groups were 4.4 mSv and 9.4 mSv, respectively. No patient had a CED higher than 100 mSv. Nineteen patients fell into the 'moderate risk' group, meaning that the additional risk of fatal cancer from accumulated radiation exposure lies between 1 in 1, 000 and 1 in 100. Conclusions: MRI was the most used imaging technique. No CED from repeated imaging procedures after minor or moderate traffic or occupational accident exceeded 100 mSv. However, nineteen patients fell into the 'moderate risk' group of developing radiation-induced cancer. Tracking radiation exposure can be beneficial in identifying those with high CED, although education on its proper use is necessary.