Keywords
diagnosis
adult
Crohn’s disease
inflammatory bowel disease
lidé
lidé středního věku
mužské pohlaví
retrospective study
staří
statistika jako téma
TNF-alfa
tomografie rentgenová počítačová
ulcerative colitis
ženské pohlaví
dávka záření
mladý dospělý
multivariační analýza
nádory vyvolané zářením
počítačová rentgenová tomografie
rentgendiagnostika
retrospektivní studie
ulcerózní kolitida
záření ionizující
Abstract
Background: The radiation exposure from diagnostic procedures performed to diagnose the complications of inflammatory bowel disease (IBD) has been documented in several studies. This exposure seems to reach a potentially harmful level (> 50 mSv) in about 8% of IBD patients. IBD patients treated with anti-TNF are hypothetically at higher risk of radiation exposure dueto the more severe disease course.
Aim: First, to assess the rate of potentially harmful cumulative radiation exposure among IBD patients using anti-TNF. Second, to determine the risk factors of such exposure. Methods: All patients treated with anti-TNF in one referral centre were included and the information on radiation exposure was retrieved from their medical reports. The cumulative radiation exposure was calculated based on the radiological standards for each diagnostic procedure.
Results: In total, 119 IBD patients (58% males; mean age 40 years, range 19 to 74 years; 75 Crohn's disease and 44 ulcerative colitis; mean disease duration 10 years, range 1 to 46 years) were included. The radiological procedures with radiation exposure of the abdomen were abdominal and pelvic CT (74 CT in 46 patients), CT colonography (one patient), CT enteroclysis (25 examinations in 23 patients), abdominal X-ray (18 X-rays in 15 patients), irigography (three examinations in three patients) and ERCP (one patient). The majority of patients (66 patients, 55%) had at least one diagnostic procedure involving radiation, with the mean cumulative radiation exposure of 34 mSv (range 5 to 140 mSv). Ten patients (8%) reached the potentially harmful cumulative radiation exposure of 50 mSv or more.
Conclusion: The potentially harmful cumulative radiation exposure rate resulting from diagnostic radiological procedures of IBD patients treated with anti-TNF biological therapy concerns one tenth of the patients (10% of patients). Diagnostic methods without radiation exposure should be preferred in these patients.