Diagnostic Medical Radiation Dose in Patients after诊断性医疗照射剂量.pptVIP

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Diagnostic Medical Radiation Dose in Patients after诊断性医疗照射剂量.ppt

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7/100 RYGB pts received 50 mSv (~2500 CXR) 1/100 RYGB pt received 100 mSv (~5000 CXR) Highest dose in band group was 46 mSv 1 CXR = 0.02 mSv Background radiation = 3 mSv/yr In addition to known complications, potential risks a/w DMR in the post-operative period should also be considered Possible that pts who do not undergo bariatric surgery will later develop complications from obesity that could prompt similar or even greater numbers of radiological exams Radiation risks are easily overlooked in the clinical setting since the carcinogenic effects of ionizing radiation take many years to manifest and causation is generally not provable on an individual basis How would be radiation dose change with patient size? How does patient size limit image quality and diagnostic interpretation? How often are other complications discovered at surgery or endoscopy that were not evident by radiology? While the risks-to-benefit ratio may be justified, strategies to minimize radiation dose in this patient population should be pursued. Judicious use of radiologic tests should be emphasized. Appropriate technique factors should be applied for all radiologic exams according to ALARA Research Mentor: Paul Shyn, MD Richard Nawfel, PhD (physicist) Richard Flint, MD (surgeon) Usha Govindarajulu (statistician) Tamara N. Oei, Paul B. Shyn, Usha Govindarajulu, Richard Flint. (2009) Diagnostic Medical Radiation Dose in Patients After Laparoscopic Bariatric Surgery. Obesity Surgery Online publication date: 25-Oct-2009. Brenner D, Hall E. Computed tomography—an increasing source of radiation exposure. N Engl J Med 2007; 357: 2277-2284. Health risks from exposure to low levels of ionizing radiation—BIER VII. Washington, DC: National Academies Press, 2005. Brenner D, Doll R, Goodhead, D, et al. Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci 2003; 100: 13761-13766. Overweight and obesity. Centers for Disease Control