Abstract
Purpose
To evaluate the overall dose exposure due to follow-up computed tomography (CT) examinations in patients with acute pancreatitis (AP) in comparison with clinical, radiological parameters and patients’ outcome.
Method and Materials
We retrospectively included 27 patients (22 men, mean age 65y) with AP requiring intensive care unit (ICU) for more than 24h and being followed-up by CT. Reviewing the CT images in consensus, two readers registered the CT severity index (CTSI) in each patient and collected patients’ dose exposure parameters, i.e. dose-length product (DLP), effective dose (E) resulting from follow-up CT. Clinical and laboratory parameters indicating disease’s severity, length of hospital and ICU stay, acute complications, need for intervention and/or surgery were registered and correlated with the accumulated radiation dose.
Results
In all patients 258 CT examinations were performed (mean 9.56, range 1-25) during their hospital stay. Six patients (22%) died from acute complications. Mean accumulated DLP and E per patient were 8741mGy.cm (range 682-29194) and 131mSv (range 10-438), respectively.
The individual CTSI significantly correlated with patients’ laboratory parameters (amylasis, CRP), length of hospital stay, number of CT examinations, DLP, E, and number of radiological and surgical interventions.
The accumulated DLP and E per patient significantly correlated with CRP, septic shock, length of ICU and hospital stay, need for surgery, number of CT examinations, complications and radiological interventions.
Conclusion
The overall dose exposure resulting from follow-up CT examinations in patients with AP depends on disease’s severity including complications. It is considerable and should not be neglected. We hope that in the future, the use of further developed iterative reconstruction with optimized protocols tailored to the individual patient’s type will help reduce this dose burden