Variability of radiation exposure with in-office sinus computed tomography examinations

An increasing number of patients seeking care by an otolaryngologist are undergoing computed tomography (CT) examinations via in-office CT scanners. Many otolaryngologists and patients are not fully aware of the radiation dosages and the associated risks. A recent study of common CT examinations demonstrated significant variability in radiation dosages for similar studies. Despite the relatively low doses associated with sinus scans, widely publicized studies and events have generated a renewal of physician, public, and regulatory agency awareness and concern regarding medical radiation exposure.

Phantom measurements and/or radiation dosage reports from CT scanners utilized by a large otolaryngology group in California were reviewed and compared. Different types of CT scanners from multiple manufacturers were included.

There was nearly a 10-fold difference (0.15-1.45 mSv) in radiation between scans obtained from in-office, hospital-based, and outpatient imaging facility CT scanners.

Significant relative variability can exist in radiation dosages associated with routine sinus CT scans obtained in different locations. There is a need for increased awareness and understanding among otolaryngologists and their patients regarding medical radiation exposure. All otolaryngologists should constantly consider the principle of "as low as reasonably achievable" (ALARA). Shielding, pediatric protocols, and other dosage reduction measures should be utilized whenever possible.