Risk factors for radiation exposure in newly diagnosed IBD patients

Area of Science:

• Medical Imaging
• Gastroenterology
• Radiation Oncology

Background:

• Patients diagnosed with inflammatory bowel disease (IBD) may undergo numerous diagnostic imaging procedures.
• Diagnostic radiation exposure is a concern for IBD patients, particularly with advanced disease or complications.

Purpose of the Study:

• To identify specific patient subsets within the inflammatory bowel disease population who are at higher risk for significant diagnostic radiation exposure.
• To inform clinical practice regarding radiation safety in IBD management.

Main Methods:

• A prospective study of 336 newly diagnosed IBD patients (adult and pediatric) enrolled in the Ocean State Crohn's & Colitis Area Registry (OSCCAR).
• Comprehensive chart review was conducted to assess diagnostic radiation exposure and identify associated risk factors.
• Statistical analysis was performed to determine the significance of various clinical factors on radiation dose.

Main Results:

• Over half of the IBD patients (57.1%) received GI-specific radiation, with higher doses in adults compared to pediatric patients.
• Crohn's disease (CD) patients, particularly those with stricturing or penetrating disease, received significantly higher radiation doses than ulcerative colitis (UC) patients.
• Key risk factors for increased radiation exposure included prior GI surgery, biologic therapy, pain-predominant symptoms, and isolated ileal disease.

Conclusions:

• Several clinical factors are associated with elevated ionizing radiation exposure in IBD patients.
• Identifying these risk factors allows for proactive patient stratification and consideration of alternative, lower-dose, or radiation-free imaging modalities.
• This knowledge supports personalized radiation safety strategies in the management of inflammatory bowel disease.