Challenges for managing the cumulative effective dose for patients

Area of Science:

• Radiological Sciences
• Medical Physics
• Radiation Protection

Background:

• Cumulative effective dose (CED) of ≥100 mSv from recurrent ionizing radiation imaging procedures is increasingly discussed.
• The International Commission on Radiological Protection (ICRP) highlights challenges in using effective dose for individual risk but accepts it for comparing modalities.
• A new ICRP document on effective dose use in medicine is forthcoming.

Purpose of the Study:

• To summarize challenges and management strategies for patients with high cumulative effective doses (CED) from medical imaging.
• To highlight key areas for improving radiation safety and patient care in interventional radiology and CT scans.

Main Methods:

• Review of recent publications on patient cumulative effective doses (CED).
• Identification and summarization of challenges in managing high-dose patients.
• Analysis of current and proposed strategies for dose reduction and management.

Main Results:

• Published data indicate 0.6–3.4% of CT patients and around 4% of interventional radiology patients have CED ≥100 mSv.
• Key management aspects include dose reduction technologies, refined justification/optimization, patient dose management systems, and education.

Conclusions:

• Effective management of patients with high CED requires a multi-faceted approach.
• Future research in radiation biology and epidemiology can benefit from data on high-dose patient groups.