Radiation exposure in patients with inflammatory bowel disease

Area of Science:

• Medical Imaging
• Radiology
• Gastroenterology

Background:

• Radiological imaging is vital for diagnosing and monitoring inflammatory bowel diseases (IBD).
• Concerns about radiation risks necessitate minimizing exposure to 'as low as reasonably achievable' levels, ideally below 75 mSv.
• Limited real-world data exists on cumulative radiation exposure in IBD patients.

Purpose of the Study:

• To retrospectively analyze the radiation exposure of IBD patients in a Belgian tertiary referral center.
• To determine the proportion of IBD patients exceeding a cumulative effective dose (CED) of 75 mSv.
• To identify factors contributing to radiation exposure in IBD management.

Main Methods:

• Reviewed radiation exposure examinations from electronic health records of 4333 IBD patients.
• Calculated annual effective dose (AED) and cumulative effective dose (CED).
• Conducted a sub-analysis of patients diagnosed after January 1st, 2007, for whom detailed dose data was prospectively maintained.

Main Results:

• The median AED was 0.47 mSv/year, higher in Crohn's disease (CD) than ulcerative colitis (UC).
• 5.5% of patients reached a CED ≥75 mSv after a median follow-up of 24 years.
• In patients diagnosed from 2007 onwards, 3.3% reached a CED ≥75 mSv after 9 years; comorbidities like malignancy were common reasons for exposure.

Conclusions:

• A significant percentage of IBD patients may exceed recommended cumulative radiation doses.
• While most imaging is appropriate, continued vigilance is needed to manage radiation exposure.
• Further research into optimizing imaging strategies for IBD patients is warranted.