Computed Tomography Scans in Patients With Young Adult Hip Pain Carry a Lifetime Risk of Malignancy
To calculate the lifetime risk of malignancy in young adult patients with hip pain using 5 different imaging and radiation dose protocols with or without pre- and postoperative computed tomography (CT). Radiographic and CT patient radiation doses were retrospectively reviewed. Imaging protocols for...
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| Veröffentlicht in: | Arthroscopy 2018-01, Vol.34 (1), p.155-163.e3 |
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| creator | Wylie, James D. Jenkins, Peter A. Beckmann, James T. Peters, Christopher L. Aoki, Stephen K. Maak, Travis G. |
| description | To calculate the lifetime risk of malignancy in young adult patients with hip pain using 5 different imaging and radiation dose protocols with or without pre- and postoperative computed tomography (CT).
Radiographic and CT patient radiation doses were retrospectively reviewed. Imaging protocols for hip pain composed of radiographs with or without pre- and postoperative CT scans were modeled and radiation doses were estimated using the PCXMC computer code. Based on these radiation doses, lifetime attributable risks of cancer and mortality for a 10- through 60-year-old male and female were calculated as published by the committee on the Biological Effects of Ionizing Radiation (BEIR) in the BEIR VII report. Relative risks and number needed to harm (NNH) were calculated for each protocol.
Based on a review of our institutional database, 2 CT scan doses were used for this study: a high 5.06 mSv and a low 2.86 mSv. Effective doses of radiation ranged from 0.59 to 0.66 mSv for radiographs alone to 10.71 to 10.78 mSv for radiographs and CT both pre- and postoperatively at the higher dose. Lifetime attributable risk of cancer for radiographs alone was 0.006% and 0.011% for a 20-year-old male and female, respectively. Lifetime attributable risk of cancer for radiographs along with pre- and postoperative CT scans at higher dose was 0.105% and 0.177% for a 20-year-old male and female, respectively. Radiographs alone lead to an NNH of 16,667 for males and 9,090 for females, whereas the protocol with pre- and postoperative CT scans at the higher dose led to an NNH of 952 for males and 564 for females. The relative risk of this protocol compared to radiographs alone was 17.5 for males and 16.1 for females.
Protocols with CT scans of the hip/pelvis pose a small lifetime attributable risk (0.034%-0.177% for a 20-year-old) but a large relative risk (5-17 times) of cancer compared with radiographs alone in the imaging evaluation for hip pain that decreases with increasing age.
This study illustrates the need for clinicians to understand the imaging protocols used at their institution to understand the risks and benefits of using those protocols in their practice. |
| doi_str_mv | 10.1016/j.arthro.2017.08.235 |
| format | Article |
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Radiographic and CT patient radiation doses were retrospectively reviewed. Imaging protocols for hip pain composed of radiographs with or without pre- and postoperative CT scans were modeled and radiation doses were estimated using the PCXMC computer code. Based on these radiation doses, lifetime attributable risks of cancer and mortality for a 10- through 60-year-old male and female were calculated as published by the committee on the Biological Effects of Ionizing Radiation (BEIR) in the BEIR VII report. Relative risks and number needed to harm (NNH) were calculated for each protocol.
Based on a review of our institutional database, 2 CT scan doses were used for this study: a high 5.06 mSv and a low 2.86 mSv. Effective doses of radiation ranged from 0.59 to 0.66 mSv for radiographs alone to 10.71 to 10.78 mSv for radiographs and CT both pre- and postoperatively at the higher dose. Lifetime attributable risk of cancer for radiographs alone was 0.006% and 0.011% for a 20-year-old male and female, respectively. Lifetime attributable risk of cancer for radiographs along with pre- and postoperative CT scans at higher dose was 0.105% and 0.177% for a 20-year-old male and female, respectively. Radiographs alone lead to an NNH of 16,667 for males and 9,090 for females, whereas the protocol with pre- and postoperative CT scans at the higher dose led to an NNH of 952 for males and 564 for females. The relative risk of this protocol compared to radiographs alone was 17.5 for males and 16.1 for females.
Protocols with CT scans of the hip/pelvis pose a small lifetime attributable risk (0.034%-0.177% for a 20-year-old) but a large relative risk (5-17 times) of cancer compared with radiographs alone in the imaging evaluation for hip pain that decreases with increasing age.
This study illustrates the need for clinicians to understand the imaging protocols used at their institution to understand the risks and benefits of using those protocols in their practice.</description><identifier>ISSN: 0749-8063</identifier><identifier>EISSN: 1526-3231</identifier><identifier>DOI: 10.1016/j.arthro.2017.08.235</identifier><identifier>PMID: 29100768</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Arthralgia - diagnostic imaging ; Arthralgia - etiology ; Child ; Female ; Hip Joint - diagnostic imaging ; Hip Joint - pathology ; Humans ; Male ; Middle Aged ; Neoplasms, Radiation-Induced - epidemiology ; Neoplasms, Radiation-Induced - etiology ; Radiation Dosage ; Retrospective Studies ; Risk Assessment - methods ; Risk Factors ; Tomography, X-Ray Computed - adverse effects ; Tomography, X-Ray Computed - methods ; Young Adult</subject><ispartof>Arthroscopy, 2018-01, Vol.34 (1), p.155-163.e3</ispartof><rights>2017 Arthroscopy Association of North America</rights><rights>Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-9f2bd764ef1a9072900b0ddca08ced1d019214fdba6a1cc99f6cf097345970763</citedby><cites>FETCH-LOGICAL-c362t-9f2bd764ef1a9072900b0ddca08ced1d019214fdba6a1cc99f6cf097345970763</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.arthro.2017.08.235$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29100768$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wylie, James D.</creatorcontrib><creatorcontrib>Jenkins, Peter A.</creatorcontrib><creatorcontrib>Beckmann, James T.</creatorcontrib><creatorcontrib>Peters, Christopher L.</creatorcontrib><creatorcontrib>Aoki, Stephen K.</creatorcontrib><creatorcontrib>Maak, Travis G.</creatorcontrib><title>Computed Tomography Scans in Patients With Young Adult Hip Pain Carry a Lifetime Risk of Malignancy</title><title>Arthroscopy</title><addtitle>Arthroscopy</addtitle><description>To calculate the lifetime risk of malignancy in young adult patients with hip pain using 5 different imaging and radiation dose protocols with or without pre- and postoperative computed tomography (CT).
Radiographic and CT patient radiation doses were retrospectively reviewed. Imaging protocols for hip pain composed of radiographs with or without pre- and postoperative CT scans were modeled and radiation doses were estimated using the PCXMC computer code. Based on these radiation doses, lifetime attributable risks of cancer and mortality for a 10- through 60-year-old male and female were calculated as published by the committee on the Biological Effects of Ionizing Radiation (BEIR) in the BEIR VII report. Relative risks and number needed to harm (NNH) were calculated for each protocol.
Based on a review of our institutional database, 2 CT scan doses were used for this study: a high 5.06 mSv and a low 2.86 mSv. Effective doses of radiation ranged from 0.59 to 0.66 mSv for radiographs alone to 10.71 to 10.78 mSv for radiographs and CT both pre- and postoperatively at the higher dose. Lifetime attributable risk of cancer for radiographs alone was 0.006% and 0.011% for a 20-year-old male and female, respectively. Lifetime attributable risk of cancer for radiographs along with pre- and postoperative CT scans at higher dose was 0.105% and 0.177% for a 20-year-old male and female, respectively. Radiographs alone lead to an NNH of 16,667 for males and 9,090 for females, whereas the protocol with pre- and postoperative CT scans at the higher dose led to an NNH of 952 for males and 564 for females. The relative risk of this protocol compared to radiographs alone was 17.5 for males and 16.1 for females.
Protocols with CT scans of the hip/pelvis pose a small lifetime attributable risk (0.034%-0.177% for a 20-year-old) but a large relative risk (5-17 times) of cancer compared with radiographs alone in the imaging evaluation for hip pain that decreases with increasing age.
This study illustrates the need for clinicians to understand the imaging protocols used at their institution to understand the risks and benefits of using those protocols in their practice.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Arthralgia - diagnostic imaging</subject><subject>Arthralgia - etiology</subject><subject>Child</subject><subject>Female</subject><subject>Hip Joint - diagnostic imaging</subject><subject>Hip Joint - pathology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasms, Radiation-Induced - epidemiology</subject><subject>Neoplasms, Radiation-Induced - etiology</subject><subject>Radiation Dosage</subject><subject>Retrospective Studies</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Tomography, X-Ray Computed - adverse effects</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Young Adult</subject><issn>0749-8063</issn><issn>1526-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtvEzEURi1ERUPhH1SVl2xmuLYnnvEGqYr6QAoCQRFiZTl-JA4z46ntqZR_X0cpLFndxT3ffRyELgnUBAj_uK9VzLsYagqkraGrKVu-QguypLxilJHXaAFtI6oOODtHb1PaAwBjHXuDzqkgAC3vFkivwjDN2Rr8EIawjWraHfAPrcaE_Yi_qeztmBP-5fMO_w7zuMXXZu4zvvdT6RZkpWI8YIXX3tnsB4u_-_QHB4e_qN5vRzXqwzt05lSf7PuXeoF-3t48rO6r9de7z6vrdaUZp7kSjm5MyxvriBLQUgGwAWO0gk5bQwwQQUnjzEZxRbQWwnHtQLSsWYq2fMMu0IfT3CmGx9mmLAeftO17NdowJ0kEB8GALo9oc0J1DClF6-QU_aDiQRKQR71yL0965VGvhE4WvSV29bJh3gzW_Av99VmATyfAlj-fvI0y6WKw3O-j1Vma4P-_4Rno2I1y</recordid><startdate>201801</startdate><enddate>201801</enddate><creator>Wylie, James D.</creator><creator>Jenkins, Peter A.</creator><creator>Beckmann, James T.</creator><creator>Peters, Christopher L.</creator><creator>Aoki, Stephen K.</creator><creator>Maak, Travis G.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201801</creationdate><title>Computed Tomography Scans in Patients With Young Adult Hip Pain Carry a Lifetime Risk of Malignancy</title><author>Wylie, James D. ; Jenkins, Peter A. ; Beckmann, James T. ; Peters, Christopher L. ; Aoki, Stephen K. ; Maak, Travis G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-9f2bd764ef1a9072900b0ddca08ced1d019214fdba6a1cc99f6cf097345970763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Arthralgia - diagnostic imaging</topic><topic>Arthralgia - etiology</topic><topic>Child</topic><topic>Female</topic><topic>Hip Joint - diagnostic imaging</topic><topic>Hip Joint - pathology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasms, Radiation-Induced - epidemiology</topic><topic>Neoplasms, Radiation-Induced - etiology</topic><topic>Radiation Dosage</topic><topic>Retrospective Studies</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Tomography, X-Ray Computed - adverse effects</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wylie, James D.</creatorcontrib><creatorcontrib>Jenkins, Peter A.</creatorcontrib><creatorcontrib>Beckmann, James T.</creatorcontrib><creatorcontrib>Peters, Christopher L.</creatorcontrib><creatorcontrib>Aoki, Stephen K.</creatorcontrib><creatorcontrib>Maak, Travis G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Arthroscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wylie, James D.</au><au>Jenkins, Peter A.</au><au>Beckmann, James T.</au><au>Peters, Christopher L.</au><au>Aoki, Stephen K.</au><au>Maak, Travis G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Computed Tomography Scans in Patients With Young Adult Hip Pain Carry a Lifetime Risk of Malignancy</atitle><jtitle>Arthroscopy</jtitle><addtitle>Arthroscopy</addtitle><date>2018-01</date><risdate>2018</risdate><volume>34</volume><issue>1</issue><spage>155</spage><epage>163.e3</epage><pages>155-163.e3</pages><issn>0749-8063</issn><eissn>1526-3231</eissn><abstract>To calculate the lifetime risk of malignancy in young adult patients with hip pain using 5 different imaging and radiation dose protocols with or without pre- and postoperative computed tomography (CT).
Radiographic and CT patient radiation doses were retrospectively reviewed. Imaging protocols for hip pain composed of radiographs with or without pre- and postoperative CT scans were modeled and radiation doses were estimated using the PCXMC computer code. Based on these radiation doses, lifetime attributable risks of cancer and mortality for a 10- through 60-year-old male and female were calculated as published by the committee on the Biological Effects of Ionizing Radiation (BEIR) in the BEIR VII report. Relative risks and number needed to harm (NNH) were calculated for each protocol.
Based on a review of our institutional database, 2 CT scan doses were used for this study: a high 5.06 mSv and a low 2.86 mSv. Effective doses of radiation ranged from 0.59 to 0.66 mSv for radiographs alone to 10.71 to 10.78 mSv for radiographs and CT both pre- and postoperatively at the higher dose. Lifetime attributable risk of cancer for radiographs alone was 0.006% and 0.011% for a 20-year-old male and female, respectively. Lifetime attributable risk of cancer for radiographs along with pre- and postoperative CT scans at higher dose was 0.105% and 0.177% for a 20-year-old male and female, respectively. Radiographs alone lead to an NNH of 16,667 for males and 9,090 for females, whereas the protocol with pre- and postoperative CT scans at the higher dose led to an NNH of 952 for males and 564 for females. The relative risk of this protocol compared to radiographs alone was 17.5 for males and 16.1 for females.
Protocols with CT scans of the hip/pelvis pose a small lifetime attributable risk (0.034%-0.177% for a 20-year-old) but a large relative risk (5-17 times) of cancer compared with radiographs alone in the imaging evaluation for hip pain that decreases with increasing age.
This study illustrates the need for clinicians to understand the imaging protocols used at their institution to understand the risks and benefits of using those protocols in their practice.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29100768</pmid><doi>10.1016/j.arthro.2017.08.235</doi></addata></record> |
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| subjects | Adolescent Adult Arthralgia - diagnostic imaging Arthralgia - etiology Child Female Hip Joint - diagnostic imaging Hip Joint - pathology Humans Male Middle Aged Neoplasms, Radiation-Induced - epidemiology Neoplasms, Radiation-Induced - etiology Radiation Dosage Retrospective Studies Risk Assessment - methods Risk Factors Tomography, X-Ray Computed - adverse effects Tomography, X-Ray Computed - methods Young Adult |
| title | Computed Tomography Scans in Patients With Young Adult Hip Pain Carry a Lifetime Risk of Malignancy |
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