Cervical and lumbar spine imaging after traffic and occupational accidents: Evaluation of the use of imaging techniques, cumulative radiation dose and associated lifetime cancer risk

Abstract

PurposeTo study number and type of imaging techniques, cumulative radiation exposure and radiation-induced risk from repeated imaging of cervical and lumbar spine attained after traffic or occupational accident. MethodThe study cohort comprised of 500 patients after traffic or occupational accident. Amount of radiography, CT and MRI procedures and injury severity were tallied for each patient. Cumulative effective dose (CED), expressed in millisieverts (mSv), was estimated by summing up typical effective dose values. Total lifetime cancer risks and associated risk category were estimated by using risk coefficients, specified according to sex, age at exposure and exposed region. ResultsA total of 2,107 imaging procedures were performed of which 30% were radiographs (n = 631), 21% were CT (n = 438) and 49% were MRI (n = 1,038). Abbreviated Injury Scale was low (1–2) in all cases (except one). The cohort included 352 patients after traffic accident and 148 after occupational accident. Mean CED of these two groups were 4.4 mSv and 9.4 mSv, respectively. No patient had a CED higher than 100 mSv. Nineteen patients fell into the ‘moderate risk’ group, meaning that the additional risk of fatal cancer from accumulated radiation exposure lies between 1 in 1,000 and 1 in 100. ConclusionsMRI was the most used imaging technique. No CED from repeated imaging procedures after minor or moderate traffic or occupational accident exceeded 100 mSv. However, nineteen patients fell into the ‘moderate risk’ group of developing radiation-induced cancer. Tracking radiation exposure can be beneficial in identifying those with high CED, although education on its proper use is necessary.