Abstract

Inflammatory bowel diseases (IBD) are chronic and relapsing disorders usually requiring numerous medical imaging. IBD patients might be exposed to a large dose of radiation. As a cumulative effective dose (CED) ≥ 50 mSv is considered significant for stochastic risks of cancer, it is important to monitor the radiation exposure of IBD patients. In the present work, we aimed to quantify the mean CED in IBD patients and identify factors associated with exposure to high doses of diagnostic radiation. A retrospective chart view of patients with IBD hospitalized between 2015 and 2019 was performed. A total of 65 patients with Crohn’s disease (CD) and 98 patients with ulcerative colitis (UC) were selected. Of all imaging studies performed, 73% were with doses of ionizing radiation. Mean CED (SD) amounted to 19.20 (15.64) millisieverts (mSv) and 6.66 (12.39) mSv, respectively, in patients with CD and UC (p < 0.00001). Only 1.84% of the patients received CED ≥ 50 mSv. We identified three factors associated with CED in the IBD patients: number of surgical procedures, and number and length of hospitalization. CD patients with strictures or penetrating disease and UC patients with extensive colitis were more likely to receive higher radiation doses.

Highlights

  • We aimed to quantify the mean cumulative effective dose (CED) in patients with Inflammatory bowel diseases (IBD) to assess any harmful effects of radiation and identify factors associated with exposure to high doses of diagnostic radiation

  • IBD patients were divided into two groups (CD and ulcerative colitis (UC)) that were statistically homogenous

  • A total of 40 patients with Crohn’s disease (CD) underwent a total of 93 CD-related surgeries, while 10 patients with UC underwent proctocolectomy

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Summary

Introduction

Inflammatory bowel diseases (IBD) are chronic, progressive disorders that include. Crohn’s disease (CD) and ulcerative colitis (UC). The first symptoms of the disease usually occur in the second to fourth decade of life. IBD is characterized by periods of remission and exacerbations. Patients with IBD require frequent diagnostic tests, which are performed in order to state the diagnosis, estimate the extent of the disease, determine the patient’s response to the treatment, monitor disease activity, and evaluate complications [1,2]. Endoscopic examination is a gold standard for the diagnosis and evaluation of disease activity but has limitations. Colonoscopy is an invasive procedure and requires difficult preparation [3]. The mucosa and the lumen of the gut can be described but the deeper layers of the wall cannot be evaluated

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