Abstract
BackgroundNeuroimaging is widely used for diagnosis and treatment of stroke. However, little is known about whether the radiation doses received by patients comply with international safety guidelines.ObjectivesThe aim of this study was to evaluate the effective radiation dose received while in hospital for stroke and analyze its safety according to current guidelines.MethodsThis cross-sectional study included 109 patients who were hospitalized and diagnosed with ischemic stroke. The National Institutes of Health Stroke Scale was used to evaluate stroke severity, the Bamford clinical classification was used for topography, and the TOAST classification was used for etiology. The computed tomography dose index and size-specific dose estimates were used to calculate the effective radiation dose (ERD) received while in hospital. A Mann-Whitney test was used to compare the ERD received by thrombolysed and non-thrombolysed patients. Non-parametric statistics were used to analyze the data with a 95% confidence interval.ResultsDuring the study period, the median ERD received was 10.9 mSv. Length of stay was not associated with radiation exposure. No differences were demonstrated in ERD according to stroke etiology or Bamford clinical classification. Patients who had CT perfusion (only or in addition to CT or angiotomography) received the highest ERD (46.5 mSv) and the difference compared to those who did not (10.8 mSv) was statistically significant (p<0.001). No differences were found in the ERD between thrombolysed and non-thrombolysed patients. There was no correlation between ERD while in hospital and stroke severity.ConclusionsAccording to the current national guidelines, the protocol for examining images at our stroke unit is safe in terms of the ERD received by the patient while in hospital. There was no difference in the ERD received by patients stratified by thrombolytic treatment or stroke severity.
Highlights
Stroke is a leading cause of death and functional disability worldwide and is an important public health problem
This cross-sectional observational study included 109 patients aged ≥18 years diagnosed with ischemic stroke based on clinical evaluation and neuroimaging findings, who were hospitalized at the Stroke unit at the Botucatu Medical School between March and August 2019
The protocol for performing imaging tests employed in the stroke unit was safe in terms of the effective radiation dose (ERD) received by patients while in hospital and no differences were observed in the effective dose according to treatment, severity, etiology, or clinical signs of stroke
Summary
Stroke is a leading cause of death and functional disability worldwide and is an important public health problem. One in four people will have a stroke during their lifetime It is a medical emergency, diagnosed using clinical and imaging tests, and computed tomography (CT) is the most commonly used test in the acute care of patients with stroke and, in some cases, magnetic resonance imaging.[1,2]. Objectives: The aim of this study was to evaluate the effective radiation dose received while in hospital for stroke and analyze its safety according to current guidelines. No differences were demonstrated in ERD according to stroke etiology or Bamford clinical classification. Conclusions: According to the current national guidelines, the protocol for examining images at our stroke unit is safe in terms of the ERD received by the patient while in hospital. There was no difference in the ERD received by patients stratified by thrombolytic treatment or stroke severity
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