Potentially harmful radiation exposure rate among inflammatory bowel disease patients treated with biological therapy

Czech version

Authors: Z. Zelinková; T. Hlavatý; I. Šturdík; A. Krajčovičová; T. Koller; J. Tóth; M. Huorka
Authors‘ workplace: Gastroenterologické a hepatologické oddelenie, V. interná klinika LF UK a UN Bratislava
Published in: Gastroent Hepatol 2014; 68(1): 19-23
Category: IDB: Original Article

Overview

Background:
The radiation exposure from diagnostic procedures performed to diagnose the complications of inflammatory bowel disease (IBD) has been documented in several studies. This exposure seems to reach a potentially harmful level (> 50 mSv) in about 8% of IBD patients. IBD patients treated with anti-TNF are hypothetically at higher risk of radiation exposure due to the more severe disease course.

Aim:
First, to assess the rate of potentially harmful cumulative radiation exposure among IBD patients using anti-TNF. Second, to determine the risk factors of such exposure. Methods: All patients treated with anti-TNF in one referral centre were included and the information on radiation exposure was retrieved from their medical reports. The cumulative radiation exposure was calculated based on the radiological standards for each diagnostic procedure.

Results:
In total, 119 IBD patients (58% males; mean age 40 years, range 19 to 74 years; 75 Crohn's disease and 44 ulcerative colitis; mean disease duration 10 years, range 1 to 46 years) were included. The radiological procedures with radiation exposure of the abdomen were abdominal and pelvic CT (74 CT in 46 patients), CT colonography (one patient), CT enteroclysis (25 examinations in 23 patients), abdominal X-ray (18 X-rays in 15 patients), irigography (three examinations in three patients) and ERCP (one patient). The majority of patients (66 patients, 55%) had at least one diagnostic procedure involving radiation, with the mean cumulative radiation exposure of 34 mSv (range 5 to 140 mSv). Ten patients (8%) reached the potentially harmful cumulative radiation exposure of 50 mSv or more.

Conclusion:
The potentially harmful cumulative radiation exposure rate resulting from diagnostic radiological procedures of IBD patients treated with anti-TNF biological therapy concerns one tenth of the patients (10% of patients). Diagnostic methods without radiation exposure should be preferred in these patients.

Key words:
radiation – diagnostics – inflammatory bowel disease – biologic therapy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
6. 1. 2014

Accepted:
28. 1. 2014

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