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P160. Quantifying exposure to diagnostic radiation and factors associated with exposure to high levels of radiation in Korean patients with inflammatory bowel disease

D.I. Park1, Y.S. Jung1, Y.H. Kim2, E.R. Kim2, C.K. Lee3, J.H. Kim4, K.C. Huh5, S.-A. Jung6, S.M. Yoon7, H.J. Song8, H.J. Jang9, Y.S. Kim10, K.-M. Lee11, J.E. Shin12, 1Kangbuk Samsung Hospital, Internal Medicine, Seoul, South Korea, 2Samsung Medical Center, Medicine, Seoul, South Korea, 3Kyung Hee University, Internal Medicine, Seoul, South Korea, 4Dongguk University Ilsan Hospital, Internal Medicine, Seoul, South Korea, 5Konyang University, Internal Medicine, Seoul, South Korea, 6Ewha Womans University, Internal Medicine, Seoul, South Korea, 7Chungbuk National University Hospital, Internal Medicine, Seoul, South Korea, 8Jeju National University, Internal Medicine, Jeju, South Korea, 9Hallym University, Internal Medicine, Seoul, South Korea, 10Seoul Paik Hospital, Inje University, Internal Medicine, Seoul, South Korea, 11St. Vincent's Hospital, The Catholic University, Internal Medicine, Suwon, South Korea, 12Dankook University, Internal Medicine, Cheonan, South Korea

Background

Several recent studies have revealed that diagnostic imaging can result in exposure to potentially harmful levels of ionizing radiation in inflammatory bowel disease (IBD) patients. However, these studies have been conducted exclusively in Western countries and no data are available in Asian populations. The aim of this study was to estimate the diagnostic radiation exposure in Korean IBD patients and to determine the factors associated with high radiation exposure.

Methods

Patients with an established diagnosis of IBD between July 1987 and January 2012 were investigated in thirteen university hospitals in Korea. The cumulative effective dose (CED) was calculated retrospectively from standard tables and by counting the number of radiological studies.

Results

A total of 777 Crohn's disease (CD) cases and 1422 ulcerative colitis (UC) cases were included in the study. The mean CED for CD and UC were 53.6 and 16.4 mSv respectively (P < 0.001). Computed tomography (CT) of CD and UC accounted for 81.6% and 71.2% of total effective dose, respectively. Importantly, 34.7% of CD patients and 8.4% of UC patients were exposed to high levels of radiation (CED >50 mSv) (P < 0.001). High radiation exposure was associated with long disease duration, ileocolonic disease, upper gastrointestinal tract involvement, surgery, hospitalization, and the requirement for oral steroids in CD, and with surgery, hospitalization, and the requirement for infliximab in UC.

Conclusion

A substantial proportion of IBD patients, especially CD patients, were exposed to significantly harmful amounts of diagnostic radiation, mainly due to CT examination. Given that IBD is a life-long illness, strategies to reduce radiation exposure from diagnostic imaging need to be considered.