Introduction The aim of this audit was to establish how much radiation patients with newly diagnosed Crohn’s disease are exposed to and if this has changed over time within our practise. We hoped that with the increased availability of new imaging modalities such as ultrasound and MRI scanning the exposure of these patients to radiation may have fallen.
Methods Using the IBD database all Crohn’s patients diagnosed from 1995 to 2011 were identified. We then collected data on 59 patients diagnosed from 1995 to 2001 and on 61 patients diagnosed from 2006 to 2011. These dates were chosen as ultrasound of the small bowel was introduced in UHL in 2002, and took a few years to become established as an imaging technique in Crohn’s.
Data for each patient was collected only on studies performed in the first year of diagnosis, to prevent bias occurring due to the length of time that patients had the disease. We also felt the first year was likely to encompass studies performed to establish the diagnosis and extent of disease.
Results For patients diagnosed between 1995 and 2001 with Crohn’s disease the average exposure to radiation in the first year was 1.83 mSv (range 0–12.3 mSv). For patients diagnosed between 2006 and 2011 we found an average exposure of 2.67 mSv (range 0–24 mSv), an increase of 46%.
Conclusion Radiation exposure in Crohn’s disease appears to be increasing despite new modalities such as ultrasound and MRI. The increase is attributed to the increased use of CT scanning, as availability and accuracy of imaging via CT in Crohn’s disease have improved in recent years. With the gradual introduction of low-dose CT scanning, we would hope these levels will fall again in the near future. Furthermore we observed an increase in the use of plain abdominal films of 87.5%. We feel this may be attributable to the shift in attitude towards treating unwell patients with the increasingly effective and available pharmacological therapies, rather than surgical options, although further audit should be carried out to establish if this is indeed the case.
Disclosure of Interest None Declared
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