RADIATION DOSE TO THE EYE AND POTENTIAL OCCURRENCE RADIATION- INDUCED CATARACT FOLLOWING COMPUTED TOMOGRAPHY (CT) HEAD EXAMINATION

  • Muhammad Ikhmal Naim Mohd Hilal Diagnostic Imaging and Radiotherapy Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
  • Rekha Ganesan Diagnostic Imaging and Radiotherapy Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
  • Norhashimah Mohd Norsuddin Diagnostic Imaging and Radiotherapy Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
  • Mohd Izuan Ibrahim Diagnostic Imaging and Radiotherapy Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
  • Said Mohd Shaffiq Said. Rahmat Department of Radiology, National Cancer Institute, 4, Jalan P7, Presint 7, 62250 Putrajaya, Wilayah Persekutuan Putrajaya, Malaysia
  • Muhammad Khalis Abd Karim Department of Physics, Faculty of Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
  • Iza Nurzawani Che Isa Diagnostic Imaging and Radiotherapy Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
Keywords: CT brain, CT temporal, cataract

Abstract

The eye is a radiosensitive organ that lies within the scan range during Computed Tomography (CT) of the head. The utilization of the head CT is increasing with growing concern about the chances of development of cataract which induces by ionising radiation. This research aimed to calculate eye absorbed dose and to study the potential occurrence of radiation induces cataracts between CT Brain and CT Temporal. A total of 399 set data were obtained retrospectively according to inclusion and exclusion criteria. 364 patients underwent CT Brain while 35 patients’ data obtained for CT Temporal. The scanning parameters such as tube current, tube potential, pitch factor, beamwidth, filter, revolution time, and filter were recorded. Eye absorbed dose was significantly different (p<0.05) between CT brain (49.07±10.08mGy) and CT temporal (25.72 ± 6.12mGy). None of the analysed data exceeded the eye threshold dose recommended by ICRP 2012. However, as expected, the cumulative eye absorbed dose was increased as the frequencies of the scan increase. The highest number of repeated scans is five times with cumulative dose was recorded as 278.27mGy. In conclusion, the eye absorbed dose is higher in CT Brain compared to CT Temporal and has potential for induction of cataract in the future especially with the patient that undergoes repeated CT examination.

References

Bhattacharyya K. Godfrey Newbold Hounsfield (1919-2004): The man who revolutionized neuroimaging. Vol. 19, Annals of Indian Academy of Neurology. 2016. p. 448–50.

Edyvean S. CT equipment and performance issues: radiation protection 162. Radiat Prot Dosimetry [Internet]. 2013 Feb 1;153(2):190–6. Available from: https://doi.org/10.1093/rpd/ncs285

Rao P, Bekhit E, Ramanauskas F, Kumbla S. CT head in children. Eur J Radiol. 2013;82(7):1050–8.

Vassileva J, Rehani MM, Al-Dhuhli H, Al-Naemi HM, Al-Suwaidi JS, Appelgate K, et al. IAEA survey of pediatric CT practice in 40 countries in Asia, Europe, Latin America, and Africa: Part 1, frequency and appropriateness. Am J Roentgenol. 2012;198(5):1021–31.

Vassileva J, Rehani M, Kostova-Lefterova D, Al-Naemi HM, Al Suwaidi JS, Arandjic D, et al. A study to establish international diagnostic reference levels for paediatric computed tomography. Radiat Prot Dosimetry. 2015;165(1–4):70–80.

Thukral CL, Singh A, Singh S, Sood AS, Singh K. Role of High Resolution Computed Tomography in Evaluation of Pathologies of Temporal Bone. J Clin Diagn Res [Internet]. 2015 Sep;9(9):TC07—10. Available from: https://europepmc.org/articles/PMC4606307

Singh N, Mohacsy A, Connell DA, Schneider ME. A snapshot of patients’ awareness of radiation dose and risks associated with medical imaging examinations at an Australian radiology clinic. Radiography. 2017;23(2):94–102.

Alkhorayef M, Sulieman A, Alonazi B, Alnaaimi M, Alduaij M, Bradley D. Estimation of radiation-induced cataract and cancer risks during routine CT head procedures. Radiat Phys Chem. 2019;155:65–8.

Michel M, Jacob S, Roger G, Pelosse B, Laurier D, Le Pointe HD, et al. Eye lens radiation exposure and repeated head CT scans: A problem to keep in mind. Eur J Radiol [Internet]. 2012;81(8):1896–900. Available from: https://www.sciencedirect.com/science/article/pii/S0720048X11003214

Elmoheen A, Salem W, Bashir K. Reducing unnecessary CT scan of the head for minor paediatric head injuries at the emergency department. BMJ Open Qual. 2021;10(1).

Karim MKA, Hashim S, Sabarudin A, Bradley DA, Bahruddin NA. Evaluating organ dose and radiation risk of routine CT examinations in Johor Malaysia. Sains Malaysiana. 2016;45(4):567–73.

Rehani MM, Vano E, Ciraj-Bjelac O, Kleiman NJ. Radiation and cataract. Vol. 147, Radiation Protection Dosimetry. 2011. p. 300–4.

Görtz H, Al Halabi A. The radiation cataract—an actual risk for vascular surgeons. Vol. 25, Gefasschirurgie. 2020. p. 6–11.

Clement CH, Stewart FA, Akleyev A V., Hauer-Jensen M, Hendry JH, Kleiman NJ, et al. ICRP publication 118: ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs Threshold Doses for Tissue Reactions in a Radiation Protection Context. Ann ICRP. 2012;41(1–2):1–322.

Litmanovich DE, Tack DM, Shahrzad M, Bankier AA. Dose Reduction in Cardiothoracic CT: Review of Currently Available Methods. RadioGraphics [Internet]. 2014 Oct 1;34(6):1469–89. Available from: https://doi.org/10.1148/rg.346140084

Ban N, Takahashi F, Sato K, Endo A, Ono K, Hasegawa T, et al. Development of a web-based CT dose calculator: Waza-ARI. Radiat Prot Dosimetry. 2011;147(1–2):333–7.

Takahashi F, Sato K, Endo A, Ono K, Ban N, Hasegawa T, et al. Numerical analysis of organ doses delivered during computed tomography examinations using Japanese Adult Phantoms with the WAZA-ARI dosimetry system. Health Phys. 2015;109(2):104–12.

Suzuki S, Furui S, Ishitake T, Abe T, Machida H, Takei R, et al. Lens exposure during brain scans using multidetector row CT scanners: Methods for estimation of lens dose. Am J Neuroradiol. 2010;31(5):822–6.

Kroft LJM, Roelofs JJH, Geleijns J. Scan time and patient dose for thoracic imaging in neonates and small children using axial volumetric 320-detector row CT compared to helical 64-, 32-, and 16- detector row CT acquisitions. Pediatr Radiol. 2010;40(3):294–300.

Dauer LT, Ainsbury EA, Dynlacht J, Hoel D, Klein BEK, Mayer D, et al. Guidance on radiation dose limits for the lens of the eye: Overview of the recommendations in NCRP commentary no. 26. Vol. 93, International Journal of Radiation Biology. 2017. p. 1015–23.

Foray N, Bourguignon M, Hamada N. Individual response to ionizing radiation. Mutat Res - Rev Mutat Res. 2016;770:369–86.

Yuan MK, Tsai DC, Chang SC, Yuan MC, Chang SJ, Chen HW, et al. The risk of cataract associated with repeated head and neck CT studies: A nationwide population-based study. Am J Roentgenol. 2013;201(3):626–30.

Nikupaavo U, Kaasalainen T, Reijonen V, Ahonen SM, Kortesniemi M. Lens dose in routine head CT: Comparison of different optimization methods with anthropomorphic phantoms. Am J Roentgenol. 2015;204(1):117–23.

Wang J, Duan X, Christner JA, Leng S, Grant KL, McCollough CH. Bismuth shielding, organ-based tube current modulation, and global reduction of tube current for dose reduction to the eye at head CT. Radiology. 2012;262(1):191–8.

Niu Y, Wang Z, Liu Y, Liu Z, Yao V. Radiation dose to the lens using different temporal bone CT scanning protocols. Am J Neuroradiol. 2010;31(2):226–9.

Lee TF, Chu CY, Sung HT, Leung ST, Leung KW, Kan WK. Reduction in lens Dose in temporal Bone Computed tomography by Modification of Scanning Plane. Hong Kong J Radiol. 2016;19(2):91–5.

Trattner S, Pearson GDN, Chin C, Cody DD, Gupta R, Hess CP, et al. Standardization and optimization of CT protocols to achieve low dose. J Am Coll Radiol. 2014;11(3):271–8.

Published
2021-08-28
How to Cite
Mohd Hilal, M. I. N., Ganesan, R., Mohd Norsuddin, N., Ibrahim, M. I., Said. Rahmat, S. M. S., Abd Karim, M. K., & Iza Nurzawani Che Isa. (2021). RADIATION DOSE TO THE EYE AND POTENTIAL OCCURRENCE RADIATION- INDUCED CATARACT FOLLOWING COMPUTED TOMOGRAPHY (CT) HEAD EXAMINATION. Malaysian Journal of Public Health Medicine, 21(2), 1-7. https://doi.org/10.37268/mjphm/vol.21/no.2/art.518