Diagnostic imaging and radiation exposure in inflammatory bowel disease

Diagnostic imaging plays a key role in the diagnosis and management of inflammatory bowel disease (IBD). However due to the relapsing nature of IBD, there is growing concern that IBD patients may be exposed to potentially harmful cumulative levels of ionising radiation in their lifetime, increasing...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2016-02, Vol.22 (7), p.2165-2178
Main Authors: Zakeri, Nekisa, Pollok, Richard C G
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Child
Child, Preschool
Colitis, Ulcerative - diagnostic imaging
Colitis, Ulcerative - therapy
Crohn Disease - diagnostic imaging
Crohn Disease - therapy
Female
Humans
Infant
Intestines - diagnostic imaging
Magnetic Resonance Imaging
Male
Middle Aged
Predictive Value of Tests
Prognosis
Radiation Dosage
Radiation Exposure - adverse effects
Radiation Exposure - prevention & control
Risk Assessment
Risk Factors
Time Factors
Tomography, X-Ray Computed - adverse effects
Topic Highlight
Ultrasonography
Young Adult
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Summary:Diagnostic imaging plays a key role in the diagnosis and management of inflammatory bowel disease (IBD). However due to the relapsing nature of IBD, there is growing concern that IBD patients may be exposed to potentially harmful cumulative levels of ionising radiation in their lifetime, increasing malignant potential in a population already at risk. In this review we explore the proportion of IBD patients exposed to high cumulative radiation doses, the risk factors associated with higher radiation exposures, and we compare conventional diagnostic imaging with newer radiation-free imaging techniques used in the evaluation of patients with IBD. While computed tomography (CT) performs well as an imaging modality for IBD, the effective radiation dose is considerably higher than other abdominal imaging modalities. It is increasingly recognised that CT imaging remains responsible for the majority of diagnostic medical radiation to which IBD patients are exposed. Magnetic resonance imaging (MRI) and small intestine contrast enhanced ultrasonography (SICUS) have now emerged as suitable radiation-free alternatives to CT imaging, with comparable diagnostic accuracy. The routine use of MRI and SICUS for the clinical evaluation of patients with known or suspected small bowel Crohn's disease is to be encouraged wherever possible. More provision is needed for out-of-hours radiation-free imaging modalities to reduce the need for CT.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v22.i7.2165