Adverse effects




Diagnostic X-rays (primarily from CT scans due to the large dose used) increase the risk of developmental problems and cancer in those exposed. X-rays are classified as a carcinogen by both the World Health Organization's International Agency for Research on Cancer and the U.S. government. It is estimated that 0.4% of current cancers in the United States are due to computed tomography (CT scans) performed in the past and that this may increase to as high as 1.5-2% with 2007 rates of CT usage.

Experimental and epidemiological data currently do not support the proposition that there is a threshold dose of radiation below which there is no increased risk of cancer. However, this is under increasing doubt. It is estimated that the additional radiation from diagnostic X-rays will increase the average person's cumulative risk of getting cancer by age 75 by 0.6–3.0%. The amount of absorbed radiation depends upon the type of X-ray test and the body part involved. CT and fluoroscopy entail higher doses of radiation than do plain X-rays.

To place the increased risk in perspective, a plain chest X-ray will expose a person to the same amount from background radiation that people are exposed to (depending upon location) every day over 10 days, while exposure from a dental X-ray is approximately equivalent to 1 day of environmental background radiation. Each such X-ray would add less than 1 per 1,000,000 to the lifetime cancer risk. An abdominal or chest CT would be the equivalent to 2–3 years of background radiation to the whole body, or 4–5 years to the abdomen or chest, increasing the lifetime cancer risk between 1 per 1,000 to 1 per 10,000. This is compared to the roughly 40% chance of a US citizen developing cancer during their lifetime. For instance, the effective dose to the torso from a CT scan of the chest is about 5 mSv, and the absorbed dose is about 14 mGy. A head CT scan (1.5mSv, 64mGy) that is performed once with and once without contrast agent, would be equivalent to 40 years of background radiation to the head. Accurate estimation of effective doses due to CT is difficult with the estimation uncertainty range of about ±19% to ±32% for adult head scans depending upon the method used.

The risk of radiation is greater to a fetus, so in pregnant patients, the benefits of the investigation (X-ray) should be balanced with the potential hazards to the fetus. In the US, there are an estimated 62 million CT scans performed annually, including more than 4 million on children. Avoiding unnecessary X-rays (especially CT scans) reduces radiation dose and any associated cancer risk.

Medical X-rays are a significant source of man-made radiation exposure. In 1987, they accounted for 58% of exposure from man-made sources in the United States. Since man-made sources accounted for only 18% of the total radiation exposure, most of which came from natural sources (82%), medical X-rays only accounted for 10% of total American radiation exposure; medical procedures as a whole (including nuclear medicine) accounted for 14% of total radiation exposure. By 2006, however, medical procedures in the United States were contributing much more ionizing radiation than was the case in the early 1980s. In 2006, medical exposure constituted nearly half of the total radiation exposure of the U.S. population from all sources. The increase is traceable to the growth in the use of medical imaging procedures, in particular computed tomography (CT), and to the growth in the use of nuclear medicine.

Dosage due to dental X-rays varies significantly depending on the procedure and the technology (film or digital). Depending on the procedure and the technology, a single dental X-ray of a human results in an exposure of 0.5 to 4 mrem. A full mouth series of X-rays may result in an exposure of up to 6 (digital) to 18 (film) mrem, for a yearly average of up to 40 mrem.

Financial incentives have been shown to have a significant impact on X-ray use with doctors who are paid a separate fee for each X-ray providing more X-rays.

Early photon tomography or EPT (as of 2015) along with other techniques are being researched as potential alternatives to X-rays for imaging applications.

Comments

Post a Comment

Popular posts from this blog

Other uses

Image
Other notable uses of X-rays include: X-ray crystallography in which the pattern produced by the diffraction of X-rays through the closely spaced lattice of atoms in a crystal is recorded and then analysed to reveal the nature of that lattice. In the early 1990s, experiments were done in which layers a few atoms thick of two different materials were deposited in a Thue-Morse sequence. The resulting object was found to yield X-ray diffraction patterns. A related technique, fiber diffraction, was used by Rosalind Franklin to discover the double helical structure of DNA. X-ray astronomy, which is an observational branch of astronomy, which deals with the study of X-ray emission from celestial objects. X-ray microscopic analysis, which uses electromagnetic radiation in the soft X-ray band to produce images of very small objects. X-ray fluorescence, a technique in which X-rays are generated within a specimen and detected. The outgoing energy of the X-ray can be used to identify the compo
Read more

Units of measure and exposure

The measure of X-rays ionizing ability is called the exposure: The coulomb per kilogram (C/kg) is the SI unit of ionizing radiation exposure, and it is the amount of radiation required to create one coulomb of charge of each polarity in one kilogram of matter. The roentgen (R) is an obsolete traditional unit of exposure, which represented the amount of radiation required to create one electrostatic unit of charge of each polarity in one cubic centimeter of dry air. 1 roentgen= 2.58×10−4 C/kg. However, the effect of ionizing radiation on matter (especially living tissue) is more closely related to the amount of energy deposited into them rather than the charge generated. This measure of energy absorbed is called the absorbed dose: The gray (Gy), which has units of (joules/kilogram), is the SI unit of absorbed dose, and it is the amount of radiation required to deposit one joule of energy in one kilogram of any kind of matter. The rad is the (obsolete) corresponding traditional unit, e
Read more

Interaction with matter

Image
X-rays interact with matter in three main ways, through photoabsorption, Compton scattering, and Rayleigh scattering. The strength of these interactions depends on the energy of the X-rays and the elemental composition of the material, but not much on chemical properties, since the X-ray photon energy is much higher than chemical binding energies. Photoabsorption or photoelectric absorption is the dominant interaction mechanism in the soft X-ray regime and for the lower hard X-ray energies. At higher energies, Compton scattering dominates. Photoelectric absorption edit The probability of a photoelectric absorption per unit mass is approximately proportional to Z 3/ E 3, where Z is the atomic number and E is the energy of the incident photon. This rule is not valid close to inner shell electron binding energies where there are abrupt changes in interaction probability, so called absorption edges. However, the general trend of high absorption coefficients and thus short penetration dep
Read more