CT scan radiation, hos much?

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civilstudent
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Ive been told to get an abdominal CTscan even to rule something out (which wouldnt be treated anyway). The thing is im worrird about radiation i already had an head ct scan last year for sinuses but abdominal scans are 10msv equivelent go 500 xrays/3 years of background radiation. So im pondering shether or not to get it

is this site accurate? Scroll fown and it says the level of radiation http://www.radiologyinfo.org/mobile/...m?pg=sfty_xray
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alow
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AFAIK it's accurate but it's still a very small amount of radiation, an air steward will probably get more than you in a year. Your doctors will have weighed up the advantages and disadvantages and decided it's in your best interest.
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civilstudent
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(Original post by alow)
AFAIK it's accurate but it's still a very small amount of radiation, an air steward will probably get more than you in a year. Your doctors will have weighed up the advantages and disadvantages and decided it's in your best interest.
Ive been told that its to rule out kidney stones which they said its very unlikely to be anyway. Ultrasound and xray showed no stones, I have no pain and all my symptoms point to another cause which a nephrologist wold look at. The consultant agreed that its its very unlikely to be a structural problem but that if he just referred to nephrology without the CT scan then nephrology would wonder why stones were not 100 percent ruled out. Thing is even if I did have stones they wouldnt be treated anyway as Im getting no pain/problems that bother me. So I dont think the benefits would outweigh the risk. People are exposed to about 3 to 4msv in radiation per year, this CT scan they want to do is approx 10msv (20msv if they use contract). Equivelent to 400 x rays, its a lot more than an air steward.
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alow
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(Original post by civilstudent)
Ive been told that its to rule out kidney stones which they said its very unlikely to be anyway. Ultrasound and xray showed no stones, I have no pain and all my symptoms point to another cause which a nephrologist wold look at. The consultant agreed that its its very unlikely to be a structural problem but that if he just referred to nephrology without the CT scan then nephrology would wonder why stones were not 100 percent ruled out. Thing is even if I did have stones they wouldnt be treated anyway as Im getting no pain/problems that bother me. So I dont think the benefits would outweigh the risk. People are exposed to about 3 to 4msv in radiation per year, this CT scan they want to do is approx 10msv (20msv if they use contract). Equivelent to 400 x rays, its a lot more than an air steward.
The reason they're doing it is so if you do have kidney stones (which there is still a small probability of) they would stop testing you for other things.

I really don't think you understand just how tiny the amount of background radiation there is and just how efficient the X-Ray machines we use are.


The occupational dose is usually capped at 20mSv so it is possible for an air steward or pilot (or anyone else exposed to more radiation) to get more than 10, depending on the routes they fly and where they spend their time when they're not flying.
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Jamie
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(Original post by civilstudent)
Ive been told that its to rule out kidney stones which they said its very unlikely to be anyway. Ultrasound and xray showed no stones, I have no pain and all my symptoms point to another cause which a nephrologist wold look at. The consultant agreed that its its very unlikely to be a structural problem but that if he just referred to nephrology without the CT scan then nephrology would wonder why stones were not 100 percent ruled out. Thing is even if I did have stones they wouldnt be treated anyway as Im getting no pain/problems that bother me. So I dont think the benefits would outweigh the risk. People are exposed to about 3 to 4msv in radiation per year, this CT scan they want to do is approx 10msv (20msv if they use contract). Equivelent to 400 x rays, its a lot more than an air steward.
Sound spointless if they are simply doing a CT KUB, but might be a bit more useful and necessary if they are doing a CT urogram (uses contrast which means a cannula/injection).

you need to chat with your consultant because it sounds like you have very sensible concerns.
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civilstudent
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(Original post by alow)
The reason they're doing it is so if you do have kidney stones (which there is still a small probability of) they would stop testing you for other things.

I really don't think you understand just how tiny the amount of background radiation there is and just how efficient the X-Ray machines we use are.


The occupational dose is usually capped at 20mSv so it is possible for an air steward or pilot (or anyone else exposed to more radiation) to get more than 10, depending on the routes they fly and where they spend their time when they're not flying.
Maybe I don't understand but Ive just got the figures offline and 10 to 20 msv on one dose (when natural background exposure is about 2 to 3 msv per year sounds like a lot. The equivelent to 400xrays sounds like a lot and they sometimes have concerns about pregnant women getting just 1 xray. Just sounds like a lot.

Convince me otherwise and I will be fine with the CT, in fact I want to convince myself its fine but cant lol. Ive looked up air stewards and it does say they are exposed to higher radiation but only about 4 msv a year.

Also Im not sure if being exposed to a lot of radiation in one dose is worse than it being spread out over a year but Id say it is.
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alow
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(Original post by civilstudent)
Maybe I don't understand but Ive just got the figures offline and 10 to 20 msv on one dose (when natural background exposure is about 2 to 3 msv per year sounds like a lot. The equivelent to 400xrays sounds like a lot and they sometimes have concerns about pregnant women getting just 1 xray. Just sounds like a lot.

Convince me otherwise and I will be fine with the CT, in fact I want to convince myself its fine but cant lol. Ive looked up air stewards and it does say they are exposed to higher radiation but only about 4 msv a year.

Also Im not sure if being exposed to a lot of radiation in one dose is worse than it being spread out over a year but Id say it is.
A one-time dose really isn't going to hurt you, and don't think of it in terms of how many x-rays it would be. The X-ray machines that are used now are so incredibly efficient compared to those in the past. Not wanting to give a pregnant woman an X-ray is nothing to do with the mother, it's to do with the foetus.

Bear in mind that if someone lived in Cornwall they would get around 8mSv per year.

It's slightly more dangerous at once, but not that much worse.
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hslt
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(Original post by civilstudent)
Maybe I don't understand but Ive just got the figures offline and 10 to 20 msv on one dose (when natural background exposure is about 2 to 3 msv per year sounds like a lot. The equivelent to 400xrays sounds like a lot and they sometimes have concerns about pregnant women getting just 1 xray. Just sounds like a lot.

Convince me otherwise and I will be fine with the CT, in fact I want to convince myself its fine but cant lol. Ive looked up air stewards and it does say they are exposed to higher radiation but only about 4 msv a year.

Also Im not sure if being exposed to a lot of radiation in one dose is worse than it being spread out over a year but Id say it is.
It's about as much as people in Cornwall are exposed to yearly.
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civilstudent
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(Original post by alow)
A one-time dose really isn't going to hurt you, and don't think of it in terms of how many x-rays it would be. The X-ray machines that are used now are so incredibly efficient compared to those in the past. Not wanting to give a pregnant woman an X-ray is nothing to do with the mother, it's to do with the foetus.

Bear in mind that if someone lived in Cornwall they would get around 8mSv per year.

It's slightly more dangerous at once, but not that much worse.
The foetus is make up as the same stuff as the mother ..cells, they dont want to damage cells. I had 2 CT scans last year for sinuses they are lower dose but abdominal is high dose.
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civilstudent
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(Original post by hslt)
It's about as much as people in Cornwall are exposed to yearly.
Is that a lot? I dont know how much people can handle before it increases their risk
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CraigKirk
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One of the major cons of CT scans is definitely quite a high radiation dose, when compared to other methods of medical imagery. At the end of the day, if you feel that the CT scan is unnecessary and you are of age 18+, or can demonstrate 'capacity' to make this decision for yourself at 16+, then you are allowed to refuse any medical testing or treatment.

However, where the doctor says this is to rule out kidney stones, they may also be looking for anything potentially more malicious. The decision to refer you to a CT scan is reviewed and approved by a second doctor, the radiologist, who is an expert in the area and knows how much risk is involved. The radiologist's job is to make sure that an unnecessary CT scan doesn't go ahead - so in this case, it is two doctors' opinions that you should get this scan, because the potential benefits (of finding something early, when it more treatable) outweigh the risks (if you went without and it turned out to be something bad, treating it would be more difficult). Nonetheless, if you're feeling this way, you should at least ask if there were any other reasons for this referral - if the doctor tells you that there are no other concerns besides the kidney stones, which wouldn't then get treated, then I agree you should refuse.
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civilstudent
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(Original post by CraigKirk)
One of the major cons of CT scans is definitely quite a high radiation dose, when compared to other methods of medical imagery. At the end of the day, if you feel that the CT scan is unnecessary and you are of age 18+, or can demonstrate 'capacity' to make this decision for yourself at 16+, then you are allowed to refuse any medical testing or treatment.

However, where the doctor says this is to rule out kidney stones, they may also be looking for anything potentially more malicious. The decision to refer you to a CT scan is reviewed and approved by a second doctor, the radiologist, who is an expert in the area and knows how much risk is involved. The radiologist's job is to make sure that an unnecessary CT scan doesn't go ahead - so in this case, it is two doctors' opinions that you should get this scan, because the potential benefits (of finding something early, when it more treatable) outweigh the risks (if you went without and it turned out to be something bad, treating it would be more difficult). Nonetheless, if you're feeling this way, you should at least ask if there were any other reasons for this referral - if the doctor tells you that there are no other concerns besides the kidney stones, which wouldn't then get treated, then I agree you should refuse.
The consultant at urology didnt say it was for any other reasons than kidney stones he just said that the hematuria was still present (after 3 months) and that if he referred me to nephrology then they would wonder why a CT scan hadnt been done to be fully confident there were no stones. I said that all my symptoms point to something systemic (since the hematuria came on with feeling tired followed by a virus infection), Ive had no pain at all. He said 'I agree it is more likely a problem with the kidneys'. I said didnt the ultrasound and xray ruled out stones and he said 'we cant be fully certain there are no small stones, if I refer to nephrology without the CT scan we will be making an assumption there is no stones and nephrology will question why we didnt do CT'. The thing is if there were stones they would not be treated anyway. So the CT is just so urology can tick a box and say that stones have been ruled out for certain. Ive had a cytoscopy, kidney ultrasound and KUB xray all were normal.

If I refuse though and nephrology have to make the assumption there are no stones will they still treat me the same or will they srongly request a CT?

I dont know, would you have it done?
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CraigKirk
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(Original post by civilstudent)
The consultant at urology didnt say it was for any other reasons than kidney stones he just said that the hematuria was still present (after 3 months) and that if he referred me to nephrology then they would wonder why a CT scan hadnt been done to be fully confident there were no stones. I said that all my symptoms point to something systemic (since the hematuria came on with feeling tired followed by a virus infection) and he said I agree it is more likely a problem with the kidneys. I said didnt the ultrasound and xray ruled out stones and he said we cant be fully certain there are no small stones, if I refer to nephrology without the CT scan we will be making an assumption there is no stones and nephrology will question why we didnt do CT. The thing is if there were stones they would not be treated anyway. So the CT is just so urology can tick a box and say that stones have been ruled out for certain.

I dont know, would you have it done?
I think the problem is that you still have blood in your urine - they need to find the cause for that. An abdominal CT scan will most likely also check other organs that could contribute to this problem, such as the bladder. In general, it's more likely to find any problems that the x-ray and ultrasound could have missed because CT scans provide very high resolution images.

But the suggestions I and others have made that you should speak with your doctor about this still stands. Perhaps have a phone call with your GP, or if possible the doctor who referred you, to ensure that it is a well-thought out decision and perhaps this will put your mind to rest. I can imagine the doctor meant to mention other purposes behind the testing, but simply forgot or didn't want to cause you any greater concern because it is probably unlikely to be anything serious. This is probably down to human error if it is the case, and you should ensure that you are fully informed before making a decision - for the same reason, I can't say whether I would have it done at this point, because I'm not fully informed (I'm not asking to know your medical history here).
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civilstudent
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(Original post by CraigKirk)
I think the problem is that you still have blood in your urine - they need to find the cause for that. An abdominal CT scan will most likely also check other organs that could contribute to this problem, such as the bladder. In general, it's more likely to find any problems that the x-ray and ultrasound could have missed because CT scans provide very high resolution images.

But the suggestions I and others have made that you should speak with your doctor about this still stands. Perhaps have a phone call with your GP, or if possible the doctor who referred you, to ensure that it is a well-thought out decision and perhaps this will put your mind to rest. I can imagine the doctor meant to mention other purposes behind the testing, but simply forgot or didn't want to cause you any greater concern because it is probably unlikely to be anything serious. This is probably down to human error if it is the case, and you should ensure that you are fully informed before making a decision - for the same reason, I can't say whether I would have it done at this point, because I'm not fully informed (I'm not asking to know your medical history here).
I suppose at least Id be getting a good check up even if its not likely related to the blood it will show any tumours/problems etc in the body that have nothing to do with the blood. Ive never requested a phone call with a consultant I didnt know you could lol. I guess he would just say the same thing as what he discussed with me at the appointment ..that its unlikely to be anything structural but that they need to be 100percent sure or else nephrology will question why the scan wasnt done.
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(Original post by civilstudent)
I suppose at least Id be getting a good check up even if its not likely related to the blood it will show any tumours/problems etc in the body that have nothing to do with the blood. Ive never requested a phone call with a consultant I didnt know you could lol. I guess he would just say the same thing as what he discussed with me at the appointment ..that its unlikely to be anything structural but that they need to be 100percent sure or else nephrology will question why the scan wasnt done.
Nephrology can question away - but only after you've been fully informed and made an informed decision. You can still go to nephrology if you don't have the scan, but it is likely that they'll then ask for a scan too because they'd want to find the cause of the haematuria, and it sounds as though the problem may be too difficult to pick up on ultrasound or standard x-radiograph. If you choose to have a conversation with a doctor, perhaps you'd like to mention the possibility of an MRI scan. There's no radiation involved in one of those, although you can't have one if you have any metal implants or a pacemaker (and sometimes various other things). However, MRI is expensive, so they'll probably be quite reluctant and with good reason.
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civilstudent
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(Original post by CraigKirk)
Nephrology can question away - but only after you've been fully informed and made an informed decision. You can still go to nephrology if you don't have the scan, but it is likely that they'll then ask for a scan too because they'd want to find the cause of the haematuria, and it sounds as though the problem may be too difficult to pick up on ultrasound or standard x-radiograph. If you choose to have a conversation with a doctor, perhaps you'd like to mention the possibility of an MRI scan. There's no radiation involved in one of those, although you can't have one if you have any metal implants or a pacemaker (and sometimes various other things). However, MRI is expensive, so they'll probably be quite reluctant and with good reason.
I asked him if an MRI would be effective instead and he just said no, a CT. Is it just because of the expense then that he wouldnt do MRI or are CT's somehow better at detecting stones and what not
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CraigKirk
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(Original post by civilstudent)
I asked him if an MRI would be effective instead and he just said no, a CT. Is it just because of the expense then that he wouldnt do MRI or are CT's somehow better at detecting stones and what not
Hmm I'm not an expert, but MRIs distinguish pretty perfectly between the tiniest (Edit: obviously this is exaggerated, it can't see things at the cellular level of course :P ) structures in the body, I'm reasonably sure it can achieve better resolution than even CT scans (obviously dependent on the two devices, but I think MRI can currently provide the highest resolution of all). But either way, there is a clear reluctance there to not refer you for MRI, which may well be because CT is cheaper and just as good for the job and saves funds for others at hospital. I guess it is unethical of him to perhaps be lying to you (he may not, maybe MRI is no good for kidney stones, although a quick Google search disproves this), but it's a difficult thing to say to a patient 'no, we won't give you that because it costs more'. Some people would react badly to that.

Regardless, if that's what he said, probably best to forget about MRI and think about the CT instead.
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civilstudent
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(Original post by CraigKirk)
Hmm I'm not an expert, but MRIs distinguish pretty perfectly between the tiniest (Edit: obviously this is exaggerated, it can't see things at the cellular level of course :P ) structures in the body, I'm reasonably sure it can achieve better resolution than even CT scans (obviously dependent on the two devices, but I think MRI can currently provide the highest resolution of all). But either way, there is a clear reluctance there to not refer you for MRI, which may well be because CT is cheaper and just as good for the job and saves funds for others at hospital. I guess it is unethical of him to perhaps be lying to you (he may not, maybe MRI is no good for kidney stones, although a quick Google search disproves this), but it's a difficult thing to say to a patient 'no, we won't give you that because it costs more'. Some people would react badly to that.

Regardless, if that's what he said, probably best to forget about MRI and think about the CT instead.
ok thanks, Ive just googled and some sites say that CT is more effective as MRI dont accurately reveal small stones. Guess I'l end up having it but it will probably be normal like the other tests.
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alow
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(Original post by civilstudent)
The foetus is make up as the same stuff as the mother ..cells, they dont want to damage cells. I had 2 CT scans last year for sinuses they are lower dose but abdominal is high dose.
It's because there is so much cell division and differentiation going on in a foetus that even a little damage could be really bad. In a fully grown person there isn't as much.
(Original post by civilstudent)
Is that a lot? I dont know how much people can handle before it increases their risk
Cornwall has a lot of a rock called shale in the ground, which is very porous and contains a relatively large amount of Radon. It's the same as in a lot of places in the US. You may have heard of shale in relation to fracking, where it is cracked to release natural gas, that's because it's really good at containing gases, which in Cornwall is radon instead of natural gas.
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CraigKirk
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(Original post by civilstudent)
ok thanks, Ive just googled and some sites say that CT is more effective as MRI dont accurately reveal small stones. Guess I'l end up having it but it will probably be normal like the other tests.
Oh yes, you're quite right, it's only good for 'normal' sized stones. Glad I've realised this. Okay, but I still think you should rest your concerns by talking to the doctor. It's your choice of course!
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