Estimating of cumulative radiation dose and cumulative effective dose in superior mesenteric venous thrombosis.

Purpose: To estimate the cumulative radiation dose from the recurrent imaging examinations (CT and fluoroscopy-guided interventional radiology) from initial diagnosis, follow-up, and treatment of patients with acute superior mesenteric venous thrombosis (SMVT).

Methods/Materials: We identified all adult patients (age> 18 years) with acute SMVT between 2016-2022 who underwent at least two abdomen-pelvis CT exams. Subjects with chronic SMVT and SMVT related to pancreatic cancer were excluded. For the eligible 26 patients, (50 ± 15 years; male: female 20:16). We recorded following details for each patient: frequency and details of all imaging tests for initial diagnosis and follow-up for CT (CTDIvol and DLP), MRI, and ultrasound. We also recorded the details of any interventional (IR) procedures (dose area product – DAP), fluoroscopy time). The effective doses from CT, IR and nuclear medicine (PET-CT) were estimated separately. Data were analyzed using pair-wise t-test and chi square test.

Results: 35/36 patients were diagnosed with the SMVT on CT and 1/36 with abdominal ultrasound. Patients had 4 ± 2 (mean ± SD) imaging tests with the range of 2-15 CT over the course of their diagnosis to follow-up. The interval between the first and last CT imaging was 153 ± 311 days (average ± SD), with the range of 0-1801 days. The CTDIvol and DLP (median, interquartile range) were 9 (7-11 mGy) and 460 (366-593 mGy.cm) for non-contrast phase, 11 (10-14 mGy) and 506 (456-729 mGy.cm) for arterial phase, 11 (8-15 mGy) and 595 (448-812 mGy.cm) for venous phase, and 13 (9-16 mGy) and 577 (475-827 mGy.cm) for delayed phase, respectively. The median cumulative radiation doses for patients with SMVT: CTDIvol xx mGy and DLP yy mGy.cm.

Conclusions: Our study highlights high cumulative doses and frequency of multiphase CT in patients with SMVT.