Ruedeekorn Suwannanon ,

Investigation-Test

Symptoms and Signs do not lead to diagnosis

Invasive
Cost
Time
Change the management

Functional
Functional
-

Mammogram

Iodinate contrast agent ( )

Cerebral
Angiogram

Safty of radiation imaging and

iodinate contrast media
Natural radiation
Diagnostic imaging test
X-rays (plain flim, fluoroscopy,
IVP, intervention under
fluoroscopy or CT guidance)
CT scan
Nuclear medicine study

Effective dose
Dose : Millisievert (mSv)
Background radiation exposure : 3 mSv per year
Diagnostic imaging?

For this procedure:

ABDOMINAL REGION:
Computed Tomography (CT)-Abdomen and
Pelvis
Computed Tomography (CT)-Abdomen and
Pelvis, repeated with and without contrast
material
Computed Tomography (CT)-Colonography

Intravenous Pyelogram (IVP)

Radiography (X-ray)-Lower GI Tract
Radiography (X-ray)-Upper GI Tract
BONE:
Radiography (X-ray)-Spine
Radiography (X-ray)-Extremity
CENTRAL NERVOUS SYSTEM:
Computed Tomography (CT)-Head
Computed Tomography (CT)-Head, repeated
with and without contrast material
Computed Tomography (CT)-Spine
CHEST:
Computed Tomography (CT)-Chest
Computed Tomography (CT)-Chest Low Dose
Radiography-Chest
DENTAL:
Intraoral X-ray
HEART:
Coronary Computed Tomography Angiography
(CTA)
Cardiac CT for Calcium Scoring
MEN'S IMAGING:
Bone Densitometry (DEXA)
NUCLEAR MEDICINE:
Positron Emission Tomography Computed
Tomography (PET/CT)
WOMEN'S IMAGING:
Bone Densitometry (DEXA)
Mammography

* Your approximate effective

radiation dose is:

Comparable to natural background ** Additional lifetime risk of fatal

radiation for:
cancer from examination:

10 mSv

3 years

Low

20 mSv

7 years

Moderate

10 mSv

3 years

Low

3 mSv
8 mSv
6 mSv

1 year
3 years
2 years

Low
Low
Low

1.5 mSv
0.001 mSv

6 months
3 hours

Very Low
Negligible

2 mSv
4 mSv

8 months
16 months

Very Low
Low

6 mSv

2 years

Low

7 mSv
1.5 mSv

2 years
6 months

Low
Very Low

0.1 mSv

10 days

Minimal

0.005 mSv

1 day

Negligible

12 mSv

4 years

Low

3 mSv

1 year

Low

0.001 mSv

3 hours

Negligible

25 mSv

8 years

Moderate

0.001 mSv
0.4 mSv

3 hours
7 weeks

Negligible
Very Low

Idionate contrastmedia safety

Contrast allergy and adverse reaction
Contrast induced nephropathy (CIN)**

MRI contrast agent

Is it safe?

Safty of MRI and gadolinium contrast agent

MRI
1.
2.
3.
4.
5.

No radiation
High tissue contrast
Claustrophobia
Timing
Prenancy ?

Gadolinium contrast
agent
1. No iodine
2. SE and adverse
reaction : unusal
3. Cross placenta (cat C
by FDA)
4. NSF***

NSF (Nephrogenic systemic fibrosis)

Feature

Description

Distribution

Distal lower extremities > lower thighs > lower abdomen >
upper extremities

Appearance

Swelling, skin induration, skin-colored or erythematous papules with a

peau dorange appearance, skin thickening with a woody texture

Systemic involvement

Skeletal muscle, myocardium, lungs, kidneys, testes, dura mater

Time course

From a few days to 3 months after exposure (median 25 days)

Piezoelectric effect

Possible biochemistry
Not histology