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Thyroid Radiation Dose to Patients from Diagnostic Radiology Procedures over Eight Decades: 1930–2010

Chang, Lienard A.*; Miller, Donald L.; Lee, Choonsik; Melo, Dunstana R.; Villoing, Daphnée; Drozdovitch, Vladimir; Thierry-Chef, Isabelle§; Winters, Sarah J.; Labrake, Michael; Myers, Charles F.; Lim, Hyeyeun; Kitahara, Cari M.; Linet, Martha S.; Simon, Steven L.

doi: 10.1097/HP.0000000000000723

This study summarizes and compares estimates of radiation absorbed dose to the thyroid gland for typical patients who underwent diagnostic radiology examinations in the years from 1930 to 2010. The authors estimated the thyroid dose for common examinations, including radiography, mammography, dental radiography, fluoroscopy, nuclear medicine, and computed tomography (CT). For the most part, a clear downward trend in thyroid dose over time for each procedure was observed. Historically, the highest thyroid doses came from the nuclear medicine thyroid scans in the 1960s (630 mGy), full-mouth series dental radiography (390 mGy) in the early years of the use of x rays in dentistry (1930s), and the barium swallow (esophagram) fluoroscopic exam also in the 1930s (140 mGy). Thyroid uptake nuclear medicine examinations and pancreatic scans also gave relatively high doses to the thyroid (64 mGy and 21 mGy, respectively, in the 1960s). In the 21st century, the highest thyroid doses still result from nuclear medicine thyroid scans (130 mGy), but high thyroid doses are also associated with chest/abdomen/pelvis CT scans (18 and 19 mGy for males and females, respectively). Thyroid doses from CT scans did not exhibit the same downward trend as observed for other examinations. The largest thyroid doses from conventional radiography came from cervical spine and skull examinations. Thyroid doses from mammography (which began in the 1960s) were generally a fraction of 1 mGy. The highest average doses to the thyroid from mammography were about 0.42 mGy, with modestly larger doses associated with imaging of breasts with large compressed thicknesses. Thyroid doses from dental radiographic procedures have decreased markedly throughout the decades, from an average of 390 mGy for a full-mouth series in the 1930s to an average of 0.31 mGy today. Upper GI series fluoroscopy examinations resulted in up to two orders of magnitude lower thyroid doses than the barium swallow. There are considerable uncertainties associated with the presented doses, particularly for characterizing exposures of individual identified patients. Nonetheless, the tabulations provide the only comprehensive report on the estimation of typical radiation doses to the thyroid gland from medical diagnostic procedures over eight decades (1930–2010). These data can serve as a resource for epidemiologic studies that evaluate the late health effects of radiation exposure associated with diagnostic radiologic examinations.

*Radiation Epidemiology Branch (REB)/Division of Cancer Epidemiology and Genetics (DCEG)/National Cancer Institute (NCI)/National Institutes of Health (NIH), Bethesda, MD. Now at Department of Radiation Safety and Imaging Physics/Houston Methodist Hospital, Houston, TX; †Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD; ‡REB/DCEG/NCI/NIH, Bethesda, MD; §International Agency for Research on Cancer (IARC), Lyon, France.

The authors declare no conflicts of interest.

For correspondence contact: Steven L. Simon, 9609 Medical Center Drive, Room 7E442, MSC 9778, Rockville, MD 20850, or email at

(Manuscript accepted 10 July 2017)

© 2017 by the Health Physics Society