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Quantifying Exposure to Diagnostic Radiation and Factors Associated With Exposure to High Levels of Radiation in Korean Patients With Inflammatory Bowel Disease

Jung, Yoon Suk MD, MS1; Park, Dong Il MD, PhD1; Kim, Eun Ran MD, MS2; Kim, Young Ho MD, PhD2; Lee, Chang Kyun MD, PhD3; Lee, Suck Ho MD, PhD4; Kim, Jae Hak MD, PhD5; Chan Huh, Kyu MD, PhD6; Jung, Sung-Ae MD, PhD7; Yoon, Soon Man MD, PhD8; Song, Hyun Joo MD, PhD9; Boo, Sun-Jin MD, MS9; Jang, Hyun Joo MD, PhD10; Kim, You Sun MD, PhD11; Lee, Kang-Moon MD, PhD12; Shin, Jeong Eun MD, PhD13

doi: 10.1097/MIB.0b013e31828c844f
Original Clinical Articles

Background: Several recent studies have revealed that diagnostic imaging can result in exposure to potentially harmful levels of ionizing radiation in patients with inflammatory bowel disease (IBD). However, these studies have been conducted exclusively in Western countries, and no data are available in Asian populations. The aim of this study was to estimate the diagnostic radiation exposure in Korean patients with IBD and to determine the factors associated with high radiation exposure.

Methods: Patients with an established diagnosis of IBD between July 1987 and January 2012 were investigated in 13 university hospitals in Korea. The cumulative effective dose (CED) was calculated retrospectively from standard tables.

Results: A total of 777 patients with Crohn’s disease (CD) and 1422 patients with ulcerative colitis (UC) were included in the study. The mean CED for CD and UC were 53.6 and 16.4 mSv, respectively (P < 0.001). CTof CD and UC accounted for 81.6% and 71.2% of total effective dose, respectively. Importantly, 34.7% of patients with CD and 8.4% of patients with UC were exposed to high levels of radiation (CED > 50 mSv) (P < 0.001). High radiation exposure was associated with long disease duration, ileocolonic disease, upper gastrointestinal tract involvement, surgical intervention, hospitalization, and the requirement for oral steroids in CD, and with surgical intervention, hospitalization, and the requirement for infliximab in UC.

Conclusions: A substantial proportion of patients with IBD, especially patients with CD, were exposed to significantly harmful amounts of diagnostic radiation, mainly as a result of CT examination. Given that IBD is a life-long illness, strategies to reduce radiation exposure from diagnostic imaging need to be considered.

Article first published online 22 May 2013

1Department of Internal Medicine, Kangbuk Samsung Hospital and

2Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea,

3Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, South Korea,

4Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea,

5Department of Internal Medicine, Dongguk University College of Medicine, Goyang, South Korea,

6Department of Internal Medicine, Konyang University College of Medicine, Daejeon, South Korea,

7Department of Internal Medicine, Ewha Womans University, Seoul, South Korea,

8Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, South Korea,

9Department of Internal Medicine, Jeju National University School of Medicine, Jeju, South Korea,

10Department of Internal Medicine, Hallym University Hangang Sacred Heart Hospital, Seoul, South Korea,

11Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, South Korea,

12Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, South Korea,

13Department of Internal Medicine, Dankook University College of Medicine, Cheonan, South Korea.

Reprints: Dong Il, Park, MD, PhD, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108, Pyung-Dong, Jongro-Ku, Seoul, South Korea 110-746 (e-mail:

The authors have no conflicts of interest to disclose.

Received December 29, 2012

Accepted February 9, 2013

© Crohn's & Colitis Foundation of America, Inc.
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