ArticleBMC gastroenterology2026
10 year cumulative diagnostic radiation exposure after acute pancreatitis: a retrospective comparison of acute interstitial oedematous and necrotising pancreatitis.
Article in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeComputed tomography (CT) plays a pivotal role in the diagnosis, severity assessment and recognition of complications in patients with acute pancreatitis (AP). Exposure to cumulative radiation dose increases the risk of malignancy. This study aims to retrospectively investigate imaging utilisation patterns in AP and quantify cumulative effective dose (CED), and identify predictors of high radiation exposure.
methodsAdults admitted with AP between 2012 and 2013 were retrospectively reviewed. All imaging over the subsequent 10 years was analysed, and CED was calculated from dose reports or estimated using diagnostic reference levels where required. High exposure was defined as CED > 100 mSv, a dose associated with an increased lifetime risk of malignancy.
resultsOne hundred-thirteen patients were included with 3022 imaging studies (92 acute interstitial oedematous pancreatitis (AIOP), 21 necrotising pancreatitis (NP)), CT comprised approximately 18% of examinations but delivered > 85% of radiation. Median (IQR) CED was 19.5 mSv for AIOP and 43.3 mSv for NP (p = 0.004). CED exceeded 100 mSv in 4.3% (4/92) of AIOP and 19% (4/21) of NP patients. Overall, 7% (8/113) of the cohort exceeded a CED of 100 mSv. No significant associations were found between CED and aetiology, pseudocyst formation, or mortality.
conclusionOver a decade of follow-up, 7% of patients with acute pancreatitis exceeded the 100 mSv threshold, with CT accounting for the vast majority of exposure. Necrotising pancreatitis was associated with significantly higher cumulative doses than interstitial disease. Given that up to 30% of patients develop recurrent pancreatitis, strategies to minimize radiation exposure are essential. Optimisation of CT protocols and wider use of non-ionising modalities, including magnetic resonance imaging (MRI) and endoscopic ultrasound where appropriate, may help balance diagnostic accuracy with radiation stewardship.
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