Computed tomography use in a large Italian region: trend analysis 2004-2014 of emergency and outpatient CT examinations in children and adults

Objectives: To analyse CT use in recent years in a high-density Italian area (±10 million inhabitants, including 1 million children), focusing on developing age. Methods: Retrospective analysis of records from HealthCare IT System, covering >400 hospitals and clinics. Description of CT use between 2004–2014 in emergency and outpatient care and assessment of radiation exposure trend. Results: Over 9 million scans were performed. Emergency procedures showed a global increase of 230 %, mainly head examinations. In the global outpatient setting, the annual number of CT scans/person increased ±19 %. A moderate increase in CT examinations was observed in the developing age population, while a remarkable increase in dental, chest and abdominal procedures occurred for the 10- to 30-year age range. The increase in mean annual dose/capita in the global patient pool was approximately 42 %, increasing from 0.72–1.03 mSv. The population rate receiving an annual CT radiation dose/capita higher than 1 mSv tripled in the 11-year interval, increasing from 16–48 %. Conclusions: The remarkable increase in radiation exposure raises a special concern for teenagers and young adults, whose risk tends to be underestimated. The fivefold increase in dental CTs in the younger age groups requires further investigations. Key Points: • Literature highlights a remarkable increase in CT use over the last decades.• The paediatric age had higher exposure to X-ray risk.• A detailed retrospective analysis of more than 9 million scans was performed.• Dental, chest, abdominal procedures increased remarkably in 10- to 30-year age range.• This study raises concern about exposure for teenagers and young adults.