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    Review of 'Assessment of the Radiation Exposure and Cancer Risks of Disabled People Undergoing Different Computed Tomography Scans'

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    Assessment of the Radiation Exposure and Cancer Risks of Disabled People Undergoing Different Computed Tomography ScansCrossref
    The paper is not reliable with its heading
    Average rating:
        Rated 4 of 5.
    Level of importance:
        Rated 4 of 5.
    Level of validity:
        Rated 3 of 5.
    Level of completeness:
        Rated 3 of 5.
    Level of comprehensibility:
        Rated 5 of 5.
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    Assessment of the Radiation Exposure and Cancer Risks of Disabled People Undergoing Different Computed Tomography Scans

    The usage of radiological investigations is increasing rapidly in Saudi Arabia. It has been estimated that 7.1% of the populace in the Kingdom of Saudi Arabia is disabled. Out of 32.94 million citizens, 1,445,723 (52.2% males and 47.8% females) millions are considered disabled. Disabled individuals are frequently undergoing medical imaging procedures, and there are not enough studies regarding the risk of radiation exposure to disabled patients from these machines. This study aims to quantify the frequency of medical procedures and estimate the collective dose for disabled individuals to predict the overall cancer risk from medical exposure. A total of 108 computed tomography (CT) procedures were carried out for disabled patients. The procedures include the brain, chest, abdomen, pelvis, and cervical spine. A 128-slice CT machine was used in this study Philips Ingenuity (Philips, Netherlands). The CT machine is subjected to regular quality control tests to ensure compliance with national recommendations. In this study, 108 [11 (10.2%) females and 97 (89.8%) males] CT procedures were carried out for disabled patients at the radiology department, King Khalid Hospital and Prince Sultan Center. The average and standard deviation radiation dose per CT procedure [DLP (mGy.cm)] for the brain, chest, abdomen, pelvis, and cervical spine were 1183.4 ± 187, 352.8 ± 88, 654 ± 73, 803 ± 800, and 527 ± 186, respectively. The estimated cancer risk is 1 cancer per 1000 to 10,000 CT procedures. Patient doses are comparable with those of previous studies carried out for normal patients. However, the protection of disabled patients from unnecessary radiation exposure is crucial to reduce the projected radiation risks and minimize the number of repeated CT scans and unproductive radiation exposure.
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      Review text

      The problem of potential cancer risk resulted from low dose ionizing radiation due to CT exams is of high importance.

      There are two opposite points of view in the scientific society today: the official position of ICRP is based on the opinion that any radiation dose will lead to cancer risk after time (Linear non-threshold theory).

      The other position is based on real data from studies of patients, exposed to CT and followed-up for a long time after the exposure, that often delivers little evidience of cancer cases related to the radiation dose from CT (and not affected by reverse causation), and wide confidence intervals for risk estimates.

      Obviously, the second is more problematic, more resiurce and time-consuming but however more informative for science, than using handsome ICRP raiation risk coefficients obtained from LSS cohort studies on acute exposure to high levels of gamma-neutron radiation.

      Regarding this paper - this study contains well described dosimetry but nothing about the cancer risk analyses.

      The conclusion "The estimated cancer risk is 1 cancer per 1000 to 10,000 CT procedures. " (in Abstract) is only appropriate for the Discussion chapter, provided with the proper link on the source of information.

      Recommendation:

      I would like to recommend this paper to publish with change in heading "Assessment of the Radiation Exposure of Disabled People Undergoing Different Computed Tomography Scans"

      For the future work, I would like to recommend to perform the follow-up of those patients to assess late effects (particularly cancer).

      Due to local exposure scenario, it will be useful to assess the absorbed doses for each individual patient using DICOM records.

       

       

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