Cumulative Radiation Exposure Post Aneurysmal Subarachnoid Haemorrhage

Shreepad H Asundi¹, Mark P Plummer^{1

2}, Krishnaswamy Sundararajan^{1

2}, Gerry O'Callaghan^{1

3}, Palash Kar^{1

4}, Alistair Jukes^{2

5}, Chris M Boyd^{6

7}, Weitong Chen⁸, Chang Dong⁹, Timothy Webber^{10

11}

Affiliations

¹ Department of Intensive Care, Royal Adelaide Hospital, 5000, Adelaide, South Australia, Australia.
² Adelaide Medical School, The University of Adelaide. Adelaide, South Australia 5000, Adelaide, Australia.
³ Faculty of Health Sciences, School of Public Health, The University of Adelaide, South Australia 5000, Adelaide, Australia.
⁴ Discipline of Acute Care Medicine, University of Adelaide, Adelaide, Australia.
⁵ Department of Neurosurgery, Royal Adelaide Hospital, South Australia 5000, Adelaide, Australia.
⁶ Medical Physics & Radiation Safety, South Australia Medical Imaging, South Australia 5000, Adelaide, Australia.
⁷ Allied Health &Human Performance, University of South Australia, South Australia 5000, Adelaide, Australia.
⁸ Australian Institute for Machine Learning, The University of Adelaide, 5005, Adelaide, South Australia, Australia.
⁹ School of computer and mathematical Sciences, The University of Adelaide, South Australia 5005, Adelaide, Australia.
¹⁰ Department of Intensive Care, Royal Adelaide Hospital, 5000, Adelaide, South Australia, Australia. Timothy.webber@sa.gov.au.
¹¹ School of Biomedicine, The University of Adelaide, 5000, Adelaide, South Australia, Australia. Timothy.webber@sa.gov.au.

PMID: 40164929
PMCID: PMC12454507
DOI: 10.1007/s00062-025-01513-8

Observational Study

Cumulative Radiation Exposure Post Aneurysmal Subarachnoid Haemorrhage

Shreepad H Asundi et al. Clin Neuroradiol. 2025 Sep.

. 2025 Sep;35(3):559-564.

doi: 10.1007/s00062-025-01513-8. Epub 2025 Mar 31.

Authors

Affiliations

¹ Department of Intensive Care, Royal Adelaide Hospital, 5000, Adelaide, South Australia, Australia.
² Adelaide Medical School, The University of Adelaide. Adelaide, South Australia 5000, Adelaide, Australia.
³ Faculty of Health Sciences, School of Public Health, The University of Adelaide, South Australia 5000, Adelaide, Australia.
⁴ Discipline of Acute Care Medicine, University of Adelaide, Adelaide, Australia.
⁵ Department of Neurosurgery, Royal Adelaide Hospital, South Australia 5000, Adelaide, Australia.
⁶ Medical Physics & Radiation Safety, South Australia Medical Imaging, South Australia 5000, Adelaide, Australia.
⁷ Allied Health &Human Performance, University of South Australia, South Australia 5000, Adelaide, Australia.
⁸ Australian Institute for Machine Learning, The University of Adelaide, 5005, Adelaide, South Australia, Australia.
⁹ School of computer and mathematical Sciences, The University of Adelaide, South Australia 5005, Adelaide, Australia.
¹⁰ Department of Intensive Care, Royal Adelaide Hospital, 5000, Adelaide, South Australia, Australia. Timothy.webber@sa.gov.au.
¹¹ School of Biomedicine, The University of Adelaide, 5000, Adelaide, South Australia, Australia. Timothy.webber@sa.gov.au.

PMID: 40164929
PMCID: PMC12454507
DOI: 10.1007/s00062-025-01513-8

Abstract

Background: Patients with aneurysmal subarachnoid haemorrhage (aSAH) often receive multiple radiation based diagnostic studies. Cumulative radiation exposure has been associated with long term health consequences from both dose dependent deterministic harm and increased risk of developing adverse events in a non-dose dependant manner i.e. stochastic harm.

Objective: The objective was to calculate cumulative radiation exposure in the acute phase after aSAH.

Design, setting, participants, main outcome measures: Single centre retrospective, observational study of consecutive adult patients admitted to the ICU for management of aSAH over five years. Organ and effective radiation doses were determined using institution specific conversion coefficients based on scanner radiation output metrics for all computed tomography imaging and fluoroscopy examinations. Calculated patient doses for the duration of the hospital admission were determined using National Cancer Institute radiation dosimetry tools.

Results: A total of 276 patients met the inclusion criteria; 180 females (65%), mean (SD) age 56 (13) years. There were 222 (80%) patients who survived to hospital discharge. The median [IQR] effective cumulative radiation dose was 17.7 [9.7-30.5] mSv. Twenty-one patients (8%) received an effective dose > 50 mSV consistent with potentially harmful ionising radiation exposure. In 162 patients (59%), the equivalent radiation dose to the lens of the eye exceeded the 500 mSv threshold for radiation induced damage.

Conclusion: Survivors of aSAH are exposed to high levels of medical radiation. The eyes are particularly at risk with most patients exposed to levels known to induce lens damage. This highlights the importance of strategies to reduce incidental and cumulative medical radiation exposure in this population.

Keywords: Ionising radiation; Lens; Neurosurgery; Subarachnoid haemorrhage.

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Conflict of interest statement

Declarations. Conflict of interest: S.H. Asundi, M.P. Plummer, K. Sundararajan, G. O’Callaghan, P. Kar, A. Jukes, C.M. Boyd, W. Chen, C. Dong and T. Webber declare that they have no competing interests. Ethical standards: The study was conducted according to the Strengthening and Reporting of Observational Studies in Epidemiology (STROBE) statement and checklist [10]. This study was performed in line with the principles of the Declaration of Helsinki. Approval for the project was granted by the Central Adelaide Local Health Network Human Research Ethics Committee (CALHN HREC) with reference number 17482. A waiver of consent was granted.

References

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Cumulative Radiation Exposure Post Aneurysmal Subarachnoid Haemorrhage

Affiliations

Cumulative Radiation Exposure Post Aneurysmal Subarachnoid Haemorrhage

Authors

Affiliations

Abstract

Conflict of interest statement

References

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