Any radiologists around? Multiple CT concern.

[SummerPanic]

I am 35 and have had a bit of a tricky year health wise. I have had to have multiple scans this year and I am on a waiting list for more. In February, I had a pelvis and back X-ray. Then two weeks ago, I had to have a chest X-ray and then chest CT scan to rule out a blood clot - they found a small nodule on both my lungs and want to do another chest CT in August. I am also due a head/brain CT scan at the end of July.

I am really worried about having a chest CT scan and a head/brain CT scan within weeks of each other - then another chest CT scan within a month of that. I am worried about the risk of accumulated radiation from all the scans, plus the risk of having the scans close together.

I am not sure how to tackle this, I asked to speak to healthcare professional about my concern when they booked the brain/head scan - but they just directed me to the internet which gives a very mixed review about the risk.

I don't feel like it will be option to have an MRI on my brain instead unless I am willing to wait a very long time, which is a risk in itself. My GP referred me for the head/brain CT whilst I am waiting for a neurology referral to be reviewed. I could get a private MRI but it would mean going into debt. If relevant, I may also need a pelvis/abdomen CT scan at some point this year too.

I am looking for advice or reassurance if possible, thank you.

It's impossible to quantify the risk without also knowing the justification ie possible knowledge gain.
3 month follow up for lung nodules is standard. If you do not want it you could ask for a chest x-ray instead or ask if you can wait until you need the abdo pelvis and then add it on to that. (Presuming the module was standard non worrying one).
A CT head is about a years radiation. Lung / Pelvis sig more.
Sure others will be around soon with better info.

Thank you for taking the time to reply @Currybean - I appreciate it.

The head/brain scan is due to headaches I have been getting on the right side of my face, especially behind my eye. I also get jaw ache as I clench my jaw, so I think it could be linked to that. However, I think they want to rule out something more serious as the pains have been going on, intermittently, for months. I have experienced some numbness and dizziness too.

With regards to the chest - I was sent to A&E with chest pain and they found my blood clot markers were slightly raised so they did the X-ray then a CT. I have been told the pain was likely muscular and that the nodules are probably an incidental finding. They are small and I don't have much information about them but I am on a waiting list for respiratory clinic, with a follow up CT scan late august.

RE abdomen, I have had pain in the right side of my lower abdomen/pelvic area coming up for 6 months now, along with bloating. It is always there but gets worse and better in waves. I have had ovarian cysts ruled out via ultrasound and I am waiting to speak to a colorectal surgeon to understand next steps.

Thanks again, I didn't realise it was an option to have chest X-ray instead, that is good to know. I feel like these scans seem to be happening before I can speak to a consultant about anything, so it is really hard to get my head around the risks.

I'm not a radiologist but I do work in radiation protection. The annual radiation limit for my job is 20 mSv radiation dose per year. If I was cabin crew/pilot I would get ~6 mSv dose per year. UK background dose is 2.6 mSv per year e.g. from rocks/cosmic rays etc.

Two chest CTs and a head CT is 14.6 mSv. This might seem a lot, but they're not something that you're going to repeat often. There is a principle when dealing with radiation that is always followed called ALARP - As Low As Reasonably Practicable. This means that the most benefit will be aimed for, whilst trying to minimise the dose. The medical benefit to you should far outweigh a few scans.

If it makes you feel better, this year I've had a couple of CTs and a few x-rays, plus MRI, alongside my nuclear occupational dose. I am not worried, although I suppose it's easy for me to say since I work with radiation.

This is a reassuring read thank you @BobbinThreadbare123 - sorry to hear you've had to have a few scans this year too!

Do you think it is an extra concern having the scans so close together? I read that it doesn't give time for the cells to repair - there doesn't seem to be much available research on the actual increased risk relating to timescale between scans out there.

Do you have health anxiety?

Yes I do @WhatTheHelll. I work really hard to try and keep it under control - I typically avoid going to the doctors. However, this year I have been having issues that I haven't been able to ignore that have needed further investigation - which has really worsened the anxiety.

I don't know the stats but when I was 36 I had about 5 xrays and a CT scan in one week. In the same year, then had a full abdomen CT scan and another 3-4 xrays. Wasn't thrilled but was okay - think you have to weigh up if it's essential.

Mine were for lung issues too.

Do you know what might be wrong op?

Thanks for your reply @TarquinsTurnips - glad all was okay!

I don't really know to be honest - the lung nodules could be harmless but they said they want to scan again to rule out anything suspicious. I don't have any other symptoms currently and the chest pain has eased.

With regards to the lower right abdomen pain, there are quite a few possibilities - although the symptoms do match chronic appendicitis (although not all doctors agree this is a thing).

The right-sided head pain, I think it could be due to the jaw clenching. Possibly TMJD - another doctor said it could be trigeminal neuralgia. I think they want to rule out something more serious though.

Have they mentioned cluster headaches for your head/eye pain?

I have just been diagnosed but didn’t have CT scan.

No they hadn't @itsgettingweird - will look it up though, thank you. Sorry to hear you're suffering with headaches too. Have you been given anything that helps with the pain?

It's risk vs benefit. The clinicians who have ordered these scans did so because they believe the benefits outweighed the risk.

Within the space of 2 months I had 3 chest X-rays, 2 cts and a couple of spinal mris.

with ct they found a lung nodule which wasn’t picked up on any of the X-rays. I’ve got one more to go then hopefully will be discharged as I’ve been monitored for 3 years now.

good luck.

Just seen a neurologist and prescribed verapamil and sumatriptan injections.

Have a look at the website “OUCH”. (Organisation for understanding cluster headaches). It’ll help you pinpoint if your symptoms match.

@SummerPanic good they are investigating everything. I don't have this condition but may be worth ruling out TSC and TSC-LAM. Push for the abdomen scan if that pain continues too.

There are studies that look at having multiple exposures in rapid succession. If you are interested I will dig out some links. It really is medically safe to do this though, I promise.