Thyroid Doses and Risks to Adult Patients Undergoing Neck CT Examinations

Tipnis, Sameer; Spampinato, Maria Vittoria; Hungerford, John P; Huda, Walter

doi:10.2214/ajr.14.13102

Cited by 24 publications

(18 citation statements)

References 17 publications

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“…Smoking is less common in Sweden now than previously [ 35 ] and there is no information on a sudden change in eating habits and exposure to xenobiotics and viruses. Increasing use of CT scans including of the thorax, head and neck might be of concern, especially since previous studies have shown an increased risk for thyroid cancer [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…Since the first correlation was reported in the late 1940s, several studies have confirmed the association. Especially studies of childhood X-ray treatment of thymus and scalp ringworm have established radiation as a risk factor, as well as among A-bomb survivors [ 37 ]. The dose-response curve seems to be linear and several studies have indicated that the risk increase begins between 5 to 10 years after irradiation.…”

Section: Discussionmentioning

confidence: 99%

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Increasing incidence of thyroid cancer in the Nordic countries with main focus on Swedish data

Carlberg

Hedendahl

Ahonen³

et al. 2016

BMC Cancer

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BackgroundRadiofrequency radiation in the frequency range 30 kHz–300 GHz was evaluated to be Group 2B, i.e. ‘possibly’ carcinogenic to humans, by the International Agency for Research on Cancer (IARC) at WHO in May 2011. Among the evaluated devices were mobile and cordless phones, since they emit radiofrequency electromagnetic fields (RF-EMF). In addition to the brain, another organ, the thyroid gland, also receives high exposure. The incidence of thyroid cancer is increasing in many countries, especially the papillary type that is the most radiosensitive type.MethodsWe used the Swedish Cancer Register to study the incidence of thyroid cancer during 1970–2013 using joinpoint regression analysis.ResultsIn women, the incidence increased statistically significantly during the whole study period; average annual percentage change (AAPC) +1.19 % (95 % confidence interval (CI) +0.56, +1.83 %). Two joinpoints were detected, 1979 and 2001, with a high increase of the incidence during the last period 2001–2013 with an annual percentage change (APC) of +5.34 % (95 % CI +3.93, +6.77 %). AAPC for all men during 1970–2013 was +0.77 % (95 % CI −0.03, +1.58 %). One joinpoint was detected in 2005 with a statistically significant increase in incidence during 2005–2013; APC +7.56 % (95 % CI +3.34, +11.96 %). Based on NORDCAN data, there was a statistically significant increase in the incidence of thyroid cancer in the Nordic countries during the same time period. In both women and men a joinpoint was detected in 2006. The incidence increased during 2006–2013 in women; APC +6.16 % (95 % CI +3.94, +8.42 %) and in men; APC +6.84 % (95 % CI +3.69, +10.08 %), thus showing similar results as the Swedish Cancer Register. Analyses based on data from the Cancer Register showed that the increasing trend in Sweden was mainly caused by thyroid cancer of the papillary type.ConclusionsWe postulate that the whole increase cannot be attributed to better diagnostic procedures. Increasing exposure to ionizing radiation, e.g. medical computed tomography (CT) scans, and to RF-EMF (non-ionizing radiation) should be further studied. The design of our study does not permit conclusions regarding causality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Increasing incidence of thyroid cancer in the Nordic countries with main focus on Swedish data

Carlberg

Hedendahl

Ahonen³

et al. 2016

BMC Cancer

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“…26,27 The amount of lifetime ionizing radiation exposure that many US residents are exposed to has doubled over the past 20 years, mainly due to the increased use of medical imaging, especially CT scans. 28 Studies have tried to determine a correlation between increasing thyroid cancer rates and an increase in exposure to ionizing radiation. Pediatric studies have shown that a low but nonnegligible risk of thyroid malignancy exists with exposure to CT scans.…”

Section: Introductionmentioning

confidence: 99%

“…29 Age at exposure is inversely correlated with cancer risk; children aged o5 years have the highest risk, and after the age of 20 years, the risk decreases exponentially. 26,28 Because most CT scans are performed in patients aged 450 years, the likelihood that CT scan exposure significantly contributes to the increasing incidence of thyroid cancer is low.…”

Section: Introductionmentioning

confidence: 99%

Increasing Incidence of Thyroid Nodules and Thyroid Cancer: Does Increased Detection of a Subclinical Reservoir Justify the Associated Anxiety and Treatment?

Ukrainski

Pribitkin

Miller

2016

Clinical Therapeutics

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The incidence of thyroid cancer has been increasing over the last few decades, and it is subject to debate regarding whether the incidence is reflective of better diagnostic techniques and therefore better detection or if it is a reflection of a true increase in incidence. This increase in incidence has been most clearly manifested by an exponential increase in the diagnosis of micropapillary thyroid carcinomas. This article reviews the diagnosis of thyroid cancers, the dilemmas facing clinicians in the management of these micropapillary thyroid carcinomas, and the advances in molecular diagnostics that are being used to assist in the decision-making process. We consider the possibility of overtreatment of a relatively indolent disease and propose a less aggressive management plan in the appropriate clinical scenario.

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“…6,7 The threshold of radiation-induced thyroid cancer is lower for younger individuals. 8 There is an increased risk of thyroid cancer during multiple exposures during dental radiography. 9 In 2008 in Finland, the majority of lateral cephalometric radiography (75%) was performed on patients younger than 17 years.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic localization of the thyroid gland for its optimal shielding prior to lateral cephalometric radiography: a pilot study

Esmaeili¹,

Hurmerinta²,

Rice

et al. 2016

Dentomaxillofacial Radiology

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Objectives: Lateral cephalometric radiography is a common radiographic examination technique in children. The exclusion of the thyroid gland from the primary X-ray beam is important especially with children. However, patient treatment might require displaying the four most cranial cervical vertebrae (C1-C4) for the assessment of cervical vertebral maturation. Our aim was to present a safe way to display C1-C4 and exclude the thyroid gland from the X-ray beam during lateral cephalometric radiography. Methods: The thyroid glands of 25, 7-to 12-year-old patients were localized by ultrasound examination and shielded prior to lateral cephalometric radiography. A roentgen-positive mark was taped on the patient's skin at the level of most cranial level of the thyroid gland in the midsagittal plane. After exposure, each lateral cephalometric radiograph (LCR) was analyzed for the visibility of the cervical vertebrae. The distance between the ear post and the highest edge of the thyroid shield (TS) at the lateral part of the neck was measured and compared with the distance between the centre of the radiological external auditory meatus, and a roentgen-positive mark was made on the LCR. Results: 68% of the LCRs displayed C1-C4, and the rest of them displayed C1-C3. In all of the patients, the highest edge of the TS in the lateral parts of the neck was located in a higher position than the actual most cranial level of the thyroid gland. Conclusions: Despite localizing the thyroid gland prior to lateral cephalometric radiography, simultaneous visualization of C1-C4 and exclusion of the thyroid gland from the primary Xray beam during lateral cephalometric radiography might not be completely possible in children because of the design and poor fitness of the TS.

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Thyroid Doses and Risks to Adult Patients Undergoing Neck CT Examinations

Abstract: Patient sex and age are the most important factors in determining thyroid cancer risk, with the thyroid dose being secondary.

Cited by 24 publications

References 17 publications

Increasing incidence of thyroid cancer in the Nordic countries with main focus on Swedish data

Increasing incidence of thyroid cancer in the Nordic countries with main focus on Swedish data

Increasing Incidence of Thyroid Nodules and Thyroid Cancer: Does Increased Detection of a Subclinical Reservoir Justify the Associated Anxiety and Treatment?

Ultrasonographic localization of the thyroid gland for its optimal shielding prior to lateral cephalometric radiography: a pilot study

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