Whole-Body PET/CT Scanning: Estimation of Radiation Dose and Cancer Risk

Huang, Bingsheng; Law, Martin; Khong, Pek‐Lan

doi:10.1148/radiol.2511081300

Cited by 429 publications

(323 citation statements)

References 21 publications

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“…Previous studies reported an increased secondary cancer risk due to surveillance CT scans in patients with NHL [18,19]. As regards to the use of 18 F-FDG-PET/CT, it is well known that involves exposure to a substantial dose of ionising radiations, again with increasing cancer risk [20]. However, 18 F-FDG-PET/CT has a crucial role in FL management.…”

Section: Imaging Monitoring and Wwmentioning

confidence: 99%

Whole body magnetic resonance in indolent lymphomas under watchful waiting: The time is now

et al. 2017

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The indolent non-Hodgkin lymphomas (i-NHLs) are characterised by 'indolent' clinical behaviour with slow growth and prolonged natural history. The watchful waiting (WW) strategy is a frequently employed treatment option in these patients. This implies a strict monitoring by imaging examinations, including 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) and CT. A major concern is radiation exposure due to regularly monitoring by conventional imaging procedures. Several studies have demonstrated the reliability of whole-body magnetic resonance imaging (WB-MRI) for lymphoma staging. WB-MRI could be useful for active surveillance in iNHLs providing the suspect of disease progression that can be then confirmed by additional diagnostic procedures, including 18F-FDG-PET/CT. The directive 2013/59 by the European Union claims that if a radiation-free imaging technique allows obtaining the same diagnostic results, it should be invariably used.In this setting, WB-MRI may be considered a reasonable option in i-NHLs under WW, replacing imaging modalities that cause exposure to ionising radiations. This will help to reduce the cancer risk in i-NHL patients for whom chemo-/radiotherapy remain the usual treatment options following the usually long WW phase. The scientific community should raise the awareness of the risk of ionising radiations in i-NHLs and the emphasise the need for establishing the proper place of WB-MRI in lymphoma imaging. Key Points• Watchful waiting is a reasonable option in patients with indolent non-Hodgkin lymphomas.• Imaging is crucial to monitor patients with indolent nonHodgkin lymphomas.• CT and 18 F-FDG-PET/CT are commonly used, implying a substantial radiation exposure.• WB-MRI is highly reliable in lymphoma staging.• WB-MRI may be considered to monitor indolent nonHodgkin lymphomas under watchful waiting.

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Section: Imaging Monitoring and Wwmentioning

confidence: 99%

Whole body magnetic resonance in indolent lymphomas under watchful waiting: The time is now

et al. 2017

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“…More recently, it has become possible to integrate cardiac and coronary artery imaging into chest CT examinations, a concept applicable to numerous thoracic diseases [5]. The consequence of such developments is the substantial increase in the radiation dose delivered to patients, individually but also collectively [6], and the subsequent risks, even small, of cancer induction by lowlevel radiation [7,8]. Facing the challenge of providing diagnostic image quality at the lowest radiation dose, the radiological community has modified chest CT protocols at the pace of new technology implementations aiming to reduce radiation exposure, such as anatomical tube current modulation, ECG-controlled tube current modulation or dynamically adjustable pre-patient collimation of the X-ray beam in the z-axis direction [9,10].…”

Section: Introductionmentioning

confidence: 99%

Chest computed tomography using iterative reconstruction vs filtered back projection (Part 1): evaluation of image noise reduction in 32 patients

et al. 2010

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“…It carries a 1.5-2 times greater dose of radiation than conventional CT chest abdomen pelvis depending on the protocol. 4 It does, however, provide a clear, non-invasive method for confirming a diagnosis that is otherwise difficult to make with good sensitivity and specificity. 5,6 Delayed diagnosis of large vessel vasculitis could result in vessel occlusion or aneurysmal formation and lead to significant mortality ranging from 3-21%.…”

Section: Discussionmentioning

confidence: 99%

Lesson of the month 1: Large vessel vasculitis – a diagnostic challenge and the role of 18-fluorodeoxyglucose positron emission tomography

Allard

Mootoo

2017

Clinical Medicine

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Large vessel vasculitis can pose a significant diagnostic challenge. It may be insidious in onset with the only presenting symptoms consisting of constitutional compromise. It may mimic other pathologies and the only serological abnormalities may be abnormal inflammatory markers. Conventional imaging modalities may not be diagnostic. We present a case of large vessel vasculitis that proved a significant diagnostic challenge with diagnosis established on 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) computerised tomography (CT) imaging. This is one of five cases of large vessel vasculitis that were diagnosed in the rheumatology department at our trust over a 12-month period with diagnosis established with the use of 18F-FDG PET CT. We discuss the advantages of 18F-FDG PET CT over more conventional imaging modalities in diagnosing large vessel vasculitis.

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Whole-Body PET/CT Scanning: Estimation of Radiation Dose and Cancer Risk

Abstract: Whole-body PET/CT scanning is accompanied by substantial radiation dose and cancer risk. Thus, examinations should be clinically justified, and measures should be taken to reduce the dose.

Cited by 429 publications

References 21 publications

Whole body magnetic resonance in indolent lymphomas under watchful waiting: The time is now

Whole body magnetic resonance in indolent lymphomas under watchful waiting: The time is now

Chest computed tomography using iterative reconstruction vs filtered back projection (Part 1): evaluation of image noise reduction in 32 patients

Lesson of the month 1: Large vessel vasculitis – a diagnostic challenge and the role of 18-fluorodeoxyglucose positron emission tomography

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