Estimation of Lifetime Attributable Risk (LAR) of Cancer Associated with Chest Computed Tomography Procedures in Children
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Abstract
Purpose: The danger of radiation at low doses continues linearly, and without a threshold, investigations concluded that although the risk of cancer from Computed Tomography (CT) scans is low, it is not zero.
This study aims to determine the patient's radiation dose and estimate the Lifetime Attributable Risk (LAR) of cancer incidence for a single chest CT scan in children.
Materials and Methods: We divided 1,105 children into four age groups: 0 years, 5 years, 10 years, and 15 years. Dosimetric data of chest CT scan were plugged in VirtualDoseCT software, and organ dose and effective dose were calculated. The cancer risk based on organ dose is estimated according to the BEIR VII report.
Results: The highest dose in boys was related to lung (5.13 - 6.8 mSv) and heart (5.27-5.97 mSv), and in girls, lung (4.98 - 5.91 mSv), breast (4.24 - 5.21 mSv), and heart (4.9 - 5.71 mSv) had the highest dose. The highest LAR (per 100,000) was obtained for the breast in the age group of 0 years (61.01), followed by the breast for the age group of 5 years (46.16) and lung in the age group of 0 years (43.32) in girls.
Conclusion: This study shows a better concept of radiation dose in the chest CT scan in children and how much effective dose and organ dose values increase the cancer risk.
1- Bat Conservation International. (2008, December 15, 2011). Bat Conservation International. [Online]. Available: http://www.batcon.org.
2- Choonsik Lee, Kwang Pyo Kim, Wesley E Bolch, Brian E Moroz, and Les Folio, "NCICT: a computational solution to estimate organ doses for pediatric and adult patients undergoing CT scans." Journal of radiological protection, Vol. 35 (No. 4), p. 891, (2015).
3- Eike I Piechowiak, Jan-Friedrich W Peter, Beate Kleb, Klaus J Klose, and Johannes T Heverhagen, "Intravenous iodinated contrast agents amplify DNA radiation damage at CT." Radiology, Vol. 275 (No. 3), pp. 692-97, (2015).
4- Richard Wakeford, Mark P Little, and Gerald M Kendall, "Risk of childhood leukemia after low-level exposure to ionizing radiation." Expert review of hematology, Vol. 3 (No. 3), pp. 251-54, (2010).
5- National Research Council, "Health risks from exposure to low levels of ionizing radiation: BEIR VII phase 2." (2006).
6- Joseph P Neglia et al., "New primary neoplasms of the central nervous system in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study." Journal of the National Cancer Institute, Vol. 98 (No. 21), pp. 1528-37, (2006).
7- Christopher Rääf, Nikola Markovic, Martin Tondel, Robert Wålinder, and Mats Isaksson, "Introduction of a method to calculate cumulative age-and gender-specific lifetime attributable risk (LAR) of cancer in populations after a large-scale nuclear power plant accident." Plos one, Vol. 15 (No. 2), p. e0228549, (2020).
8- Diana L Miglioretti et al., "The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk." JAMA pediatrics, Vol. 167 (No. 8), pp. 700-07, (2013).
9- Neige Journy et al., "Predicted cancer risks induced by computed tomography examinations during childhood, by a quantitative risk assessment approach." Radiation and environmental biophysics, Vol. 53 (No. 1), pp. 39-54, (2014).
10- Neige MY Journy, Choonsik Lee, Richard W Harbron, Kieran McHugh, Mark S Pearce, and Amy Berrington de González, "Projected cancer risks potentially related to past, current, and future practices in paediatric CT in the United Kingdom, 1990–2020." British journal of cancer, Vol. 116 (No. 1), pp. 109-16, (2017).
11- (2022). Virtual phantoms inc. Retrieved from virtualphantoms. [Online]. Available: https://www.virtualphantoms.com/.
12- Dale L Preston, Yukiko Shimizu, Donald A Pierce, Akihiko Suyama, and Kiyohiko Mabuchi, "Studies of mortality of atomic bomb survivors. Report 13: solid cancer and noncancer disease mortality: 1950–1997." Radiation research, Vol. 178 (No. 2), pp. AV146-AV72, (2012).
13- DL Preston et al., "Solid cancer incidence in atomic bomb survivors: 1958–1998." Radiation research, Vol. 168 (No. 1), pp. 1-64, (2007).
14- C Ghetti, O Ortenzia, M Maddalo, L Altabella, and N Sverzellati, "Dosimetric and radiation cancer risk evaluation of high resolution thorax CT during COVID-19 outbreak." Physica Medica, Vol. 80pp. 119-24, (2020).
15- Mark S Pearce et al., "Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study." The Lancet, Vol. 380 (No. 9840), pp. 499-505, (2012).
16- Tilo Niemann et al., "Estimated risk of radiation-induced cancer from paediatric chest CT: two-year cohort study." Pediatric radiology, Vol. 45 (No. 3), pp. 329-36, (2015).
17- Kotaro Ozasa et al., "Studies of the mortality of atomic bomb survivors, Report 14, 1950–2003: an overview of cancer and noncancer diseases." Radiation research, Vol. 177 (No. 3), pp. 229-43, (2012).
18- Eric J Hall and Amato J Giaccia, Radiobiology for the Radiologist. Philadelphia, (2006).
19- Atefeh Tahmasebzadeh, Reza Paydar, Mojtaba Soltani-Kermanshahi, Asghar Maziar, and Reza Reiazi, "Lifetime attributable cancer risk related to prevalent CT scan procedures in pediatric medical imaging centers." International Journal of Radiation Biology, Vol. 97 (No. 9), pp. 1282-88, (2021).
20- Charles E Land et al., "Incidence of female breast cancer among atomic bomb survivors, Hiroshima and Nagasaki, 1950–1990." Radiation research, Vol. 160 (No. 6), pp. 707-17, (2003).
21- US Environmental Protection Agency. EPA radiogenic cancer risk models and projections for the US population. . [Online]. Available: https://www.epa.gov/radiation/blue-book-epa-radiogenic-cancer-risk-models-and-projections-us-population.
22- United Nations Scientific Committee on the Effects of Atomic Radiation. Volume I: report to the general assembly. Scientific Annexes A and B. 2008. [Online]. Available: https://www.unscear.org/docs/publications/2008/UNSCEAR_2008_Report_Vol.I-CORR.pdf.
23- John D Mathews et al., "Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians." Bmj, Vol. 346(2013).
24- Atefeh Tahmasebzadeh, Reza Paydar, Mojtaba Soltani kermanshahi, Asghar Maziar, Mehdi Rezaei, and Reza Reiazi, "Pediatric regional Drl assessment in common Ct examinations for medical exposure optimization in Tehran, Iran." Radiation protection dosimetry, Vol. 192 (No. 3), pp. 341-49, (2020).
25- Daniel M Lindberg et al., "Feasibility and accuracy of fast MRI versus CT for traumatic brain injury in young children." Pediatrics, Vol. 144 (No. 4), (2019).
26- Michael Esser et al., "Radiation dose optimization in pediatric chest CT: major indicators of dose exposure in 1695 CT scans over seven years." in RöFo-Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, (2018), Vol. 190 (No. 12): © Georg Thieme Verlag KG, pp. 1131-40.
27- Marilyn J Siegel, Demetrios Raptis, Sanjeev Bhalla, and Juan Carlos Ramirez-Giraldo, "Comparison of 100-Kilovoltage Tin Filtration With Advanced Modeled Iterative Reconstruction Protocol to an Automated Kilovoltage Selection With Filtered Back Projection Protocol on Radiation Dose and Image Quality in Pediatric Noncontrast-Enhanced Chest Computed Tomography." Journal of computer assisted tomography, Vol. 46 (No. 1), pp. 64-70, (2022).
28- Paul A Oakley and Deed E Harrison, "Death of the ALARA radiation protection principle as used in the medical sector." Dose-Response, Vol. 18 (No. 2), p. 1559325820921641, (2020).
29- MH Jamshidi, A Keshavarz, A Karami, Y Salimi, and GA Valizadeh, "Patient radiation dose and lifetime attributable risk of cancer due to ionizing radiation in cardiovascular interventional radiological procedures." Radioprotection, Vol. 57 (No. 2), pp. 113-21, (2022).
30- Xiao-ying Zhao et al., "Effects of Adaptive Statistical Iterative Reconstruction-V Technology on the Image Quality and Radiation Dose of Unenhanced and Enhanced CT Scans of the Piglet Abdomen." Radiation research, (2021).
31- Touko Kaasalainen, Kirsi Palmu, Anniina Lampinen, and Mika Kortesniemi, "Effect of vertical positioning on organ dose, image noise and contrast in pediatric chest CT—phantom study." Pediatric radiology, Vol. 43 (No. 6), pp. 673-84, (2013).
2- Choonsik Lee, Kwang Pyo Kim, Wesley E Bolch, Brian E Moroz, and Les Folio, "NCICT: a computational solution to estimate organ doses for pediatric and adult patients undergoing CT scans." Journal of radiological protection, Vol. 35 (No. 4), p. 891, (2015).
3- Eike I Piechowiak, Jan-Friedrich W Peter, Beate Kleb, Klaus J Klose, and Johannes T Heverhagen, "Intravenous iodinated contrast agents amplify DNA radiation damage at CT." Radiology, Vol. 275 (No. 3), pp. 692-97, (2015).
4- Richard Wakeford, Mark P Little, and Gerald M Kendall, "Risk of childhood leukemia after low-level exposure to ionizing radiation." Expert review of hematology, Vol. 3 (No. 3), pp. 251-54, (2010).
5- National Research Council, "Health risks from exposure to low levels of ionizing radiation: BEIR VII phase 2." (2006).
6- Joseph P Neglia et al., "New primary neoplasms of the central nervous system in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study." Journal of the National Cancer Institute, Vol. 98 (No. 21), pp. 1528-37, (2006).
7- Christopher Rääf, Nikola Markovic, Martin Tondel, Robert Wålinder, and Mats Isaksson, "Introduction of a method to calculate cumulative age-and gender-specific lifetime attributable risk (LAR) of cancer in populations after a large-scale nuclear power plant accident." Plos one, Vol. 15 (No. 2), p. e0228549, (2020).
8- Diana L Miglioretti et al., "The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk." JAMA pediatrics, Vol. 167 (No. 8), pp. 700-07, (2013).
9- Neige Journy et al., "Predicted cancer risks induced by computed tomography examinations during childhood, by a quantitative risk assessment approach." Radiation and environmental biophysics, Vol. 53 (No. 1), pp. 39-54, (2014).
10- Neige MY Journy, Choonsik Lee, Richard W Harbron, Kieran McHugh, Mark S Pearce, and Amy Berrington de González, "Projected cancer risks potentially related to past, current, and future practices in paediatric CT in the United Kingdom, 1990–2020." British journal of cancer, Vol. 116 (No. 1), pp. 109-16, (2017).
11- (2022). Virtual phantoms inc. Retrieved from virtualphantoms. [Online]. Available: https://www.virtualphantoms.com/.
12- Dale L Preston, Yukiko Shimizu, Donald A Pierce, Akihiko Suyama, and Kiyohiko Mabuchi, "Studies of mortality of atomic bomb survivors. Report 13: solid cancer and noncancer disease mortality: 1950–1997." Radiation research, Vol. 178 (No. 2), pp. AV146-AV72, (2012).
13- DL Preston et al., "Solid cancer incidence in atomic bomb survivors: 1958–1998." Radiation research, Vol. 168 (No. 1), pp. 1-64, (2007).
14- C Ghetti, O Ortenzia, M Maddalo, L Altabella, and N Sverzellati, "Dosimetric and radiation cancer risk evaluation of high resolution thorax CT during COVID-19 outbreak." Physica Medica, Vol. 80pp. 119-24, (2020).
15- Mark S Pearce et al., "Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study." The Lancet, Vol. 380 (No. 9840), pp. 499-505, (2012).
16- Tilo Niemann et al., "Estimated risk of radiation-induced cancer from paediatric chest CT: two-year cohort study." Pediatric radiology, Vol. 45 (No. 3), pp. 329-36, (2015).
17- Kotaro Ozasa et al., "Studies of the mortality of atomic bomb survivors, Report 14, 1950–2003: an overview of cancer and noncancer diseases." Radiation research, Vol. 177 (No. 3), pp. 229-43, (2012).
18- Eric J Hall and Amato J Giaccia, Radiobiology for the Radiologist. Philadelphia, (2006).
19- Atefeh Tahmasebzadeh, Reza Paydar, Mojtaba Soltani-Kermanshahi, Asghar Maziar, and Reza Reiazi, "Lifetime attributable cancer risk related to prevalent CT scan procedures in pediatric medical imaging centers." International Journal of Radiation Biology, Vol. 97 (No. 9), pp. 1282-88, (2021).
20- Charles E Land et al., "Incidence of female breast cancer among atomic bomb survivors, Hiroshima and Nagasaki, 1950–1990." Radiation research, Vol. 160 (No. 6), pp. 707-17, (2003).
21- US Environmental Protection Agency. EPA radiogenic cancer risk models and projections for the US population. . [Online]. Available: https://www.epa.gov/radiation/blue-book-epa-radiogenic-cancer-risk-models-and-projections-us-population.
22- United Nations Scientific Committee on the Effects of Atomic Radiation. Volume I: report to the general assembly. Scientific Annexes A and B. 2008. [Online]. Available: https://www.unscear.org/docs/publications/2008/UNSCEAR_2008_Report_Vol.I-CORR.pdf.
23- John D Mathews et al., "Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians." Bmj, Vol. 346(2013).
24- Atefeh Tahmasebzadeh, Reza Paydar, Mojtaba Soltani kermanshahi, Asghar Maziar, Mehdi Rezaei, and Reza Reiazi, "Pediatric regional Drl assessment in common Ct examinations for medical exposure optimization in Tehran, Iran." Radiation protection dosimetry, Vol. 192 (No. 3), pp. 341-49, (2020).
25- Daniel M Lindberg et al., "Feasibility and accuracy of fast MRI versus CT for traumatic brain injury in young children." Pediatrics, Vol. 144 (No. 4), (2019).
26- Michael Esser et al., "Radiation dose optimization in pediatric chest CT: major indicators of dose exposure in 1695 CT scans over seven years." in RöFo-Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, (2018), Vol. 190 (No. 12): © Georg Thieme Verlag KG, pp. 1131-40.
27- Marilyn J Siegel, Demetrios Raptis, Sanjeev Bhalla, and Juan Carlos Ramirez-Giraldo, "Comparison of 100-Kilovoltage Tin Filtration With Advanced Modeled Iterative Reconstruction Protocol to an Automated Kilovoltage Selection With Filtered Back Projection Protocol on Radiation Dose and Image Quality in Pediatric Noncontrast-Enhanced Chest Computed Tomography." Journal of computer assisted tomography, Vol. 46 (No. 1), pp. 64-70, (2022).
28- Paul A Oakley and Deed E Harrison, "Death of the ALARA radiation protection principle as used in the medical sector." Dose-Response, Vol. 18 (No. 2), p. 1559325820921641, (2020).
29- MH Jamshidi, A Keshavarz, A Karami, Y Salimi, and GA Valizadeh, "Patient radiation dose and lifetime attributable risk of cancer due to ionizing radiation in cardiovascular interventional radiological procedures." Radioprotection, Vol. 57 (No. 2), pp. 113-21, (2022).
30- Xiao-ying Zhao et al., "Effects of Adaptive Statistical Iterative Reconstruction-V Technology on the Image Quality and Radiation Dose of Unenhanced and Enhanced CT Scans of the Piglet Abdomen." Radiation research, (2021).
31- Touko Kaasalainen, Kirsi Palmu, Anniina Lampinen, and Mika Kortesniemi, "Effect of vertical positioning on organ dose, image noise and contrast in pediatric chest CT—phantom study." Pediatric radiology, Vol. 43 (No. 6), pp. 673-84, (2013).
| Files | ||
| Issue | Vol 10 No 4 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/fbt.v10i4.13726 | |
| Keywords | ||
| Lifetime Attributable Risk Chest Computed Tomography Scan Radiation Dose Cancer Risk Children Biologic Effects of Ionizing Radiation VII | ||
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How to Cite
1.
Jamshidi MH, Karami A, Ordoni J, Bijari S. Estimation of Lifetime Attributable Risk (LAR) of Cancer Associated with Chest Computed Tomography Procedures in Children. Frontiers Biomed Technol. 2023;10(4):441-448.
