Key result
Cumulative effective radiation doses >100 mSv from medical imaging occurred in 0.68% of patients, carrying an estimated radiation-induced cancer mortality risk of approximately 1 in 2000.
Why the study?
Following calls to strengthen radiation protection for recurrent imaging, the study aimed to evaluate excess risks of cancer incidence among UK patients receiving cumulative effective doses.
What is the estimated excess risk of cancer incidence from cumulative effective radiation doses in patients undergoing recurrent medical imaging?
Observational (n=105,757)
Yes
What is the estimated excess risk of cancer incidence from cumulative effective radiation doses in patients undergoing recurrent medical imaging?
The estimated excess risk of cancer from cumulative medical imaging radiation is low, but optimization of imaging procedures remains important, especially for children and adolescents.
Low estimated mortality risk at high doses; leaves open need for protocol optimization in recurrent imaging, especially younger patients.
The International Atomic Energy Agency issued a statement calling for action to strengthen the radiation protection of patients undergoing recurrent imaging. This followed reports of patients receiving cumulative effective doses over 100 mSv from multiple computed tomography examinations. In order to evaluate excess risks of cancer incidence among UK patients, data from an exposure management system covering three hospitals within one trust have been studied over 5½ years. Cumulative effective doses for 105 757 patients, from whom 719 (0.68%) received effective dose over 100 mSv, have been analysed using age and sex specific risk factors for stochastic effects. Two cancers might be expected to be initiated in the patients receiving over 100 mSv, while five might be expected to develop cancer among patients receiving 50-100 mSv. However, the calculations ignore health conditions for which the patients are being treated that may shorten their lives, and rely on the linear-no-threshold dose-effect model which is a subject of debate, so they are likely to overestimate cancer incidence. If health of the patients receiving >100 mSv is taken into account, the risk of mortality from cancer initiated by medical exposure might be the order of 1 in 2000. Recommendations on further strengthening of optimisation should be applied to imaging procedures for all patients with special focus on those performed on children and adolescents.
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Martin et al. (2021) conducted an observational in Recurrent medical imaging (n=105,757). Recurrent medical imaging was evaluated on Excess risk of cancer incidence. Cumulative effective radiation doses >100 mSv from medical imaging occurred in 0.68% of patients, carrying an estimated radiation-induced cancer mortality risk of approximately 1 in 2000.
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