Radiating Disparity in IBD

Flasar, Mark; Patil, Seema

doi:10.1007/s10620-013-2922-4

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…It has been estimated that exposure to ionising radiation for diagnostic purposes may account for 2% of all cancers worldwide (13). The ED in other patient groups requiring long-term radiological follow-up has been reported previously.…”

Section: Discussionmentioning

confidence: 99%

Radiological surveillance in multiple endocrine neoplasia type 1: a double-edged sword?

Casey

Saunders

Challis

et al. 2017

Endocrine Connections

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ContextMultiple endocrine neoplasia type 1 (MEN1) is a hereditary condition characterised by the predisposition to hyperplasia/tumours of endocrine glands. MEN1-related disease, moreover, malignancy related to MEN1, is increasingly responsible for death in up to two-thirds of patients. Although patients undergo radiological and biochemical surveillance, current recommendations for radiological monitoring are based on non-prospective data with little consensus or evidence demonstrating improved outcome from this approach. Here, we sought to determine whether cumulative radiation exposure as part of the recommended radiological screening programme posed a distinct risk in a cohort of patients with MEN1.Patients and study designA retrospective review of 43 patients with MEN1 attending our institution between 2007 and 2015 was performed. Demographic and clinical information including phenotype was obtained for all patients. We also obtained details regarding all radiological procedures performed as part of MEN1 surveillance or disease localisation. An estimated effective radiation dose (ED) for each individual patient was calculated.ResultsThe mean ED for the total patient cohort was 121 mSv, and the estimated mean lifetime risk of cancer secondary to radiation exposure was 0.49%. Patients with malignant neuroendocrine tumours (NETS) had significantly higher ED levels compared to patients without metastatic disease (P < 0.0022).ConclusionsIn MEN1, radiological surveillance is associated with clinically significant exposure to ionising radiation. In patients with MEN1, multi-modality imaging strategies designed to minimise this exposure should be considered.

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Section: Discussionmentioning

confidence: 99%

Radiological surveillance in multiple endocrine neoplasia type 1: a double-edged sword?

Casey

Saunders

Challis

et al. 2017

Endocrine Connections

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show abstract

“…Moreover, the ratio between diagnostic benefits of imaging and risks due to periodical exposure to ionizing radiation should be taken into account. Indeed, recent data have demonstrated to 3-fold increase in the per capita individual radiation exposure from medical diagnostic radiation sources over the past 25 years (Casey et al 2017), and it has been estimated that exposure to ionizing radiation for diagnostic purposes may account for 2% of all tumors (Flasar & Patil 2014). This oncogenic relative risk could also be higher in patients with a genetic tumor-predisposing syndrome, bearing a mutation in genes involved in DNA repair or tumor suppression, such as MEN1, who constantly undergo repeated exposure to diagnostic doses of ionizing radiation (Allan 2008).…”

Section: Introductionmentioning

confidence: 99%

Management impact: effects on quality of life and prognosis in MEN1

Marini¹,

Giusti²,

Tonelli³

et al. 2017

Endocrine-Related Cancer

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Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant endocrine tumor syndrome, caused by inactivating mutations of the MEN1 tumor suppressor gene at 11q13 locus, which predisposes to develop tumors in target neuroendocrine tissues. As the positional cloning and identification of the causative gene in 1997, genetic diagnosis, by the sequencing-based research of gene mutations, has become an important tool in the early and differential diagnosis of the disease. Application of the genetic test, in MEN1 index cases and in first-degree relatives of mutated patients, has been constantly increasing during the last two decades, also thanks to the establishment of multidisciplinary referral centers and specific genetic counseling, and thanks to the wide availability of high throughput instruments for gene sequencing and gene mutation identification. The MEN1 genetic test helps the specific diagnosis of probands, and allows the early identification of asymptomatic carriers, strongly contributing, together with progressions in tumor diagnostic techniques and in pharmacological and surgical therapeutic approaches, to the reduction of morbidity and mortality associated with the syndrome. International clinical guidelines for MEN1 have been drafted by panels of specialists in the field, with the main goal to improve the management of the disease and grant patients a better quality of life. Here, we review main recommendations and suggestions derived by the last published general guidelines in 2012, and by most recent published studies about MEN1 syndrome diagnosis, clinical management, therapeutic approaches and patients' quality of life.

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“…However, currently, there are no data to support the notion that more aggressive radiological surveillance leads to improved survival outcomes for this patient cohort, and further prospective data are required. It has been estimated that exposure to ionising radiation for diagnostic purposes may account for 2% of all cancers worldwide (13). The ED in other patient groups requiring long-term radiological follow-up has been reported previously.…”

Section: Discussionmentioning

confidence: 66%

Radiological surveillance in multiple endocrine neoplasia type 1: A double edged sword?

Casey

Saunders

Challis

et al. 2016

EJEA

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Context: Multiple endocrine neoplasia type 1 (MEN1) is a hereditary condition characterised by the predisposition to hyperplasia/tumours of endocrine glands. MEN1-related disease, moreover, malignancy related to MEN1, is increasingly responsible for death in up to two-thirds of patients. Although patients undergo radiological and biochemical surveillance, current recommendations for radiological monitoring are based on non-prospective data with little consensus or evidence demonstrating improved outcome from this approach. Here, we sought to determine whether cumulative radiation exposure as part of the recommended radiological screening programme posed a distinct risk in a cohort of patients with MEN1. Patients and study design: A retrospective review of 43 patients with MEN1 attending our institution between 2007 and 2015 was performed. Demographic and clinical information including phenotype was obtained for all patients. We also obtained details regarding all radiological procedures performed as part of MEN1 surveillance or disease localisation. An estimated effective radiation dose (ED) for each individual patient was calculated. Results: The mean ED for the total patient cohort was 121 mSv, and the estimated mean lifetime risk of cancer secondary to radiation exposure was 0.49%. Patients with malignant neuroendocrine tumours (NETS) had significantly higher ED levels compared to patients without metastatic disease (P < 0.0022). Conclusions: In MEN1, radiological surveillance is associated with clinically significant exposure to ionising radiation. In patients with MEN1, multi-modality imaging strategies designed to minimise this exposure should be considered.

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Radiating Disparity in IBD

Cited by 5 publications

References 15 publications

Radiological surveillance in multiple endocrine neoplasia type 1: a double-edged sword?

Radiological surveillance in multiple endocrine neoplasia type 1: a double-edged sword?

Management impact: effects on quality of life and prognosis in MEN1

Radiological surveillance in multiple endocrine neoplasia type 1: A double edged sword?

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