Radiation exposure and attributed cancer risk following lung transplantation

Rosengarten, Dror; Raviv, Yael; Rusanov, Victoria; Moreh-Rahav, Osnat; Fruchter, Oren; Allen, Aaron M.; Kramer, Mordechai R.

doi:10.1111/ctr.12315

Cited by 8 publications

(7 citation statements)

References 21 publications

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“…The maximum permissible occupational radiation exposure in the US is 50 millisievert (mSv) per year or 100 mSv over 5 years [3] while background radiation is about 3 mSv annually [4]. The lifetime excess risk of death from cancer has been estimated to increase by approximately 0.4% with 100 mSv of cumulative radiation exposure [5] and to be 5% per sievert [6]. It is controversial whether cumulative doses below 100 mSv increase the risk of malignancy [7].…”

Section: Introductionmentioning

confidence: 99%

Radiation Exposure from Diagnostic Imaging in a Cohort of Pediatric Transplant Recipients

et al. 2017

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Recipients of solid organ transplants (SOT) have extensive diagnostic imaging (DI). The purpose of this study was to quantify this exposure. Children from northern Alberta with SOTs at Stollery Children’s Hospital, Edmonton, Alberta January 1, 2006, to July 31, 2012, were included. Effective doses of radiation were estimated using published norms for DI performed post-transplant up to October 16, 2014. The 54 eligible children had 6215 DI studies (5628 plain films, 293 computerized tomography (CT) scans, 149 positron emission topography (PET) -CT scans, 47 nuclear medicine scans and 98 cardiac catheterizations). Children less than 5 years of age underwent more DI studies than did older children (median (IQR) 140 (66–210) vs 49 (19–105), p = 0.010). Children with post-transplant lymphoproliferative disorder (N = 8) had more CT scans (median (IQR) 13 (5.5–36) vs 1 (0–5), p<0.001) and PET-CT scans (median (IQR) 3.5 (1.5–8) vs 0 (0–0), p<0.001) than did other children. The estimated cumulative effective dose attributed to DI studies post-transplant was median (range) 78 (4.1–400) millisievert (mSv), and 19 of 54 children (35%; 95% confidence interval 24–49%) had a dose >100 mSv. In conclusion, a significant proportion of pediatric transplant recipients have sufficient radiation exposure post-transplant for DI to be at potential risk for radiation-induced malignancies.

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Section: Introductionmentioning

confidence: 99%

Radiation Exposure from Diagnostic Imaging in a Cohort of Pediatric Transplant Recipients

et al. 2017

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“…This radiation exposure is associated with a lifetime increase in cancer risk. 10 Chest DTS utilizes about 5% the radiation dose required chest CT. 11,12 The radiation dose for a chest DTS is 0.08 to 0.13 mSv compared with 1 to 4 mSv for a typical chest CT.…”

Section: Discussionmentioning

confidence: 99%

“Digital Tomosynthesis” As a Technique for the Evaluation of Endobronchial Stents in Lung Transplant Recipients

et al. 2022

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Lung transplant patients often suffer from posttransplant airway pathologies that require placement of endobronchial stents. In addition to surveillance bronchoscopy, patients often undergo radiographic stent evaluations. Chest x-rays are extremely limited in their ability to diagnose stent complications, so many patients require chest computed tomography (CT) scans for stent evaluation. Chest CT scans are costly and expose patients to higher cumulative radiation doses. Digital tomosynthesis (DTS) is an imaging modality that provides high-resolution images using limited angle tomography. The costs and radiation doses are comparable to conventional x-ray. We present a series of 4 postlung transplant patients with bronchial stents in whom we performed DTS and chest x-ray simultaneously. The DTS images were far superior to chest x-ray and comparable with CT in evaluating the placement and patency of the stents, especially in the case of silicone stents. Furthermore, the improved resolution provided clinically relevant diagnostic information that resulted in therapeutic bronchoscopy for suctioning of mucus impaction in one of the patients.

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“…Mean CED at the end of dose follow-up would have been significantly higher, by nearly two times, if estimated according to methodology used by Rosengarten et al [4] : 205.4 ± 86.0 (SD) mSv (range: 47-489.1 mSv) vs 110.0 ± 51.6 (SD) mSv (range: 13-261.3 mSv) ; P<0.001) (Table 1).…”

Section: Cumulative Effective and Organ Dosesmentioning

confidence: 94%

“…Briefly, the number of ionizing procedures was multiplied by the corresponding published reference effective dose: 0.1mSv for CXR, 7mSv for chest CT, 8mSV for abdominal CT, 2.5mSv for V/Q scans, 14.1mSv for PET and 0.4mSv for mammogram [4,14]. Thus, calculated and estimated CED were available for each patient.…”

Section: Carlo-based Program This Program Calculates Effective and Or...mentioning

confidence: 99%

“…LT recipients are exposed to high post-operative radiation doses because repeated imaging procedures with ionizing radiations are required to detect both short-and long-term complications. Although radiation exposure potentially increases the risk of malignancy, only one published study has evaluated its influence on the occurrence of malignancy in LT recipients and did not find any significant association, possibly because of a lack of power [4].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cumulative radiation dose after lung transplantation in patients with cystic fibrosis

Fitton

Revel

Burgel

et al. 2019

Diagnostic and Interventional Imaging

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Radiation exposure and attributed cancer risk following lung transplantation

Abstract: Lung transplant recipients are exposed to 7.8 times greater radiation dose from medical imaging compared to the general population. Nevertheless, the lifetime increase in cancer risk due to radiation is small.

Cited by 8 publications

References 21 publications

Radiation Exposure from Diagnostic Imaging in a Cohort of Pediatric Transplant Recipients

Radiation Exposure from Diagnostic Imaging in a Cohort of Pediatric Transplant Recipients

“Digital Tomosynthesis” As a Technique for the Evaluation of Endobronchial Stents in Lung Transplant Recipients

Cumulative radiation dose after lung transplantation in patients with cystic fibrosis

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