Radiobiological risks in terms of effective dose and organ dose from 18F-FDG whole-body PET/CT procedures

Abstract

Introduction Integrated Positron Emission Tomography (PET) with Computerized tomography (CT) (PET/CT) are widely used to diagnose, stage and track human diseases during whole body scanning. Multi-modality imaging is an interesting area of research that aims at acquiring united morphological-functional image information for accurate diagnosing and staging of the disease. However, PET/CT procedure accompanied with high radiation dose from CT and administered radioactivity. The aim of the present study was to estimate the patients’ dose from 18 F-fluorodeoxyglucose imaging (18F-FDG) hybrid PET/CT whole body scan. Materials and methods RADAR (Radiation Dose Assessment Resource) software was used to estimate the effective dose for 156 patients (110 (70.5%)) males and 46 (39.5%) female) examined using Discovery PET/CT 710, GE Medical Systems installed at Kuwait Cancer Control Center (KCCC). Results The effective dose results presented in this PET/CT study ranged from (1.56–9.94 mSv). The effective dose was calculated to be 3.88 mSv in females and 3.71 mSv in males. The overall breast (female), lung, liver, kidney and thyroid were 7.4, 7.2, 5.2, 4, 3 and 2.9, respectively. For females, the body mass index (BMI) was 28.49 kg/m 2 and for males it was 26.50 kg/m 2 which showed overweight values for both genders. Conclusions: The findings indicate that the effective dose of 18F-FDG in both male and female patients was not substantially different. The study suggested that the risk–benefit proportions of any 18 F-FDG whole body PET/CT scan should be clarified and carefully weighed. Patient’s doses are lower compared with previous studies.

Dual-tracer positron emission tomography/computed tomography as an imaging probe of de novo lipogenesis in preclinical models of hepatocellular carcinoma

“…Moreover, a comprehensive in vivo imaging analyses before and after lipogenesis-targeted therapy, including more types of HCC cell lines, are warranted to corroborate our findings. In addition, with the technical progress of new generation PET/CT instruments, the effective radiation dose of dual-tracer PET/CT has been substantially reduced to 14.3 mSv to avoid the radiation burden of HCC patients, compared with diagnostic abdominal CT with the effective radiation dose of 20 mSv ( 24 – 26 ). We suggest that the proposed dual-tracer PET imaging can track cancer metabolic changes and provide a clearer picture for designing suitable and individualized treatment strategies.…”

Ultra‐low dose CT scanning for PET/CT

“…The NEMA IQ and torso phantoms were filled with [ 18 F]FDG, while the CIRS phantom had a 22 Na point source with 105 kBq of activity. The torso phantom's approximate activities were spread among the liver (5.12 kBq/mL), heart (11.28 kBq/mL) and background (2.82 kBq/mL).…”

“…Another study reviewing PET/CT scans of 210 patients, including 36 whole‐body scans, found that CT contributed 69% of the effective dose of these whole‐body protocols 21 . Given the substantial contribution of CT to the overall radiation exposure in whole‐body PET/CT, the radiation dose incurred by CT is a serious issue, especially considering the importance of survival rate among younger patients 22 . Therefore, many studies investigated the possibility of ultra‐low dose CT in whole‐body PET/CT scans, or even many CT‐less attenuation correction methods 23,24 .…”

“…21 Given the substantial contribution of CT to the overall radiation exposure in whole-body PET/CT, the radiation dose incurred by CT is a serious issue, especially considering the importance of survival rate among younger patients. 22 Therefore, many studies investigated the possibility of ultra-low dose CT in whole-body PET/CT scans, or even many CT-less attenuation correction methods. 23,24 Prieto et al 5 investigated the effects of ultra-low dose whole-body CT for attenuation correction in a dual tracer PET/CT protocol.…”

Internal dose assessment of lymphoma 18F-FDG Positron Emission Tomography (PET) scan

“…This notion has been corroborated by Andersson et al [5], who developed a model to estimate radiation dose that includes the biokinetic behavior of radionuclides and the anatomical structure of the human body. To guarantee that patients are exposed to the necessary radiation dose, it is imperative to conduct regular internal dose assessments [20]. Nevertheless, there is limited research exploring the internal dose assessment in cancer patients with lymphoma, taking into account both the biokinetic behavior of radionuclides within the body and patient characteristics.…”