What do recent epidemiological studies tell us about the risk of cancer from radiation doses typical of diagnostic radiography?

Harbron, Richard W

doi:10.1016/j.radi.2016.08.007

Cited by 12 publications

(8 citation statements)

References 92 publications

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“…X-ray radiation has dose-dependent adverse effects that lead to an increased risk of developing cancer [ 3 ]. The cumulative risk of cancer, related to the diagnostic use of x-rays, is estimated to be 1.2% by the age of 75, which translates to approximately 77 new cases of cancer per year in Norway [ 4 , 5 ]. It is, therefore, the responsibility of the referring clinician to determine whether it is appropriate for a patient to undergo x-ray examinations, given the expected risks involved [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Awareness and knowledge of radiation dose and associated risks among final year medical students in Norway

Kada

2017

Insights Imaging

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ObjectivesThe objective was to assess the knowledge of radiation dose and of the associated risks with ionising imaging examinations of medical students in their final year of training prior to graduating.MethodsAn online questionnaire was sent to all final year medical students from two universities. The questionnaire consisted of radiation dose and risk related questions, with multiple choices, only one of these choices was the correct answer. A ‘correct’ answer was given one mark and no mark was given for ‘incorrect/do not know’ answers. The total mean score ranged from 0 to 11, with higher scores representing greater knowledge about radiation doses and the associated risks.ResultsNinety-nine students completed and returned the questionnaire yielding a response rate of 45%. The total mean score was 3.91 out of possible 11. Only eighteen students scored more than five points (50%). Students who reported moderate confidence in their knowledge about radiation dose and risks, scored significantly higher than students who reported no confidence (p = 0.003). There was a moderate positive correlation between students that reported moderate confidence and radiation knowledge scores (rho = .301, p = .002).ConclusionOverall medical students’ knowledge of radiation dose and the risks associated with ionising imaging examinations was reported to be low.Main messages• Medical students’ knowledge about radiation and associated risk is poor • Students are not aware of radiation doses for common radiological procedures • The majority of students underestimated radiation doses for specific examinations • Students with confidence reported greater knowledge than students with no confidence

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Section: Introductionmentioning

confidence: 99%

Awareness and knowledge of radiation dose and associated risks among final year medical students in Norway

Kada

2017

Insights Imaging

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“…Vendors of imaging equipment strive to provide technical innovations to reduce patient exposure while maintaining or even increasing image quality . The results of recent large epidemiological studies are partly in support of the linear cancer incidence models, with a proportionality between exposure and incidence, albeit the uncertainty at low exposures makes the usefulness of the results limited in diagnostic radiology …”

Section: Introductionmentioning

confidence: 93%

“…8 The results of recent large epidemiological studies are partly in support of the linear cancer incidence models, with a proportionality between exposure and incidence, albeit the uncertainty at low exposures makes the usefulness of the results limited in diagnostic radiology. 9,10 Computed tomography (CT) is a rapidly increasing examination method 11 with large contributions to the radiation exposure of the population in diagnostic radiology, in Sweden between 50% and 80% 12 of the annual dose, and an average increase in the number of CT scanners per inhabitant by 31% between 2010 and 2015 in the EC countries. 13 As imaging technology evolves, the process of radiation dose management should evolve and accommodate accurate 14 and individualized 15 calculations of organ doses, 4 which will remain the basic quantity for estimates of radiation-induced cancer risks.…”

Section: Introductionmentioning

confidence: 99%

Toward automated and personalized organ dose determination in CT examinations — A comparison of two tissue characterization models for Monte Carlo organ dose calculation with a Therapy Planning System

2019

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Purpose Computed tomography (CT) is a versatile tool in diagnostic radiology with rapidly increasing number of examinations per year globally. Routine adaption of the exposure level for patient anatomy and examination protocol cause the patients' exposures to become diversified and harder to predict by simple methods. To facilitate individualized organ dose estimates, we explore the possibility to automate organ dose calculations using a radiotherapy treatment planning system (TPS). In particular, the mapping of CT number to elemental composition for Monte Carlo (MC) dose calculations is investigated. Methods Organ dose calculations were done for a female thorax examination test case with a TPS (Raystation™, Raysearch Laboratories AB, Stockholm, Sweden) utilizing a MC dose engine with a CT source model presented in a previous study. The TPS's inherent tissue characterization model for mapping of CT number to elemental composition of the tissues was calibrated using a phantom with known elemental compositions and validated through comparison of MC calculated dose with dose measured with Thermo Luminescence Dosimeters (TLD) in an anthropomorphic phantom. Given the segmentation tools of the TPS, organ segmentation strategies suitable for automation were analyzed for high contrast organs, utilizing CT number thresholding and model‐based segmentation, and for low contrast organs utilizing water replacements in larger tissue volumes. Organ doses calculated with a selection of organ segmentation methods in combination with mapping of CT numbers to elemental composition (RT model), normally used in radiotherapy, were compared to a tissue characterization model with organ segmentation and elemental compositions defined by replacement materials [International Commission on Radiological Protection (ICRP) model], frequently favored in imaging dosimetry. Results The results of the validation with the anthropomorphic phantom yielded mean deviations from the dose to water calculated with the RT and ICRP model as measured with TLD of 1.1% and 1.5% with maximum deviations of 6.1% and 8.7% respectively over all locations in the phantom. A strategy for automated organ segmentation was evaluated for two different risk organ groups, that is, low contrast soft organs and high contrast organs. The relative deviation between organ doses calculated with the RT model and with the ICRP model varied between 0% and 20% for the thorax/upper abdomen risk organs. Conclusions After calibration, the RT model in the TPS provides accurate MC dose results as compared to measurements with TLD and the ICRP model. Dosimetric feasible segmentation of the risk organs for a female thorax demonstrates a possibility for automation using the segmentation tool available in a TPS for high contrast organs. Low contrast soft organs can be represented by water volumes, but organ dose to the esophagus and thyroid must be determined using standardized organ shapes. The uncertainties of the organ doses are small compared to the overall uncertainty, at least an order...

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“…Work completed includes collection and, importantly, dissemination to the scientific and wider community of evidence to demonstrate that risks associated with having medical x rays as part of certain types of investigations are very small and are likely to be significantly outweighed by the benefits of carrying out the medical procedures. For example, epidemiologists at the University of Newcastle have increased the size of the UK CT scan study cohort to over 450,000 individuals (Bernier et al, 2019), which has provided a sufficiently large population for the Radiation Theme partners to investigate how computed tomography (CT) risks might be modified by underlying health conditions (Harbron, 2016) or other confounders (e.g. transplantation status) (Harbron et al, 2018a), together with improved dose assessment (Harbron et al, 2016) and overall risk of cancers (Journy et al, 2016(Journy et al, , 2017Harbron et al, 2017aHarbron et al, , 2018a for low-dose medically exposed populations.…”

Section: Nihr Hpru Radiation Themementioning

confidence: 99%

The 2019 Bo Lindell Laureate Lecture: On the use of interdisciplinary, stakeholder-driven, radiation protection research in support of medical uses of ionising radiation

Ainsbury

2020

Ann ICRP

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Medical exposures form the largest manmade contributor to total ionising radiation exposure of the UK population. In recent years, new technologies have been developed to improve treatment and prognosis of individuals treated with radiation for diseases such as cancer. However, there is evidence of public, patient, and medical professional concern that radiation protection regulations and practices, as well as understanding of potential long-term adverse health effects of radiation exposure (in the context of other health risks), have not always ‘kept pace’ with technological developments in this field. This is a truly complex, multi-disciplinary problem for the modern world. The ‘Radiation Theme’ of the Public Health England and Newcastle University Health Protection Research Unit on ‘Chemical and Radiation Threats and Hazards’ is addressing this need, with a key focus on a genuinely interdisciplinary approach bringing together world-leading epidemiologists, radiation biologists, clinicians, statisticians, and artists. In addition, the project has a strong grounding in public, patient, and medical professional involvement in research. Similarly, the EU-CONCERT-funded LDLensRad project seeks to understand the mechanisms of action of low-dose ionising radiation in the lens of the eye, and the potential contribution to the development of cataract – in contemporary research, such projects will only be considered successful when they make use of expertise from a variety of fields and when they are able to demonstrate that the outputs are not only of benefit to society, but that society understands and welcomes the benefits. Finally, successful engagement, training, and retention of early career scientists within this field is crucial for sustainability of the research. Herein, the contribution of embedded interdisciplinary working, stakeholder involvement, and training of early career scientists to recent advancements in the field of medical (and wider) radiation protection research is discussed and considered.

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What do recent epidemiological studies tell us about the risk of cancer from radiation doses typical of diagnostic radiography?

Cited by 12 publications

References 92 publications

Awareness and knowledge of radiation dose and associated risks among final year medical students in Norway

Awareness and knowledge of radiation dose and associated risks among final year medical students in Norway

Toward automated and personalized organ dose determination in CT examinations — A comparison of two tissue characterization models for Monte Carlo organ dose calculation with a Therapy Planning System

The 2019 Bo Lindell Laureate Lecture: On the use of interdisciplinary, stakeholder-driven, radiation protection research in support of medical uses of ionising radiation

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