Radiation risk estimates after radiotherapy: application of the organ equivalent dose concept to plateau dose–response relationships

AbstractInverse associations between dairy consumption and CVD have been reported in several epidemiological studies. Our objective was to conduct a meta-analysis of prospective cohort studies of dairy intake and CVD. A comprehensive literature search was conducted to identify studies that reported risk estimates for total dairy intake, individual dairy products, low/full-fat dairy intake, Ca from dairy sources and CVD, CHD and stroke. Random-effects meta-analyses were used to generate summary relative risk estimates (SRRE) for high v. low intake and stratified intake dose–response analyses. Additional dose–response analyses were performed. Heterogeneity was examined in sub-group and sensitivity analyses. In total, thirty-one unique cohort studies were identified and included in the meta-analysis. Several statistically significant SRRE below 1.0 were observed, namely for total dairy intake and stroke (SRRE=0·91; 95 % CI 0·83, 0·99), cheese intake and CHD (SRRE=0·82; 95 % CI 0·72, 0·93) and stroke (SRRE=0·87; 95 % CI 0·77, 0·99), and Ca from dairy sources and stroke (SRRE=0·69; 95 % CI 0·60, 0·81). However, there was little evidence for inverse dose–response relationships between the dairy variables and CHD and stroke after adjusting for within-study covariance. The results of this meta-analysis of prospective cohort studies have shown that dairy consumption may be associated with reduced risks of CVD, although additional data are needed to more comprehensively examine potential dose–response patterns.

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Dose-responses for mortality from cerebrovascular and heart diseases in atomic bomb survivors: 1950–2003

Radiation and Environmental Biophysics ◽

10.1007/s00411-017-0722-5 ◽

2017 ◽

Vol 57 (1) ◽

pp. 17-29 ◽

Cited By ~ 8

Author(s):

Helmut Schöllnberger ◽

Markus Eidemüller ◽

Harry M. Cullings ◽

Cristoforo Simonetto ◽

Frauke Neff ◽

...

Keyword(s):

Dose Response ◽

Atomic Bomb ◽

Heart Diseases ◽

Threshold Model ◽

Accurate Determination ◽

Radiation Risk ◽

Response Curves ◽

Response Models ◽

Atomic Bomb Survivors ◽

Lnt Model

Abstract The scientific community faces important discussions on the validity of the linear no-threshold (LNT) model for radiation-associated cardiovascular diseases at low and moderate doses. In the present study, mortalities from cerebrovascular diseases (CeVD) and heart diseases from the latest data on atomic bomb survivors were analyzed. The analysis was performed with several radio-biologically motivated linear and nonlinear dose–response models. For each detrimental health outcome one set of models was identified that all fitted the data about equally well. This set was used for multi-model inference (MMI), a statistical method of superposing different models to allow risk estimates to be based on several plausible dose–response models rather than just relying on a single model of choice. MMI provides a more accurate determination of the dose response and a more comprehensive characterization of uncertainties. It was found that for CeVD, the dose–response curve from MMI is located below the linear no-threshold model at low and medium doses (0–1.4 Gy). At higher doses MMI predicts a higher risk compared to the LNT model. A sublinear dose–response was also found for heart diseases (0–3 Gy). The analyses provide no conclusive answer to the question whether there is a radiation risk below 0.75 Gy for CeVD and 2.6 Gy for heart diseases. MMI suggests that the dose–response curves for CeVD and heart diseases in the Lifespan Study are sublinear at low and moderate doses. This has relevance for radiotherapy treatment planning and for international radiation protection practices in general.

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Recent reassessments of radiation risk estimates: Implications for radiation protection

Progress in Nuclear Energy ◽

10.1016/0149-1970(90)90006-q ◽

1990 ◽

Vol 23 (2) ◽

pp. 95-99 ◽

Cited By ~ 1

Author(s):

Roger H. Clarke

Keyword(s):

Radiation Protection ◽

Radiation Risk ◽

Risk Estimates

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Radiation Doses and Risks in Breast Screening

Journal of Breast Imaging ◽

10.1093/jbi/wbaa016 ◽

2020 ◽

Vol 2 (3) ◽

pp. 188-200 ◽

Cited By ~ 6

Author(s):

R Edward Hendrick

Keyword(s):

Cancer Detection ◽

Breast Imaging ◽

Radiation Risk ◽

Digital Breast Tomosynthesis ◽

Radiation Doses ◽

Cancer Risks ◽

Detection Rates ◽

Molecular Breast Imaging ◽

Risk Estimates ◽

Efficient Detection

Abstract This article describes radiation doses and cancer risks of digital breast imaging technologies used for breast cancer detection. These include digital mammography (DM), digital breast tomosynthesis (DBT), and newer technologies such as contrast-enhanced digital or spectral mammography (CEM), whole-breast computed tomography, breast-specific gamma imaging (BSGI), molecular breast imaging (MBI), and positron emission mammography (PEM). This article describes the basis for radiation risk estimates, compares radiation doses and risks, and provides benefit-to-radiation-risk ratios for different breast imaging modalities that use ionizing radiation. Current x-ray–based screening modalities such as DM and DBT have small to negligible risks of causing radiation-induced cancers in women of normal screening age. Possible new screening modalities such as CEM have similar small cancer risks. Potential screening modalities that involve radionuclide injection such as BSGI, MBI, and PEM have significantly higher cancer risks unless efficient detection systems and reduced administered doses are used. Benefit-to-radiation-risk estimates are highly favorable for screening with DM and other modalities having comparable (or higher) cancer detection rates and comparably low radiation doses.

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