Potential risks of cardiovascular and cerebrovascular disease and cancer from cumulative doses received from diagnostic CT scans

Abstract Background and Objectives: Positron tomission tomography using 18fluoro-2-deoxyglucose in combination with low dose non-enhanced computed tomography (FDG-PET/CT) is increasingly utilized in the management of patients with lymphoma. Numerous studies have demonstrated improved accuracy for both staging and restaging as compared to standard diagnostic CT. However, there is a paucity of data on the significance of bone uptake in patients with lymphoma. This is one area in which FDG-PET has the potential to dramatically influence care of lymphoma patients. However, false positive FDG-PET has been shown in patients with traumatic or benign bone lesions. The aim of this study was to evaluate the utility and accuracy of FDG-PET/CT in comparison with standard anatomic imaging with CT and MRI in the staging and follow up of patients with Hodgkin lymphoma (HL) or diffuse large B cell lymphoma (DLBCL). Design and Methods: We reviewed a database of 75 lymphoma patients who underwent concurrent FDG-PET/CT and standard diagnostic CT scans or MRI, and identified those with bone involvement by lymphoma. Involvement of bone was demonstrated by either biopsy of a bone lesion or radiologic appearance and clinical follow up highly suggestive of bone involvement. Follow up studies were evaluated for resolution of FDG avid lesions on PET, and anatomic lesions on CT or MRI. Results: Fourteen patients with either HL or DLBCL who underwent both FDG-PET/CT and diagnostic CT were identified to have bone involvement by lymphoma. FDG-PET identified bone involvement in all 14 patients, whereas CT imaging identified bone involvement in seven. One patient in whom CT did not detect bone involvement had evidence of bone lymphoma by MRI. Eight patients had confirmation of bone lymphoma by biopsy, while 6 were confirmed by clinical criteria (radiologic appearance and clinical follow up). Thirteen of the patients had follow up FDG-PET/CT scans, and 12 had follow up CT and/or MRI. All follow up FDG-PET scans showed resolution of FDG avid bone lesions after anti-lymphoma therapy. In contrast, all CT and MRI scans which originally showed evidence of bone involvement had persistent abnormality on follow up, with only 2 showing improvement. At a median follow up of 9 months (range 0–20 months), 11 patients remain in remission, while 2 patients subsequently showed progression by FDG-PET, CT and biopsy in soft tissue sites, but not bone. One patient remains on therapy. No patient in our series was found to have a benign etiology of a lesion initially thought due to lymphoma. Conclusion: FDG-PET/CT is useful in the staging and follow up of patients with lymphoma with bone involvement. The lack of sensitivity of CT combined with the delayed resolution of anatomic abnormalities limit the utility of standard anatomic imaging, making FDG-PET/CT the imaging modality of choice for patients with bone lymphoma.

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A prospective study of incidental breast lesions detected on diagnostic CT scans

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2010.08.055 ◽

2010 ◽

Vol 36 (11) ◽

pp. 1120

Author(s):

Asad Parvaiz ◽

I. King ◽

R. McCollouch ◽

V. Dewan ◽

C. Deacon ◽

...

Keyword(s):

Prospective Study ◽

Ct Scans ◽

Breast Lesions ◽

A Prospective Study ◽

Diagnostic Ct

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Persistent DNA Double-Strand Breaks After Repeated Diagnostic CT Scans in Breast Epithelial Cells and Lymphocytes

Frontiers in Oncology ◽

10.3389/fonc.2021.634389 ◽

2021 ◽

Vol 11 ◽

Author(s):

Natalia V. Bogdanova ◽

Nina Jguburia ◽

Dhanya Ramachandran ◽

Nora Nischik ◽

Katharina Stemwedel ◽

...

Keyword(s):

Dna Damage ◽

Dna Damage Repair ◽

Cell Types ◽

Strand Break ◽

Ct Scans ◽

Breast Epithelial Cell ◽

Damage Repair ◽

Breast Epithelial ◽

The Impact ◽

Diagnostic Ct

DNA double-strand break (DSB) induction and repair have been widely studied in radiation therapy (RT); however little is known about the impact of very low exposures from repeated computed tomography (CT) scans for the efficiency of repair. In our current study, DSB repair and kinetics were investigated in side-by-side comparison of RT treatment (2 Gy) with repeated diagnostic CT scans (≤20 mGy) in human breast epithelial cell lines and lymphoblastoid cells harboring different mutations in known DNA damage repair proteins. Immunocytochemical analysis of well known DSB markers γH2AX and 53BP1, within 48 h after each treatment, revealed highly correlated numbers of foci and similar appearance/disappearance profiles. The levels of γH2AX and 53BP1 foci after CT scans were up to 30% of those occurring 0.5 h after 2 Gy irradiation. The DNA damage repair after diagnostic CT scans was monitored and quantitatively assessed by both γH2AX and 53BP1 foci in different cell types. Subsequent diagnostic CT scans in 6 and/or 12 weeks intervals resulted in elevated background levels of repair foci, more pronounced in cells that were prone to genomic instability due to mutations in known regulators of DNA damage response (DDR). The levels of persistent foci remained enhanced for up to 6 months. This “memory effect” may reflect a radiation-induced long-term response of cells after low-dose x-ray exposure.

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Trends of Computed Tomography Scan Usage among Adults and Children in Yazd Province, Iran, before the Outbreak of COVID-19

Frontiers in Biomedical Technologies ◽

10.18502/fbt.v8i4.7752 ◽

2021 ◽

Author(s):

Ghazale Perota ◽

Hamidreza Masjedi ◽

Hamed Zamani ◽

Saman Dalvand ◽

Reza Omidi ◽

...

Keyword(s):

Computed Tomography ◽

Ct Scans ◽

Annual Growth Rate ◽

Compound Annual Growth Rate ◽

Area Of Interest ◽

Adults And Children ◽

Potential Risks ◽

Risk Of Cancer ◽

Average Contribution ◽

Head Neck

Purpose: Excessive use of Computed Tomography (CT) has become a worrying issue due to the potential risks resulting from radiation exposure. This study was carried out to investigate trends in CT usage in Yazd Province, Iran. Materials and Methods: In the current study, patients were categorized according to their sex and age into two general groups, pediatrics (<18 years old) and adults (≥18 years old), each group falling into multiple subcategories. The performed CT scans were classified into six categories, based on the anatomical area of interest, including head/neck, chest, spine, abdomen-pelvis, extremities, and CT angiography (CTA). The data were collected from 2015 to 2018. Results: The mean number of CT scans increased by the Compound Annual Growth Rate (CAGR) of 11%. Across the procedures, head/neck (with an average contribution of 52% to all CT scans) was the most frequently examined region, whereas CTA had the lowest percentage (2%). More than half of the scans are performed on people over the age of 90, and among those aged<18 years old the most CT scan rates are related to 13-18-year-olds. Conclusion: The number of CT examinations is clearly increasing in Yazd Province. Some of this increase may be warranted because of the improvements in the diagnostic power of CT. The estimated number of pediatric CT scans has risen more than past. Due to the risk of cancer, efforts should be made to reduce unnecessary CT scans.

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