EXTRAPOLATING RADIATION-INDUCED CANCER RISKS FROM LOW DOSES TO VERY LOW DOSES

2009 ◽  
Vol 97 (5) ◽  
pp. 505-509 ◽  
Author(s):  
David J. Brenner
Author(s):  
Christoph I. Lee

This chapter, found in the radiation exposure from medical imaging section of the book, provides a succinct synopsis of a key study examining advanced imaging utilization trends and radiation-induced cancer risks. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. Results showed that the utilization rates for advanced imaging in a population enrolled in various integrated health systems increased substantially from 1995 to 2010. Given the potential radiation-induced cancer risks associated with advanced imaging, researchers concluded that the clinical benefits of advanced imaging should be quantified to determine the relative risk-benefit ratios of advanced imaging procedures. In addition to outlining the most salient features of the study, a clinical vignette is included in order to provide relevant clinical context.


The Lancet ◽  
1988 ◽  
Vol 331 (8593) ◽  
pp. 1045-1046
Author(s):  
B.E. Lambert

2012 ◽  
Vol 41 (3-4) ◽  
pp. 124-128 ◽  
Author(s):  
D.J. Brenner

The effective dose concept was designed to compare the generic risks of exposure to different radiation fields. More commonly these days, it is used to estimate or compare radiation-induced cancer risks. For various reasons, effective dose represents flawed science: for instance, the tissue-specific weighting factors used to calculate effective dose are a subjective mix of different endpoints; and the marked and differing age and gender dependencies for different health detriment endpoints are not taken into account. This paper suggests that effective dose could be replaced with a new quantity, ‘effective risk’, which, like effective dose, is a weighted sum of equivalent doses to different tissues. Unlike effective dose, where the tissue-dependent weighting factors are a set of generic, subjective committee-defined numbers, the weighting factors for effective risk are simply evaluated tissue-specific lifetime cancer risks per unit equivalent dose. Effective risk, which has the potential to be age and gender specific if desired, would perform the same comparative role as effective dose, be just as easy to estimate, be less prone to misuse, be more directly understandable, and would be based on solid science. An added major advantage is that it gives the users some feel for the actual numerical values of the radiation risks they are trying to control.


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