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Radiation exposure from diagnostic imaging in young patients with testicular cancer

Sullivan, C. ; Murphy, K. ; McLaughlin, P. ; Twomey, M. ; O’Regan, K. ; Power, D. ; Maher, M. ; O’Connor, O.

European Radiology, 2015, Vol.25(4), pp.1005-1013 [Peer Reviewed Journal]

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  • Title:
    Radiation exposure from diagnostic imaging in young patients with testicular cancer
  • Author/Creator: Sullivan, C. ; Murphy, K. ; McLaughlin, P. ; Twomey, M. ; O’Regan, K. ; Power, D. ; Maher, M. ; O’Connor, O.
  • Language: English
  • Subjects: Testicular cancer ; Radiation dose ; Computed tomography ; Surveillance ; Imaging
  • Is Part Of: European Radiology, 2015, Vol.25(4), pp.1005-1013
  • Description: Byline: C. J. Sullivan (1), K. P. Murphy (1,2), P. D. McLaughlin (1,3), M. Twomey (1), K. N. O'Regan (1), D. G. Power (4), M. M. Maher (1,2), O. J. O'Connor (1,2) Keywords: Testicular cancer; Radiation dose; Computed tomography; Surveillance; Imaging Abstract: Objectives Risks associated with high cumulative effective dose (CED) from radiation are greater when imaging is performed on younger patients. Testicular cancer affects young patients and has a good prognosis. Regular imaging is standard for follow-up. This study quantifies CED from diagnostic imaging in these patients. Methods Radiological imaging of patients aged 18-39 years, diagnosed with testicular cancer between 2001 and 2011 in two tertiary care centres was examined. Age at diagnosis, cancer type, dose-length product (DLP), imaging type, and frequency were recorded. CED was calculated from DLP using conversion factors. Statistical analysis was performed with SPSS. Results In total, 120 patients with a mean age of 30.7[+ or -]5.2 years at diagnosis had 1,410 radiological investigations. Median (IQR) surveillance was 4.37 years (2.0--5.5). Median (IQR) CED was 125.1 mSv (81.3-177.5). Computed tomography accounted for 65.3 % of imaging studies and 98.3 % of CED. We found that 77.5 % (93/120) of patients received high CED (>75 mSv). Surveillance time was associated with high CED (OR 2.1, CI 1.5-2.8). Conclusions Survivors of testicular cancer frequently receive high CED from diagnostic imaging, mainly CT. Dose management software for accurate real-time monitoring of CED and low-dose CT protocols with maintained image quality should be used by specialist centres for surveillance imaging. Key points acents CT accounted for 98.3 % of CED in patients with testicular cancer. acents Median CED in patients with testicular cancer was 125.1 mSv acents High CED (>75 mSv) was observed in 77.5 % (93/120) of patients. acents Dose tracking and development of low-dose CT protocols are recommended. Author Affiliation: (1) Department of Radiology, Cork and Mercy University Hospitals, Wilton, Cork, Ireland (2) Department of Radiology, University College Cork, Cork, Ireland (3) Department of Emergency and Trauma Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada (4) Department of Medical Oncology, Cork and Mercy University Hospitals, Cork, Ireland Article History: Registration Date: 13/11/2014 Received Date: 16/06/2014 Accepted Date: 13/11/2014 Online Date: 13/12/2014 Article note: Electronic supplementary material The online version of this article (doi: 10.1007/s00330-014-3507-0) contains supplementary material, which is available to authorized users.
  • Identifier: ISSN: 0938-7994 ; E-ISSN: 1432-1084 ; DOI: 10.1007/s00330-014-3507-0