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European Radiology

, Volume 24, Issue 3, pp 649–656 | Cite as

Current knowledge on tumour induction by computed tomography should be carefully used

  • Cristian Candela-JuanEmail author
  • Alegría Montoro
  • Enrique Ruiz-Martínez
  • Juan Ignacio Villaescusa
  • Luis Martí-Bonmatí
Computed Tomography

Abstract

Risks associated to ionising radiation from medical imaging techniques have focused the attention of the medical society and general population. This risk is aimed to determine the probability that a tumour is induced as a result of a computed tomography (CT) examination since it makes nowadays the biggest contribution to the collective dose. Several models of cancer induction have been reported in the literature, with diametrically different implications. This article reviews those models, focusing on the ones used by the scientific community to estimate CT detriments. Current estimates of the probability that a CT examination induces cancer are reported, highlighting its low magnitude (near the background level) and large sources of uncertainty. From this objective review, it is concluded that epidemiological data with more accurate dosimetric estimates are needed. Prediction of the number of tumours that will be induced in population exposed to ionising radiation should be avoided or, if given, it should be accompanied by a realistic evaluation of its uncertainty and of the advantages of CTs. Otherwise they may have a negative impact in both the medical community and the patients. Reducing doses even more is not justified if that compromises clinical image quality in a necessary investigation.

Key Points

• Predictions of radiation-induced cancer should be discussed alongside benefits of imaging.

• Estimates of induced cancers have noticeable uncertainties that should always be highlighted.

• There is controversy about the acceptance of the linear no-threshold model.

• Estimated extra risks of cancer are close to the background level.

• Patients should not be alarmed by potential cancer induction by CT examinations.

Keywords

Radiation risk Induced cancers Computed tomography Risk coefficients Epidemiology 

Abbreviations

ALARA

As low as reasonably achievable

BEIR

Biological Effects of Ionising Radiation

DDREF

Dose and dose-rate reduction factor

ERR

Excess relative risk

ICRP

International Commission on Radiological Protection

LAR

Lifetime attributable risks

LNT

Linear no-threshold

NCRP

National Council on Radiation Protection and Measurements

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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Cristian Candela-Juan
    • 1
    Email author
  • Alegría Montoro
    • 1
    • 2
  • Enrique Ruiz-Martínez
    • 2
    • 3
  • Juan Ignacio Villaescusa
    • 1
    • 2
  • Luis Martí-Bonmatí
    • 2
    • 3
  1. 1.Radioprotection DepartmentLa Fe University and Polytechnic HospitalValenciaSpain
  2. 2.Biomedical Imaging Research Group GIBI230IIS La FeValenciaSpain
  3. 3.Department of RadiologyLa Fe University and Polytechnic HospitalValenciaSpain

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