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Radiation burden and associated cancer risk for a typical population to be screened for lung cancer with low-dose CT: A phantom study

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To estimate (a) organ doses and organ-specific radiation-induced cancer risk from a single low-dose CT (LDCT) for lung cancer screening (LCS) and (b) the theoretical cumulative risk of radiation-induced cancer for a typical cohort to be subjected to repeated annual LCS LDCT.

Methods

Sex- and body size-specific organ dose data from scan projection radiography (SPR) and helical CT exposures involved in LCS 256-slice LDCT were determined using Monte Carlo methods. Theoretical life attributable risk (LAR) of radiogenic cancer from a single 256-slice chest LDCT at age 55–80 years and the cumulative LAR of cancer from repeated annual LDCT studies up to age 80 years were estimated and compared to corresponding nominal lifetime intrinsic risks (LIRs) of being diagnosed with cancer.

Results

The effective dose from LCS 256-slice LDCT was estimated to be 0.71 mSv. SPR was found to contribute 6–12 % to the total effective dose from chest LDCT. The radiation-cancer LAR from a single LDCT study was found to increase the nominal LIR of cancer in average-size 55-year-old males and females by 0.008 % and 0.018 %, respectively. Cumulative radiogenic risk of cancer from repeated annual scans from the age of 55–80 years was found to increase the nominal LIR of cancer by 0.13 % in males and 0.30 % in females.

Conclusion

Modern scanners may offer sub-millisievert LCS LDCT. Cumulative radiation risk from repeated annual 256-slice LDCT LCS examinations was found to minimally aggravate the lifetime intrinsic cancer risk of a typical screening population.

Key Points

• Effective dose from lung cancer screening low-dose CT may be <1 mSv.

• Screening with modern low-dose CT minimally aggravates lifetime cancer induction intrinsic risk.

• Dosimetry of lung cancer screening low-dose CT should encounter the radiation burden from the localizing scan projection radiography.

• DLP method may underestimate effective dose from low-dose chest CT by 27 %.

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Abbreviations

BMI:

Body mass index

CTDI:

Computed tomography dose index

DLP:

Dose-length product

ICRP:

International Commission on Radiological Protection

L:

Lateral

LAR:

Life-attributable risk

LCS:

Lung cancer screening

LDCT:

Low-dose CT

LIR:

Life intrinsic risk

P:

Posterior-anterior

SPR:

Scan projection radiograph

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Medical Physics, Medical School, University of Crete, P.O. Box 2208, Heraklion, 71003, Crete, Greece

    Kostas Perisinakis & John Damilakis

  2. Medical Diagnostic Center ‘Ayios Therissos’, P.O. Box 28405, 2033, Nicosia, Cyprus

    Ioannis Seimenis

  3. Department of Medical Physics, Medical School, Democritus University of Thrace, Panepistimioupolis, Dragana, 68100, Alexandroupolis, Greece

    Ioannis Seimenis

  4. Department of Medical Physics, University Hospital of Heraklion, P.O. Box 1352, Heraklion, 71110, Crete, Greece

    Antonis Tzedakis

  5. Department of Radiology, Medical School, University of Crete, P.O. Box 2208, Heraklion, 71003, Crete, Greece

    Apostolos Karantanas

Authors
  1. Kostas Perisinakis
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  2. Ioannis Seimenis
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  4. Apostolos Karantanas
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  5. John Damilakis
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Correspondence to Kostas Perisinakis.

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The scientific guarantor of this publication is Kostas Perisinakis.

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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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No complex statistical methods were necessary for this paper.

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Written informed consent was not required since the study was not on human subjects

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Perisinakis, K., Seimenis, I., Tzedakis, A. et al. Radiation burden and associated cancer risk for a typical population to be screened for lung cancer with low-dose CT: A phantom study. Eur Radiol 28, 4370–4378 (2018). https://doi.org/10.1007/s00330-018-5373-7

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  • DOI: https://doi.org/10.1007/s00330-018-5373-7

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