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Neuroembolization may expose patients to radiation doses previously linked to tumor induction

  • Clinical Article
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An Erratum to this article was published on 02 March 2012

Abstract

Objective

Epidemiological studies indicate a link between low-dose irradiation (<10,000 mGy) to the head and the local occurrence of tumors after decades of delay. Comparable radiation doses can be reached during neuro-endovascular procedures (NEP), but the incidence of similar exposures has not been completely delineated. We compared the levels of radiation to the head measured during NEP to those reported for patients developing radiation-induced cancers.

Methods

In our prospective study we determined the cumulative maximum entrance skin doses (MESD) and the incidence of epilation in 107 consecutive patients submitted to NEP between 2003 and 2007. We also extensively searched the literature and compared our results with the data we found.

Results

The cumulative MESD due to NEP was above 3,000 mGy (range 3,101–5,421 mGy) in 18 patients. In 22 we observed partial epilation within 10 weeks from the initial NEP. Sixty cases of epilation after NEP have been previously reported in the literature. The average of the reported MESD was 4,241 mGy (range 2,000–6,640 mGy).

Conclusion

Physical dosimetry and the incidence of partial epilation indicate that about one fifth of the patients submitted to NEP received radiation doses comparable to those linked to the occurrence of tumors. The potential risks of developing tumors after a long delay, when compared to the immediate benefits of endovascular treatment of aneurysm and arteriovenous malformations (AVM) of the brain, do not counterindicate NEP, but increased awareness of the risk should help physicians and patients to make a fully informed decision when other treatments are available.

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Acknowledgments

We thank Dr. Eloisa Arbustini, Dr. Gabriele Biella, Dr. Roberto Imberti, and Dr. Marco Marchionni for useful suggestions and corrections. We thank the participating patients and their families; this study would not have been possible without their cooperation.

Conflicts of interest

None.

Funding

This study was supported by Fondazione IRCCS Policlinico S. Matteo (Pavia, Italy) with funds awarded for intramural studies.

Author information

Authors and Affiliations

  1. Department of Surgical Sciences, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Via le Golgi 19, Pavia, Italy

    Lorenzo Magrassi, Daniele Bongetta & Cesare Arienta

  2. Department of Medical Physics, IRCCS Fondazione Policlinico S. Matteo, Pavia, Italy

    Loredana D’Ercole & Francesco Lisciandro

  3. Departmet of Radiology, IRCCS Fondazione Policlinico S. Matteo, Pavia, Italy

    Federico Zappoli Thyrion

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  1. Lorenzo Magrassi
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  2. Daniele Bongetta
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  3. Loredana D’Ercole
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  5. Cesare Arienta
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  6. Federico Zappoli Thyrion
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Correspondence to Lorenzo Magrassi.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s00701-012-1280-x.

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Magrassi, L., Bongetta, D., D’Ercole, L. et al. Neuroembolization may expose patients to radiation doses previously linked to tumor induction. Acta Neurochir 154, 33–41 (2012). https://doi.org/10.1007/s00701-011-1209-9

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  • DOI: https://doi.org/10.1007/s00701-011-1209-9

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