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Joanne C. Wen, Victor Sai, Bradley R. Straatsma, Tara A. McCannel; Estimation Of Cancer Risk Associated With Metastatic Surveillance Imaging For Choroidal Melanoma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3419.
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To estimate the lifetime attributable risk (LAR) of cancer incidence associated with whole-body fluorine 18 (18F)-fluorodeoxyglucose (FDG) positron emission tomographic (PET)/computerized tomography (CT) in the surveillance for choroidal melanoma metastases.
Organ doses from whole-body PET/CT studies of standardized male and female phantoms were estimated using a combination of Monte Carlo simulation methods and by multiplying the 18F-FDG radioactivity (370 MBq) with dose coefficients. Lifetime attributable risks of cancer incidence were calculated using the approach described in the Biological Effects of Ionizing Radiation VII Report.
The effective dose of a whole-body PET/CT scan was estimated to be 24.05 mSv per scan. In a 50-year-old patient, an annual PET/CT each year for 5 years carries a lifetime risk of cancer of 0.6% for men and 0.8% for women. This risk increases to 1.3% and 1.6% for men and women respectively if this annual protocol is continued for 10 years. If the frequency of surveillance is increased to every 6 months and continued for 10 years, the lifetime risk further increases to 2.6% and 3.2% for men and women respectively. The risk was found to be higher in patients diagnosed at a younger age and in female patients. The lifetime risk of cancer was estimated to be as high as 4.7% for a 30-year-old female receiving a PET/CT scan every 6 months for 10 years.
Whole-body PET/CT imaging in choroidal melanoma surveillance is associated with a nonnegligible lifetime risk of cancer. These risks should be considered when counseling patients with choroidal melanoma.
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