title: Diagnostic radiation exposure risk in a contemporary cohort of male patients with germ cell tumor.
abstract: OBJECTIVE
  We determined the total amount of diagnostic radiation that a patient with testicular cancer receives during the course of treatment and the associated risk of secondary malignancy.
  
  
  METHODS
  At a single institution 119 men with seminomatous and nonseminomatous germ cell tumors of the testis were retrospectively identified. Annual and lifetime exposure to radiation was determined for each histological subtype. Values were assessed for compliance with International Commission of Radiological Protection guidelines.
  
  
  RESULTS
  The cohorts included 55 patients with seminomatous and 64 with nonseminomatous germ cell tumor. Between the groups no difference was found in the lifetime (215.5 and 214.1 mSV, p = 0.96) or the annual (104.6 and 104.6 mSV, respectively, p = 1.0) radiation dose. Of the 41 patients with more than 5-year followup 32 (78%) were in violation of guidelines by exceeding 20 mSV per year of radiation. Also, 74 patients (61.7%) received 50 mSV or greater of radiation during a 1-year period. Using the previously calculated excess relative risk for solid cancer and leukemia, excluding chronic lymphocytic leukemia, the RR was 1.06 and 1.33, [corrected] respectively, with a 2.1% lifetime risk of fatal cancer over the baseline risk.
  
  
  CONCLUSIONS
  At a tertiary care center with experience with managing testicular cancer 78% of patients with more than 5 years of followup exceeded current national and standard safety limits for radiation exposure. Imaging should be done judiciously in this population at high risk for radiation overexposure.
authors.affiliation: Department of Urology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Mark V
authors.initials: MV
authors.lastname: Silva
authors.forename: Piruz
authors.initials: P
authors.lastname: Motamedinia
authors.forename: Gina M
authors.initials: GM
authors.lastname: Badalato
authors.forename: Gregory
authors.initials: G
authors.lastname: Hruby
authors.forename: James M
authors.initials: JM
authors.lastname: McKiernan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000000981:diagnostic imaging*; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D011829:Radiation Dosage; D011859:Radiography; D012189:Retrospective Studies; D012306:Risk; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging*; D055815:Young Adult