title: Radiation exposure and mortality risk from CT and PET imaging of patients with malignant lymphoma.
abstract: OBJECTIVE
  To quantify radiation exposure and mortality risk from computed tomography (CT) and positron emission tomography (PET) imaging with (18)F-fluorodeoxyglucose ((18)F-FDG) in patients with malignant lymphoma (Hodgkin's disease [HD] or non-Hodgkin's lymphoma [NHL]).
  
  
  METHODS
  First, organ doses were assessed for a typical diagnostic work-up in children with HD and adults with NHL. Subsequently, life tables were constructed for assessment of radiation risks, also taking into account the disease-related mortality.
  
  
  RESULTS
  In children with HD, cumulative effective dose from medical imaging ranged from 66 mSv (newborn) to 113 mSv (15 years old). In adults with NHL the cumulative effective dose from medical imaging was 97 mSv. Average fractions of radiation-induced deaths for children with HD [without correction for disease-related mortality in brackets] were 0.4% [0.6%] for boys and 0.7% [1.1%] for girls, and for adults with NHL 0.07% [0.28%] for men and 0.09% [0.37%] for women.
  
  
  CONCLUSIONS
  Taking into account the disease-related reduction in life expectancy of patients with malignant lymphoma results in a higher overall mortality but substantial lower incidence of radiation induced deaths. The modest radiation risk that results from imaging with CT and (18)F-FDG PET can be considered as justified, but imaging should be performed with care, especially in children.
authors.affiliation: Department of Radiology (E 01.132), University Medical Center, P.O. Box 85500, 3508 CX, Utrecht, The Netherlands. r.a.j.nievelstein@umcutrecht.nl
authors.forename: R A J
authors.initials: RA
authors.lastname: Nievelstein
authors.forename: H M E
authors.initials: HM
authors.lastname: Quarles van Ufford
authors.forename: T C
authors.initials: TC
authors.lastname: Kwee
authors.forename: M B
authors.initials: MB
authors.lastname: Bierings
authors.forename: I
authors.initials: I
authors.lastname: Ludwig
authors.forename: F J A
authors.initials: FJ
authors.lastname: Beek
authors.forename: J M H
authors.initials: JM
authors.lastname: de Klerk
authors.forename: W P Th M
authors.initials: WP
authors.lastname: Mali
authors.forename: P W
authors.initials: PW
authors.lastname: de Bruin
authors.forename: J
authors.initials: J
authors.lastname: Geleijns
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008017:Life Expectancy; D015993:Life Tables; D008223:Lymphoma / Q000175:diagnosis* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D049268:Positron-Emission Tomography / Q000401:mortality*; D016016:Proportional Hazards Models; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000401:mortality; D011874:Radiometry / Q000706:statistics & numerical data*; D018570:Risk Assessment; D016019:Survival Analysis; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000401:mortality*; D055815:Young Adult