title: Radiation-related cancer risk associated with surveillance imaging for metastasis from choroidal melanoma.
abstract: OBJECTIVE
  To estimate the lifetime attributable risk of cancer associated with whole-body positron emission tomography (PET)/computed tomography (CT) and with CT of the chest, abdomen, and pelvis if performed at various frequencies and for different durations for surveillance of patients with primary choroidal or ciliary body melanoma for distant metastasis.
  
  
  METHODS
  Effective radiation doses for whole-body CT and for CT of the chest, abdomen, and pelvis were calculated using Monte Carlo simulation studies. The effective dose of the PET scan was estimated by multiplying fludeoxyglucose F18 radioactivity with dose coefficients. Lifetime attributable risks of cancer were calculated using the approach described in the Biological Effects of Ionizing Radiation VII report.
  
  
  RESULTS
  For a 50-year-old patient, an annual CT of the chest, abdomen, and pelvis for 10 years carries an estimated lifetime attributable risk of cancer of 0.9% for male patients and 1.3% for female patients, whereas an annual PET/CT each year for 10 years carries an estimated lifetime attributable risk of cancer of 1.6% for male patients and 1.9% for female patients. Lifetime risk was found to be higher in younger, female patients. The lifetime attributable risk of cancer was estimated to be as high as 7.9% for a 20-year-old female patient receiving a PET/CT scan every 6 months for 10 years.
  
  
  CONCLUSIONS
  Aggressive surveillance protocols incorporating CT scanning or PET/CT scanning for detection of metastasis from primary choroidal or ciliary body melanoma appear to confer a significant substantial risk of a secondary malignant tumor in patients who do not succumb to metastatic melanoma within the first few posttreatment years.
authors.affiliation: Jules Stein Eye Institute, University of California, Los Angeles, CA 90095-7000, USA.
authors.forename: Joanne C
authors.initials: JC
authors.lastname: Wen
authors.forename: Victor
authors.initials: V
authors.lastname: Sai
authors.forename: Bradley R
authors.initials: BR
authors.lastname: Straatsma
authors.forename: Tara A
authors.initials: TA
authors.lastname: McCannel
mesh_terms: D000328:Adult; D000368:Aged; D001822:Body Burden; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D062665:Epidemiological Monitoring; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000556:secondary; D008875:Middle Aged; D009010:Monte Carlo Method; D064847:Multimodal Imaging / Q000009:adverse effects*; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D049268:Positron-Emission Tomography; D011829:Radiation Dosage; D011874:Radiometry / Q000379:methods; D019275:Radiopharmaceuticals; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects; D051598:Whole Body Imaging; D014916:Whole-Body Irradiation; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18