title: Radiation exposure from diagnostic imaging in young patients with testicular cancer.
abstract: OBJECTIVE
  Risks associated with high cumulative effective dose (CED) from radiation are greater when imaging is performed on younger patients. Testicular cancer affects young patients and has a good prognosis. Regular imaging is standard for follow-up. This study quantifies CED from diagnostic imaging in these patients.
  
  
  METHODS
  Radiological imaging of patients aged 18-39 years, diagnosed with testicular cancer between 2001 and 2011 in two tertiary care centres was examined. Age at diagnosis, cancer type, dose-length product (DLP), imaging type, and frequency were recorded. CED was calculated from DLP using conversion factors. Statistical analysis was performed with SPSS.
  
  
  RESULTS
  In total, 120 patients with a mean age of 30.7 ± 5.2 years at diagnosis had 1,410 radiological investigations. Median (IQR) surveillance was 4.37 years (2.0-5.5). Median (IQR) CED was 125.1 mSv (81.3-177.5). Computed tomography accounted for 65.3 % of imaging studies and 98.3 % of CED. We found that 77.5 % (93/120) of patients received high CED (>75 mSv). Surveillance time was associated with high CED (OR 2.1, CI 1.5-2.8).
  
  
  CONCLUSIONS
  Survivors of testicular cancer frequently receive high CED from diagnostic imaging, mainly CT. Dose management software for accurate real-time monitoring of CED and low-dose CT protocols with maintained image quality should be used by specialist centres for surveillance imaging.
  
  
  CONCLUSIONS
  • CT accounted for 98.3 % of CED in patients with testicular cancer. • Median CED in patients with testicular cancer was 125.1 mSv • High CED (>75 mSv) was observed in 77.5 % (93/120) of patients. • Dose tracking and development of low-dose CT protocols are recommended.
authors.affiliation: Department of Radiology, Cork and Mercy University Hospitals, Wilton, Cork, Ireland.
authors.forename: C J
authors.initials: CJ
authors.lastname: Sullivan
authors.forename: K P
authors.initials: KP
authors.lastname: Murphy
authors.forename: P D
authors.initials: PD
authors.lastname: McLaughlin
authors.forename: M
authors.initials: M
authors.lastname: Twomey
authors.forename: K N
authors.initials: KN
authors.lastname: O'Regan
authors.forename: D G
authors.initials: DG
authors.lastname: Power
authors.forename: M M
authors.initials: MM
authors.lastname: Maher
authors.forename: O J
authors.initials: OJ
authors.lastname: O'Connor
mesh_terms: D000328:Adult; D003952:Diagnostic Imaging; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*