Estimated cumulative radiation dose received by diagnostic imaging during staging and treatment of operable Ewing sarcoma 2005-2012.
BACKGROUND
Patients with Ewing sarcoma are subject to various diagnostic procedures that incur exposure to ionising radiation.


OBJECTIVE
To estimate the radiation doses received from all radiologic and nuclear imaging episodes during diagnosis and treatment, and to determine whether18F-fluorodeoxyglucose positron emission tomography - computed tomography (18F-FDG PET-CT) is a major contributor of radiation.


METHODS
Twenty Ewing sarcoma patients diagnosed in Norway in 2005-2012 met the inclusion criteria (age <30 years, operable disease, uncomplicated chemotherapy and surgery, no metastasis or residual disease within a year of diagnosis). Radiation doses from all imaging during the first year were calculated for each patient.


RESULTS
The mean estimated cumulative radiation dose for all patients was 34 mSv (range: 6-70), radiography accounting for 3 mSv (range: 0.2-12), CT for 13 mSv (range: 2-28) and nuclear medicine for 18 mSv (range: 2-47). For the patients examined with PET-CT, the mean estimated cumulative effective dose was 38 mSv, of which PET-CT accounted for 14 mSv (37%).


CONCLUSIONS
There was large variation in number and type of examinations performed and also in estimated cumulative radiation dose. The mean radiation dose for patients examined with PET-CT was 23% higher than for patients not examined with PET-CT.
Centre for Nuclear Medicine and PET, Department of Radiology, Haukeland University Hospital, P.O. Box 1400, 5021, Bergen, Norway. boel.johnsen@helse-bergen.no.
Boel
http://orcid.org/0000-0002-4346-2059
B
Johnsen
Department of Oncology, Medical Physics Section, Haukeland University Hospital, Bergen, Norway.
Kristine Eldevik
KE
Fasmer
Department of Oncology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
Kjetil
K
Boye
Department of Radiology, Paediatric Section, Haukeland University Hospital, Bergen, Norway.|Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Karen
K
Rosendahl
Department of Clinical Medicine, University of Bergen, Bergen, Norway.|Department of Surgery, Orthopaedic Section, Haukeland University Hospital, Bergen, Norway.
Clement
C
Trovik
Centre for Nuclear Medicine and PET, Department of Radiology, Haukeland University Hospital, P.O. Box 1400, 5021, Bergen, Norway.|Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Martin
M
Biermann
Department of Radiology, Paediatric Section, Haukeland University Hospital, Bergen, Norway.|Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Stein Magnus
SM
Aukland
D000293:Adolescent; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D009664:Norway; D000072078:Positron Emission Tomography Computed Tomography; D011829:Radiation Dosage; D019275:Radiopharmaceuticals; D012512:Sarcoma, Ewing / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
18F-fluorodeoxyglucose positron emission tomography – computed tomography (18F-FDG PET-CT); Adolescents; Children; Computed tomography; Ewing sarcoma; Oncological treatment protocol; Radiation dose; Radiography