Lifetime Attributable Risk of Cancer From CT Among Patients Surviving Severe Traumatic Brain Injury

被引:17
作者
Salibi, Patrick N. [1 ]
Agarwal, Vikas [2 ]
Panczykowski, David M. [1 ]
Puccio, Ava M. [1 ]
Sheetz, Michael A. [2 ]
Okonkwo, David O. [1 ]
机构
[1] Univ Pittsburgh, Med Ctr, Dept Neurol Surg, Pittsburgh, PA 15213 USA
[2] Univ Pittsburgh, Med Ctr, Dept Radiol, Pittsburgh, PA 15213 USA
关键词
cancer; CT; radiation; traumatic brain injury; LONG-TERM SURVIVAL; COMPUTED-TOMOGRAPHY; RADIATION-EXPOSURE;
D O I
10.2214/AJR.12.10294
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
OBJECTIVE. The purpose of this study was to determine the lifetime attributable risk of cancer from CT among patients surviving severe traumatic brain injury. MATERIALS AND METHODS. A retrospective cross-sectional study was conducted with prospectively collected data on patients 16 years old and older admitted with a Glasgow coma scale score of 8 or less to a single level 1 trauma center from 2007 to 2010. The effective dose of each CT examination the patients underwent was predicted with literature-accepted effective dose values of standard helical CT protocols. The lifetime attributable risk of cancer and related mortality incurred as a result of CT were estimated with the cumulative effective dose incurred from the time of injury to a 1-year follow-up evaluation and with the approach established by the Biologic Effects of Ionizing Radiation VII report. RESULTS. The average patient was a 34-year-old man. The median number of CT examinations received during the first 12 months after injury was 20, and the average cumulative effective dose was 87 +/- 45 mSv. This resulted in increases in the lifetime incidence of all cancer types from 45.5% to 46.3% and in the lifetime incidence of cancer-related mortality from 22.1% to 22.5%. CONCLUSION. Radiation exposure from the use of CT in the evaluation and management of severe traumatic brain injury causes negligible increases in lifetime attributable risk of cancer and cancer-related mortality. Treating physicians should not allow the concern for future risk of radiation-induced cancer to influence decisions regarding radiographic evaluation in the acute treatment of traumatic brain injury.
引用
收藏
页码:397 / 400
页数:4
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