Lifetime attributable risk of cancer incidence in whole-body 18F-Fluorodeoxyglucose PET/CT scans via 3rd order polynomial approach

Abstract

The advent of PET/CT examinations has revolutionized cancer treatment, offering greater precision in diagnosis. Nonetheless, the ionizing radiation exposure during the examination could cause a cancer risk. Hence, this study aimed to evaluate the radiation dose and radiation-induced risk associated of whole-body PET/CT scan that includes the 18F-FDG tracers. For this retrospective study, 40 participants were studied, with an even number of males and females. The average age and weight of the participants were 53.77 ± 15.78 years and 66.59 ± 16.94 kg respectively, and they were administered 424.64 ± 121.19 MBq of 18F-FDG before the PET/CT commenced. The IDAC-Dose 2.1 program was employed to calculate the absorbed dose and effective dose in organs such as the bladder, brain, lung, kidneys, colon, red bone marrow (RBM), stomach, liver, and thyroid. The potential risks of cancer were evaluated using the lifetime attributable risk (LAR) via a 3rd order polynomial approach based on the information provided in the Biological Effects of Ionizing Radiation (BEIR) VII report. The effective dose was 20.1 ± 7.9 mSv, and the ratio of E to administered activity is 1.612 × 10-2 mSv/MBq, which is in line with the ICRP standard. The study found that the average incidence of cancer among men and women was 7 and 8 cases per 100,000 examinations, respectively, with effective dose between 3.2 mSv to 27.3 mSv. In summary, the risk of cancer associated with current whole-body 18F-FDG PET/CT examinations is low, but it is essential to mitigate radiation exposure during these examinations and utilize suitable techniques to prevent stochastic effects from low-dose radiation exposure.