Radiation Dose Estimation and Lifetime Attributable Risk of Radiation-Induced Cancer from Chest CT in COVID-19 Patients.

Abstract

Background: Computerized tomography (CT) scans for COVID-19 diagnosis have increased throughout the pandemic. This growth has raised concerns about the potential radiation-induced cancer risk. This study aimed to estimate the effective dose (ED) and lifetime attributable risk (LAR) of cancer incidence and mortality associated with a single non-contrast chest CT scan for COVID-19 pneumonia diagnosis.

Methods: A retrospective analysis included 522 consecutive COVID-19 patients who underwent a single non-contrast chest CT at Gaza Strip hospitals (September 1, 2020-September 30, 2022). The ImPACT CT Dosimetry spreadsheet (Version 1.0.4) was used to estimate organ and effective doses. The XrayRisk.com calculator was used for calculating the LAR of cancer incidence from a single chest CT.

Results: The study analyzed non-contrast chest CT scans of 522 patients, with a mean age of 50.9 ± 15.8 years, and 239 males. The mean ED was 3.6 mSv, with the highest organ doses in the lungs and breast. Female patients were at a higher risk of cancer, with a higher risk in younger age groups. The mean LAR of lung cancer incidence was 5.8 per 100,000 males, while breast cancer incidence was 6.6 per 100,000 females. The whole-body ED of a single non-contrast chest CT is equivalent to 12 chest radiography series and three mammography screenings, or approximately four months of natural background radiation.

Conclusion: Chest CT scans for COVID-19 patients carry a low but measurable cancer risk, particularly for younger and female patients. The long-term health impacts of such exposure should be closely monitored.