Use of PET/CT instead of CT-only when planning for radiation therapy does not notably increase life years lost in children being treated for cancer

Josefine S. Kornerup, Nils P. Brodin, Charlotte Birk Christensen, Thomas Björk-Eriksson, Anne Kiil-Berthelsen, Lise Borgwardt, Per Munck af Rosenschöld

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: PET/CT may be more helpful than CT alone for radiation therapy planning, but the added risk due to higher doses of ionizing radiation is unknown. Objective: To estimate the risk of cancer induction and mortality attributable to the [F-18]2-fluoro-2-deoxyglucose (FDG) PET and CT scans used for radiation therapy planning in children with cancer, and compare to the risks attributable to the cancer treatment. Materials and methods: Organ doses and effective doses were estimated for 40 children (2–18 years old) who had been scanned using PET/CT as part of radiation therapy planning. The risk of inducing secondary cancer was estimated using the models in BEIR VII. The prognosis of an induced cancer was taken into account and the reduction in life expectancy, in terms of life years lost, was estimated for the diagnostics and compared to the life years lost attributable to the therapy. Multivariate linear regression was performed to find predictors for a high contribution to life years lost from the radiation therapy planning diagnostics. Results: The mean contribution from PET to the effective dose from one PET/CT scan was 24% (range: 7–64%). The average proportion of life years lost attributable to the nuclear medicine dose component from one PET/CT scan was 15% (range: 3–41%). The ratio of life years lost from the radiation therapy planning PET/CT scans and that of the cancer treatment was on average 0.02 (range: 0.01–0.09). Female gender was associated with increased life years lost from the scans (P < 0.001). Conclusion: Using FDG-PET/CT instead of CT only when defining the target volumes for radiation therapy of children with cancer does not notably increase the number of life years lost attributable to diagnostic examinations.

Original languageEnglish (US)
Pages (from-to)570-581
Number of pages12
JournalPediatric Radiology
Volume45
Issue number4
DOIs
StatePublished - Apr 1 2015

Fingerprint

Radiotherapy
Neoplasms
Fluorodeoxyglucose F18
Nuclear Medicine
Life Expectancy
Ionizing Radiation
Linear Models
Therapeutics
Mortality
Positron Emission Tomography Computed Tomography

Keywords

  • Long-term complications
  • Pediatric
  • Positron emission tomography/computed tomography (PET/CT)
  • Radiation therapy planning
  • Risk estimation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Radiology Nuclear Medicine and imaging

Cite this

Kornerup, J. S., Brodin, N. P., Birk Christensen, C., Björk-Eriksson, T., Kiil-Berthelsen, A., Borgwardt, L., & Munck af Rosenschöld, P. (2015). Use of PET/CT instead of CT-only when planning for radiation therapy does not notably increase life years lost in children being treated for cancer. Pediatric Radiology, 45(4), 570-581. https://doi.org/10.1007/s00247-014-3197-4

Use of PET/CT instead of CT-only when planning for radiation therapy does not notably increase life years lost in children being treated for cancer. / Kornerup, Josefine S.; Brodin, Nils P.; Birk Christensen, Charlotte; Björk-Eriksson, Thomas; Kiil-Berthelsen, Anne; Borgwardt, Lise; Munck af Rosenschöld, Per.

In: Pediatric Radiology, Vol. 45, No. 4, 01.04.2015, p. 570-581.

Research output: Contribution to journalArticle

Kornerup, JS, Brodin, NP, Birk Christensen, C, Björk-Eriksson, T, Kiil-Berthelsen, A, Borgwardt, L & Munck af Rosenschöld, P 2015, 'Use of PET/CT instead of CT-only when planning for radiation therapy does not notably increase life years lost in children being treated for cancer', Pediatric Radiology, vol. 45, no. 4, pp. 570-581. https://doi.org/10.1007/s00247-014-3197-4
Kornerup, Josefine S. ; Brodin, Nils P. ; Birk Christensen, Charlotte ; Björk-Eriksson, Thomas ; Kiil-Berthelsen, Anne ; Borgwardt, Lise ; Munck af Rosenschöld, Per. / Use of PET/CT instead of CT-only when planning for radiation therapy does not notably increase life years lost in children being treated for cancer. In: Pediatric Radiology. 2015 ; Vol. 45, No. 4. pp. 570-581.
@article{2a5e7924afb444fc9a136dca3a069ff9,
title = "Use of PET/CT instead of CT-only when planning for radiation therapy does not notably increase life years lost in children being treated for cancer",
abstract = "Background: PET/CT may be more helpful than CT alone for radiation therapy planning, but the added risk due to higher doses of ionizing radiation is unknown. Objective: To estimate the risk of cancer induction and mortality attributable to the [F-18]2-fluoro-2-deoxyglucose (FDG) PET and CT scans used for radiation therapy planning in children with cancer, and compare to the risks attributable to the cancer treatment. Materials and methods: Organ doses and effective doses were estimated for 40 children (2–18 years old) who had been scanned using PET/CT as part of radiation therapy planning. The risk of inducing secondary cancer was estimated using the models in BEIR VII. The prognosis of an induced cancer was taken into account and the reduction in life expectancy, in terms of life years lost, was estimated for the diagnostics and compared to the life years lost attributable to the therapy. Multivariate linear regression was performed to find predictors for a high contribution to life years lost from the radiation therapy planning diagnostics. Results: The mean contribution from PET to the effective dose from one PET/CT scan was 24{\%} (range: 7–64{\%}). The average proportion of life years lost attributable to the nuclear medicine dose component from one PET/CT scan was 15{\%} (range: 3–41{\%}). The ratio of life years lost from the radiation therapy planning PET/CT scans and that of the cancer treatment was on average 0.02 (range: 0.01–0.09). Female gender was associated with increased life years lost from the scans (P < 0.001). Conclusion: Using FDG-PET/CT instead of CT only when defining the target volumes for radiation therapy of children with cancer does not notably increase the number of life years lost attributable to diagnostic examinations.",
keywords = "Long-term complications, Pediatric, Positron emission tomography/computed tomography (PET/CT), Radiation therapy planning, Risk estimation",
author = "Kornerup, {Josefine S.} and Brodin, {Nils P.} and {Birk Christensen}, Charlotte and Thomas Bj{\"o}rk-Eriksson and Anne Kiil-Berthelsen and Lise Borgwardt and {Munck af Rosensch{\"o}ld}, Per",
year = "2015",
month = "4",
day = "1",
doi = "10.1007/s00247-014-3197-4",
language = "English (US)",
volume = "45",
pages = "570--581",
journal = "Pediatric Radiology",
issn = "0301-0449",
publisher = "Springer Verlag",
number = "4",

}

TY - JOUR

T1 - Use of PET/CT instead of CT-only when planning for radiation therapy does not notably increase life years lost in children being treated for cancer

AU - Kornerup, Josefine S.

AU - Brodin, Nils P.

AU - Birk Christensen, Charlotte

AU - Björk-Eriksson, Thomas

AU - Kiil-Berthelsen, Anne

AU - Borgwardt, Lise

AU - Munck af Rosenschöld, Per

PY - 2015/4/1

Y1 - 2015/4/1

N2 - Background: PET/CT may be more helpful than CT alone for radiation therapy planning, but the added risk due to higher doses of ionizing radiation is unknown. Objective: To estimate the risk of cancer induction and mortality attributable to the [F-18]2-fluoro-2-deoxyglucose (FDG) PET and CT scans used for radiation therapy planning in children with cancer, and compare to the risks attributable to the cancer treatment. Materials and methods: Organ doses and effective doses were estimated for 40 children (2–18 years old) who had been scanned using PET/CT as part of radiation therapy planning. The risk of inducing secondary cancer was estimated using the models in BEIR VII. The prognosis of an induced cancer was taken into account and the reduction in life expectancy, in terms of life years lost, was estimated for the diagnostics and compared to the life years lost attributable to the therapy. Multivariate linear regression was performed to find predictors for a high contribution to life years lost from the radiation therapy planning diagnostics. Results: The mean contribution from PET to the effective dose from one PET/CT scan was 24% (range: 7–64%). The average proportion of life years lost attributable to the nuclear medicine dose component from one PET/CT scan was 15% (range: 3–41%). The ratio of life years lost from the radiation therapy planning PET/CT scans and that of the cancer treatment was on average 0.02 (range: 0.01–0.09). Female gender was associated with increased life years lost from the scans (P < 0.001). Conclusion: Using FDG-PET/CT instead of CT only when defining the target volumes for radiation therapy of children with cancer does not notably increase the number of life years lost attributable to diagnostic examinations.

AB - Background: PET/CT may be more helpful than CT alone for radiation therapy planning, but the added risk due to higher doses of ionizing radiation is unknown. Objective: To estimate the risk of cancer induction and mortality attributable to the [F-18]2-fluoro-2-deoxyglucose (FDG) PET and CT scans used for radiation therapy planning in children with cancer, and compare to the risks attributable to the cancer treatment. Materials and methods: Organ doses and effective doses were estimated for 40 children (2–18 years old) who had been scanned using PET/CT as part of radiation therapy planning. The risk of inducing secondary cancer was estimated using the models in BEIR VII. The prognosis of an induced cancer was taken into account and the reduction in life expectancy, in terms of life years lost, was estimated for the diagnostics and compared to the life years lost attributable to the therapy. Multivariate linear regression was performed to find predictors for a high contribution to life years lost from the radiation therapy planning diagnostics. Results: The mean contribution from PET to the effective dose from one PET/CT scan was 24% (range: 7–64%). The average proportion of life years lost attributable to the nuclear medicine dose component from one PET/CT scan was 15% (range: 3–41%). The ratio of life years lost from the radiation therapy planning PET/CT scans and that of the cancer treatment was on average 0.02 (range: 0.01–0.09). Female gender was associated with increased life years lost from the scans (P < 0.001). Conclusion: Using FDG-PET/CT instead of CT only when defining the target volumes for radiation therapy of children with cancer does not notably increase the number of life years lost attributable to diagnostic examinations.

KW - Long-term complications

KW - Pediatric

KW - Positron emission tomography/computed tomography (PET/CT)

KW - Radiation therapy planning

KW - Risk estimation

UR - http://www.scopus.com/inward/record.url?scp=84939941089&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84939941089&partnerID=8YFLogxK

U2 - 10.1007/s00247-014-3197-4

DO - 10.1007/s00247-014-3197-4

M3 - Article

C2 - 25378209

AN - SCOPUS:84939941089

VL - 45

SP - 570

EP - 581

JO - Pediatric Radiology

JF - Pediatric Radiology

SN - 0301-0449

IS - 4

ER -