Methodology for assessment of radiation risks from medical exposure on the example of multiple computed tomography

«Radiation and Risk», 2021, vol. 30, No. 4, pp.24-39

DOI: 10.21870/0131-3878-2021-30-4-24-39

Authors

Kashcheev V.V. – Head of Lab., C. Sc., Biol.
Pryakhin E.A. – Researcher, A. Tsyb MRRC. Contacts: 4 Korolyov str., Obninsk, Kaluga region, Russia, 249035. Tel.: (484) 399-32-81; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. .
Kurashvili Yu.B. – Adviser of Vice-President, MD. Rusatom Overseas.
A. Tsyb MRRC, Obninsk
¹ Joint Stock Company PRORYV, Moscow

Abstract

Currently the application of diagnostic imaging procedures is extended. After the COVID-19 outbreak the number of radiological examinations have increased significantly. The number of repeated radiological examinations increased as well. Although the risk of cancer from single radiological scanning is small, risk from multiple imaging has not been estimated yet. The development of methodology for assessment of cancer risks from multiple radiological examinations is needed. This paper presents the procedure for assessment of radiation risks from multiple radiological examinations of any type. The validity of the developed approach was tested on the example of assessment of lifetime attributable risk (LAR) of cancer incidence from multiple computed tomography (CT) examinations, the re-sults are discussed in the paper. The authors developed the method for estimating radiation detriment from multiple radiological CT scans for remaining life years. The method is based on equivalent ra-diation doses to organs and tissues of a patient’s body. Tables of LARs values per dose unit for males and females within the age range 0-95 years and a step of 5 years were designed. The tables were computed for the following cancer sites: bladder, breast, colon, bone marrow, liver, lungs, esophagus, ovary, stomach, thyroid and other solid. The authors estimated cancer risks for a female, she was exposed to radiation from CT scanning. The female’s risks assessed with the developed methodology were compared with radiation risks estimated with mathematical model ICRP (Publication 103). The comparison showed that the difference between risks estimated with the developed method and the risks estimated with the ICRP model did not exceed 12%. In models sex and age were accounted, medical and demographic data applicable to the Russian population were taken into account as well.

Key words
radiation risk, methodology for assessment of radiation risks, medical exposure, computed tomography, equivalent doses, mathematical model, ICRP Publication 103, lifetime attributable risk (LAR), multiple exposure.

References

1. Kashcheev V.V., Pryakhin E.A. Medical diagnostic imaging: radiation safety issues. Review. Radiatsiya i risk – Radiation and Risk, 2018, vol. 27, no. 4, pp. 49-64. (In Russian).

2. Kashcheev V.V., Pryakhin E.A., Menyajlo A.N., Panin M.S., Seleva N.G., Kashcheeva P.V., Ivanov S.A., Kaprin A.D., Ivanov V.K. Radiation risks assessment of children cancer incidence based on computed tomography examination protocols. Radiatsiya i risk – Radiation and Risk, 2020, vol. 29, no. 2, pp. 21-31. (In Russian).

3. IAEA Safety Standards. Radiation protection and safety of radiation sources: International Basic Safety Standards. General Safety Requirements No. GSR Part 3 (Interim). Vienna, IAEA, 2011.

4. Radiation Safety Standards (RSS-99/2009). Sanitary-epidemiological rules and standards. Moscow, Federal Center of Hygiene and Epidemiology of Rospotrebnadzor, 2009. 100 p. (In Russian).

5. Basic Sanitary Rules for Radiation Safety (OSPORB-99/2010). Health regulations, SP 2.6.1.2612-10. Moscow, Center for Sanitary and Epidemiological Rationing, Hygienic Certification of Russian Ministry of Health, 2010. (In Russian).

6. MR 2.6.1.0215-20. Assessment of radiation risk in patients during X-ray and radiological studies. Guideline. Moscow, Rospotrebnadzor, 2020. (In Russian).

7. Ivanov V.K., Tsyb A.F., Mettler F.A., Menyaylo A.N., Kashcheev V.V. Methodology for estimating cancer risks of diagnostic medical exposure: with an example of the risks associated with computed tomography. Health Phys., 2012, vol. 103, no. 6, pp. 732-739.

8. Ivanov V.K., Kashcheev V.V., Chekin S.Yu., Menyaylo A.N., Pryakhin E.A., Tsyb A.F., Mettler F.A. Estimation of risk from medical radiation exposure based on effective and organ dose: how much difference is there? Radiat. Prot. Dosim., 2013, vol. 155, no. 3, pp. 317-328. DOI: 10.1093/rpd/nct008.

9. Communicating radiation risks in pediatric imaging: information to support health care discussions about benefit and risk. Geneva, WHO, 2016. 88 p.

10. ICRP, 2007. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann. ICRP, 2007, vol. 37, no. 2-4, pp. 1-332.

11. Ivanov V.K., Kashcheev V.V., Chekin S.Yu., Menyaylo A.N., Pryakhin E.A., Tsyb A.F., Mettler F.A. Estimating personal radiation risks attributed to multiple computed tomography scanning. ANRI, 2014, no. 1, pp. 65-77. (In Russian).

12. Ivanov V.K., Menyailo A.N., Kashcheev V.V., Chekin S.Yu., Gorsky A.I., Maksioutov M.A., Tumanov K.A. Comparative analysis of modern risk models developed by ICRP and UNSCEAR. ANRI, 2011, no. 3, pp. 18-29. (In Russian).

13. The radiation doses to the Russian population in 2016: information collection. St. Petersburg, Ramzaev’s NIIRG Publ., 2017. 125 p. (In Russian).

14. Stamm G., Nagel H.D. CT-expo: a novel program for dose evaluation in CT. Rofo, 2002, vol. 174, no. 12, pp. 1570-1576.

15. Malignant neoplasms in Russia in 2017 (morbidity and mortality). Eds.: A.D. Kaprin, V.V. Starinskiy, G.V. Petrova. Moscow, Р. Hertsen MORI, 2018. 250 p. (In Russian).

16. Malignant neoplasms in Russia in 2008 (morbidity and mortality). Eds.: V.I. Chissov, V.V. Starinskiy. Moscow, 2010. (In Russian).

Full-text article (in Russian)