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Title: Comparison of radiation exposure and associated radiation-induced cancer risks from mammography and molecular imaging of the breast

Abstract

Purpose: Recent studies have raised concerns about exposure to low-dose ionizing radiation from medical imaging procedures. Little has been published regarding the relative exposure and risks associated with breast imaging techniques such as breast specific gamma imaging (BSGI), molecular breast imaging (MBI), or positron emission mammography (PEM). The purpose of this article was to estimate and compare the risks of radiation-induced cancer from mammography and techniques such as PEM, BSGI, and MBI in a screening environment. Methods: The authors used a common scheme for all estimates of cancer incidence and mortality based on the excess absolute risk model from the BEIR VII report. The lifetime attributable risk model was used to estimate the lifetime risk of radiation-induced breast cancer incidence and mortality. All estimates of cancer incidence and mortality were based on a population of 100 000 females followed from birth to age 80 and adjusted for the fraction that survives to various ages between 0 and 80. Assuming annual screening from ages 40 to 80 and from ages 50 to 80, the cumulative cancer incidence and mortality attributed to digital mammography, screen-film mammography, MBI, BSGI, and PEM was calculated. The corresponding cancer incidence and mortality from natural background radiationmore » was calculated as a useful reference. Assuming a 15%-32% reduction in mortality from screening, the benefit/risk ratio for the different imaging modalities was evaluated. Results: Using conventional doses of 925 MBq Tc-99m sestamibi for MBI and BSGI and 370 MBq F-18 FDG for PEM, the cumulative cancer incidence and mortality were found to be 15-30 times higher than digital mammography. The benefit/risk ratio for annual digital mammography was >50:1 for both the 40-80 and 50-80 screening groups, but dropped to 3:1 for the 40-49 age group. If the primary use of MBI, BSGI, and PEM is in women with dense breast tissue, then the administered doses need to be in the range 75-150 MBq for Tc-99m sestamibi and 35 MBq-70 MBq for F-18 FDG in order to obtain benefit/risk ratios comparable to those of mammography in these age groups. These dose ranges should be achievable with enhancements to current technology while maintaining a reasonable examination time. Conclusions: The results of the dose estimates in this study clearly indicate that if molecular imaging techniques are to be of value in screening for breast cancer, then the administered doses need to be substantially reduced to better match the effective doses of mammography.« less

Authors:
; ; ; ; ;  [1]
  1. Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905 (United States)
Publication Date:
OSTI Identifier:
22096832
Resource Type:
Journal Article
Journal Name:
Medical Physics
Additional Journal Information:
Journal Volume: 37; Journal Issue: 12; Other Information: (c) 2010 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0094-2405
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; 61 RADIATION PROTECTION AND DOSIMETRY; AGE GROUPS; BACKGROUND RADIATION; BIOMEDICAL RADIOGRAPHY; FLUORINE 18; FLUORODEOXYGLUCOSE; GYNECOLOGY; HEALTH HAZARDS; IONIZING RADIATIONS; MAMMARY GLANDS; MORTALITY; NEOPLASMS; POSITRON COMPUTED TOMOGRAPHY; POSITRONS; RADIATION DOSES; RADIOTHERAPY; SCREENING; TECHNETIUM 99; WOMEN

Citation Formats

O'Connor, Michael K., Hua, Li, Rhodes, Deborah J., Hruska, Carrie B., Clancy, Conor B., Vetter, Richard J., Department of Medicine, Mayo Clinic, Rochester, Minnesota 55905, Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, Department of Medical Physics, St. James's Hospital, Dublin, and Radiation Safety, Mayo Clinic, Rochester, Minnesota 55905. Comparison of radiation exposure and associated radiation-induced cancer risks from mammography and molecular imaging of the breast. United States: N. p., 2010. Web. doi:10.1118/1.3512759.
O'Connor, Michael K., Hua, Li, Rhodes, Deborah J., Hruska, Carrie B., Clancy, Conor B., Vetter, Richard J., Department of Medicine, Mayo Clinic, Rochester, Minnesota 55905, Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, Department of Medical Physics, St. James's Hospital, Dublin, & Radiation Safety, Mayo Clinic, Rochester, Minnesota 55905. Comparison of radiation exposure and associated radiation-induced cancer risks from mammography and molecular imaging of the breast. United States. https://doi.org/10.1118/1.3512759
O'Connor, Michael K., Hua, Li, Rhodes, Deborah J., Hruska, Carrie B., Clancy, Conor B., Vetter, Richard J., Department of Medicine, Mayo Clinic, Rochester, Minnesota 55905, Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, Department of Medical Physics, St. James's Hospital, Dublin, and Radiation Safety, Mayo Clinic, Rochester, Minnesota 55905. 2010. "Comparison of radiation exposure and associated radiation-induced cancer risks from mammography and molecular imaging of the breast". United States. https://doi.org/10.1118/1.3512759.
@article{osti_22096832,
title = {Comparison of radiation exposure and associated radiation-induced cancer risks from mammography and molecular imaging of the breast},
author = {O'Connor, Michael K. and Hua, Li and Rhodes, Deborah J. and Hruska, Carrie B. and Clancy, Conor B. and Vetter, Richard J. and Department of Medicine, Mayo Clinic, Rochester, Minnesota 55905 and Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905 and Department of Medical Physics, St. James's Hospital, Dublin and Radiation Safety, Mayo Clinic, Rochester, Minnesota 55905},
abstractNote = {Purpose: Recent studies have raised concerns about exposure to low-dose ionizing radiation from medical imaging procedures. Little has been published regarding the relative exposure and risks associated with breast imaging techniques such as breast specific gamma imaging (BSGI), molecular breast imaging (MBI), or positron emission mammography (PEM). The purpose of this article was to estimate and compare the risks of radiation-induced cancer from mammography and techniques such as PEM, BSGI, and MBI in a screening environment. Methods: The authors used a common scheme for all estimates of cancer incidence and mortality based on the excess absolute risk model from the BEIR VII report. The lifetime attributable risk model was used to estimate the lifetime risk of radiation-induced breast cancer incidence and mortality. All estimates of cancer incidence and mortality were based on a population of 100 000 females followed from birth to age 80 and adjusted for the fraction that survives to various ages between 0 and 80. Assuming annual screening from ages 40 to 80 and from ages 50 to 80, the cumulative cancer incidence and mortality attributed to digital mammography, screen-film mammography, MBI, BSGI, and PEM was calculated. The corresponding cancer incidence and mortality from natural background radiation was calculated as a useful reference. Assuming a 15%-32% reduction in mortality from screening, the benefit/risk ratio for the different imaging modalities was evaluated. Results: Using conventional doses of 925 MBq Tc-99m sestamibi for MBI and BSGI and 370 MBq F-18 FDG for PEM, the cumulative cancer incidence and mortality were found to be 15-30 times higher than digital mammography. The benefit/risk ratio for annual digital mammography was >50:1 for both the 40-80 and 50-80 screening groups, but dropped to 3:1 for the 40-49 age group. If the primary use of MBI, BSGI, and PEM is in women with dense breast tissue, then the administered doses need to be in the range 75-150 MBq for Tc-99m sestamibi and 35 MBq-70 MBq for F-18 FDG in order to obtain benefit/risk ratios comparable to those of mammography in these age groups. These dose ranges should be achievable with enhancements to current technology while maintaining a reasonable examination time. Conclusions: The results of the dose estimates in this study clearly indicate that if molecular imaging techniques are to be of value in screening for breast cancer, then the administered doses need to be substantially reduced to better match the effective doses of mammography.},
doi = {10.1118/1.3512759},
url = {https://www.osti.gov/biblio/22096832}, journal = {Medical Physics},
issn = {0094-2405},
number = 12,
volume = 37,
place = {United States},
year = {Wed Dec 15 00:00:00 EST 2010},
month = {Wed Dec 15 00:00:00 EST 2010}
}