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Cumulative radiation exposure during follow-up after curative surgery for gastric cancer.

 Yeo Jin Lee  ;  Yong Eun Chung  ;  Joon Seok Lim  ;  Joo Hee Kim  ;  Young Jin Kim  ;  Hye-Jeong Lee  ;  Je Sung You  ;  Myeong-Jin Kim  ;  Ki Whang Kim 
 KOREAN JOURNAL OF RADIOLOGY, Vol.13(2) : 144-151, 2012 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Male ; Middle Aged ; Multimodal Imaging* ; Neoplasm Staging ; Positron-Emission Tomography* ; Radiation Dosage* ; Retrospective Studies ; Risk Assessment ; Statistics, Nonparametric ; Stomach Neoplasms/diagnostic imaging* ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery ; Tomography, X-Ray Computed* ; Treatment Outcome
Computed tomography ; Effective dose ; Follow-up ; Gastric cancer ; Lifetime attributable risk ; Radiation exposure
OBJECTIVE: To quantify the cumulative effective dose (cED) of radiation due to repeated CT and PET/CT examinations after curative resection of gastric cancer and to assess the lifetime attributable risk (LAR) estimates based on Biological Effects of Ionizing Radiation VII models. SUBJECTS AND METHODS: Patients who underwent a curative resection for gastric cancer between January 2006 and December 2006 and were followed-up until May 2010 were included in this study. The cED was calculated by using the dose-length product values and conversion factors for quantitative risk assessment of radiation exposure. cED and LAR were compared between early and advanced gastric cancer patients and among American Joint Committee on Cancer TNM stage groups (stage I, II, and III). The nonparametric Mann-Whitney U and Kruskal-Wallis tests, followed by a post-hoc analysis with Bonferroni adjustment, were employed as part of the statistical analysis. RESULTS: The overall median cED was 57.8 mSv (interquartile range [IQR], 43.9-74.7). The cED was significantly higher in the advanced (median, 67.0; IQR, 49.1-102.3) than in the early gastric cancer group (median, 52.3; IQR, 41.5-67.9) (p < 0.001), and increased as the TNM stage increased. For radiation exposure, 62% of all patients received an estimated cED of over 50 mSv, while 11% of patients received over 100 mSv. The median LAR of cancer incidence was 0.28% (IQR, 0.20-0.40) and there were significant differences between the early gastric cancer and advanced gastric cancer group (p < 0.001) as well as among the three TNM stage groups (p = 0.015). The LAR of cancer incidence exceeded 1% in 2.4% of the patients. CONCLUSION: The cED increases proportionally along with tumor stage and, even in early gastric cancer or stage I patients, cED is much higher than that found among the general population. Considering the very good prognosis of early gastric cancer after curative surgery, the cED should be considered when designing a postoperative follow-up CT protocol.
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1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Lee, Yeo Jin(이여진)
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
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