Sains Malaysiana 50(11)(2021): 3365-3372

http://doi.org/10.17576/jsm-2021-5011-20

 

 

Estimated Effective Lifetime Risks of Radiation-Induced Thyroid Cancer in Computed Tomography (CT) Brain Examination

(Anggaran Keberkesanan Risiko Sepanjang Hayat Kanser Tiroid Disebabkan Radiasi dalam Pemeriksaan Tomografi Berkomputer Otak)

 

REKHA GANESAN1, MUHAMMAD IKHMAL NAIM MOHD HILAL1, IZA NURZAWANI CHE ISA1*, NORHASHIMAH NORSUDDIN1, KHADIJAH MOHD NASSIR1, SAID MOHD SHAFFIQ SAID RAHMAT2 & MUHAMMAD KHALIS ABD KARIM3

 

1Diagnostic Imaging and Radiotherapy Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Federal Territory, Malaysia

 

2Department of Radiology, National Cancer Institute, 62250 Putrajaya, Wilayah Persekutuan Putrajaya, Malaysia

 

3Department of Physics, Faculty of Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia

 

Diserahkan: 19 Jun 2020/Diterima: 7 Mac 2021

 

ABSTRACT

Thyroid is one of the most radiosensitive organs in the human body. Although the scanning range of brain computed tomography (CT) does not include lower neck region, there is possibility for thyroid to be irradiated due to scattered radiation because of its location near to the external beam collimation. The objective of this study was to evaluate effective lifetime risk of radiation-induced thyroid cancer in young adults following brain CT examination. A total of 306 patient data within the age range between 18 and 39 years old were retrospectively analysed. Absorbed dose of the thyroid organ was obtained through the input of data using WAZA- ARI v2. Effective lifetime risk was calculated by multiplying equivalent dose of the thyroid organ with the lifetime attributable cancer risk adapted from Biological Effects in Ionising Radiation (BEIR) Report V11. The effective lifetime risks were recorded as 0.45 ± 0.70 per 100 000 and 0.93 ± 1.52 per 100 000 for single and multiple exposures, respectively. In terms of gender, woman data (0.99 ± 0.76; 1.95 ± 2.15) were found higher as compared to man data (0.13 ± 0.39; 0.35 ± 0.45) for both single and multiple exposure. The percentage difference of effective lifetime risks between single and multiple exposures was up to 107%. The effective lifetime risk noted in this study may be low, however, the long-term risk of cancer development should be considered. This study serves as preliminary reference when revising clinical protocol especially in those involving repeated exposures in young adult patients. Future study should include other radiosensitive organs exploring the effective lifetime risk of radiation induced cancer following CT procedure.

 

Keywords: CT brain; effective lifetime risk; radiation risk; thyroid cancer; young adult

 

ABSTRAK

Tiroid ialah organ badan manusia yang sangat sensitif terhadap radiasi. Walaupun kawasan dedahan kepada radiasi semasa prosedur tomografi berkomputer (CT) otak tidak meliputi kawasan leher, namun begitu masih terdapat risiko radiasi yang diterima oleh tiroid kerana kedudukannya terletak berhampiran dengan kawasan kolimasi. Objektif kajian ini adalah untuk mengkaji risiko berkesan radiasi kanser tiroid sepanjang hayat dalam kalangan pesakit bagi peringkat awal dewasa yang menjalani pemeriksaan CT otak. Sebanyak 306 data pesakit antara umur 18 dan 39 tahun telah dianalisis secara retrospektif. Dos serapan tiroid dihitung menggunakan WAZA-ARI v2. Risiko berkesan sepanjang hayat dihitung menggunakan data tiroid dos setara dan data risiko pembentukan kanser yang diambil daripada Laporan V11, Biological Effects in Ionising Radiation (BEIR). Risiko berkesan sepanjang hayat telah dicatatkan sebagai 0.45 ± 0.70 bagi dedahan tunggal dan 0.93 ± 1.52 bagi dedahan berulang. Dari segi perbandingan antara jantina, data pesakit wanita (0.99 ± 0.76; 1.95 ± 2.15) mencatatkan risiko berkesan yang lebih tinggi berbanding dengan data pesakit lelaki (0.13 ± 0.39; 0.35 ± 0.45) bagi dedahan tunggal dan berulang. Peratusan perbezaan risiko yang dicatatkan adalah sehingga 107%. Risiko berkesan sepanjang hayat yang dicatatkan dalam kajian ini mungkin rendah, namun begitu risiko jangka panjang perkembangan kanser perlu diambil kira. Kajian ini menunjukkan bahawa protokol untuk peperiksaan CT perlu disemak terutamanya kepada pesakit peringkat awal dewasa yang perlu menjalani prosedur CT secara berulang. Kajian pada masa hadapan perlu dilakukan merangkumi organ lain yang sensitif terhadap radiasi seperti bahagian peranakan dan mata.

 

Kata kunci: Awal dewasa; CT otak; kanser tiroid; risiko berkesan sepanjang hayat; risiko radiasi

 

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*Pengarang untuk surat-menyurat; email: zawaniisa@ukm.edu.my

 

 

 

 

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