来自EVAR和CTA随访的增加癌症风险估计
Bharti Singh1,2, Martin Andersson3,4, Andreas Edsfeldt2,5,6
1Vascular Center Malmö-Lund, Department of Thoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden.
概括
下内血管动脉瘤修复 (EVAR) 和CTA后患癌症的风险为219名患者中的1人. 尽量减少后续CTA可以显著降低这种辐射诱导的癌症风险.
科学领域:
- 医学成像和放射瘤学医学成像和放射瘤学
- 血管外科 血管外科
- 在瘤学瘤学.
背景情况:
- 内血管动脉瘤修复 (EVAR) 是用于下腹腔大动脉动脉瘤 (AAA) 的常见程序.
- 术后监测通常涉及定期的计算机断层扫描血管图 (CTA),导致累积的辐射暴露.
- 评估与EVAR相关的长期癌症风险及其随访成像对于患者管理至关重要.
研究的目的:
- 为了评估辐射诱导的癌症的风险,在接受内EVAR的患者.
- 区分EVAR程序和术前/术后CTA对癌症风险的贡献.
- 估计各种器官癌症的终身可归因风险 (LAR).
主要方法:
- 器官特定的吸收辐射剂量是从患者数据中计算的 (CTA为95,EVAR为45).
- 为14个器官计算了终身归因风险 (LAR) 癌症预测.
- 使用了以前EVAR队列的预期寿命数据.
主要成果:
- 超过15年的总癌症风险估计为0.0046 (1在220名患者中).
- EVAR手术和手术前CTA占总额外风险的38%.
- 消除随访CTA将使过度风险降低到0.0018 (560名患者中的1人).
结论:
- 大约每219名接受红外EVAR治疗的患者中,就有1人因辐射暴露而面临终身癌症风险.
- 这种风险的大部分来源于每年术后的CTA.
- 建议减少后续CTA的频率或必要性,以减轻辐射诱导的癌症风险.
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