Estimated cumulative radiation dose received by diagnostic imaging during staging and treatment of operable Ewing sarcoma 2005–2012

Background Patients with Ewing sarcoma are subject to various diagnostic procedures that incur exposure to ionising radiation. Objective To estimate the radiation doses received from all radiologic and nuclear imaging episodes during diagnosis and treatment, and to determine whether 18 F-fluorodeoxyglucose positron emission tomography – computed tomography ( 18 F-FDG PET-CT) is a major contributor of radiation. Materials and methods Twenty Ewing sarcoma patients diagnosed in Norway in 2005–2012 met the inclusion criteria (age <30 years, operable disease, uncomplicated chemotherapy and surgery, no metastasis or residual disease within a year of diagnosis). Radiation doses from all imaging during the first year were calculated for each patient. Results The mean estimated cumulative radiation dose for all patients was 34 mSv (range: 6–70), radiography accounting for 3 mSv (range: 0.2-12), CT for 13 mSv (range: 2–28) and nuclear medicine for 18 mSv (range: 2–47). For the patients examined with PET-CT, the mean estimated cumulative effective dose was 38 mSv, of which PET-CT accounted for 14 mSv (37%). Conclusion There was large variation in number and type of examinations performed and also in estimated cumulative radiation dose. The mean radiation dose for patients examined with PET-CT was 23% higher than for patients not examined with PET-CT.