Radiological surveillance in multiple endocrine neoplasia type 1: a double-edged sword?
Context: Multiple endocrine neoplasia type 1 (MEN1) is a hereditary condition characterised by the predisposition to hyperplasia/tumours of endocrine glands. MEN1-related disease, moreover, malignancy related to MEN1, is increasingly responsible for death in up to two-thirds of patients. Although pa...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Bioscientifica
2017-03-01
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| Series: | Endocrine Connections |
| Subjects: | |
| Online Access: | http://www.endocrineconnections.com/content/6/3/151.full |
| _version_ | 1819230263959355392 |
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| author | Ruth Therese Casey Deborah Saunders Benjamin George Challis Deborah Pitfield Heok Cheow Ashley Shaw Helen Lisa Simpson |
| author_facet | Ruth Therese Casey Deborah Saunders Benjamin George Challis Deborah Pitfield Heok Cheow Ashley Shaw Helen Lisa Simpson |
| author_sort | Ruth Therese Casey |
| collection | DOAJ |
| description | Context: Multiple endocrine neoplasia type 1 (MEN1) is a hereditary condition characterised by the predisposition to hyperplasia/tumours of endocrine glands. MEN1-related disease, moreover, malignancy related to MEN1, is increasingly responsible for death in up to two-thirds of patients. Although patients undergo radiological and biochemical surveillance, current recommendations for radiological monitoring are based on non-prospective data with little consensus or evidence demonstrating improved outcome from this approach. Here, we sought to determine whether cumulative radiation exposure as part of the recommended radiological screening programme posed a distinct risk in a cohort of patients with MEN1.Patients and study design: A retrospective review of 43 patients with MEN1 attending our institution between 2007 and 2015 was performed. Demographic and clinical information including phenotype was obtained for all patients. We also obtained details regarding all radiological procedures performed as part of MEN1 surveillance or disease localisation. An estimated effective radiation dose (ED) for each individual patient was calculated.Results: The mean ED for the total patient cohort was 121 mSv, and the estimated mean lifetime risk of cancer secondary to radiation exposure was 0.49%. Patients with malignant neuroendocrine tumours (NETS) had significantly higher ED levels compared to patients without metastatic disease (P < 0.0022).Conclusions: In MEN1, radiological surveillance is associated with clinically significant exposure to ionising radiation. In patients with MEN1, multi-modality imaging strategies designed to minimise this exposure should be considered. |
| first_indexed | 2024-12-23T11:26:18Z |
| format | Article |
| id | doaj.art-04d8e60a7b4d4dd590b7533ba1ad1d2c |
| institution | Directory Open Access Journal |
| issn | 2049-3614 2049-3614 |
| language | English |
| last_indexed | 2024-12-23T11:26:18Z |
| publishDate | 2017-03-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Connections |
| spelling | doaj.art-04d8e60a7b4d4dd590b7533ba1ad1d2c2022-12-21T17:48:55ZengBioscientificaEndocrine Connections2049-36142049-36142017-03-016315115810.1530/EC-17-0006Radiological surveillance in multiple endocrine neoplasia type 1: a double-edged sword?Ruth Therese Casey0Deborah Saunders1Benjamin George Challis2Deborah Pitfield3Heok Cheow4Ashley Shaw5Helen Lisa Simpson6Department of Endocrinology, University of Cambridge, Cambridge Biomedical Research Centre, Addenbrooke’s Hospital, Cambridge, UKEast Anglian Regional Radiation Protection Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UKDepartment of Endocrinology, University of Cambridge, Cambridge Biomedical Research Centre, Addenbrooke’s Hospital, Cambridge, UKDepartment of Endocrinology, University of Cambridge, Cambridge Biomedical Research Centre, Addenbrooke’s Hospital, Cambridge, UKDepartment of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UKDepartment of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UKWolfson Diabetes and Endocrine Clinic, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UKContext: Multiple endocrine neoplasia type 1 (MEN1) is a hereditary condition characterised by the predisposition to hyperplasia/tumours of endocrine glands. MEN1-related disease, moreover, malignancy related to MEN1, is increasingly responsible for death in up to two-thirds of patients. Although patients undergo radiological and biochemical surveillance, current recommendations for radiological monitoring are based on non-prospective data with little consensus or evidence demonstrating improved outcome from this approach. Here, we sought to determine whether cumulative radiation exposure as part of the recommended radiological screening programme posed a distinct risk in a cohort of patients with MEN1.Patients and study design: A retrospective review of 43 patients with MEN1 attending our institution between 2007 and 2015 was performed. Demographic and clinical information including phenotype was obtained for all patients. We also obtained details regarding all radiological procedures performed as part of MEN1 surveillance or disease localisation. An estimated effective radiation dose (ED) for each individual patient was calculated.Results: The mean ED for the total patient cohort was 121 mSv, and the estimated mean lifetime risk of cancer secondary to radiation exposure was 0.49%. Patients with malignant neuroendocrine tumours (NETS) had significantly higher ED levels compared to patients without metastatic disease (P < 0.0022).Conclusions: In MEN1, radiological surveillance is associated with clinically significant exposure to ionising radiation. In patients with MEN1, multi-modality imaging strategies designed to minimise this exposure should be considered.http://www.endocrineconnections.com/content/6/3/151.fullradiationneuroendocrine tumoursradiological surveillancerisk |
| spellingShingle | Ruth Therese Casey Deborah Saunders Benjamin George Challis Deborah Pitfield Heok Cheow Ashley Shaw Helen Lisa Simpson Radiological surveillance in multiple endocrine neoplasia type 1: a double-edged sword? Endocrine Connections radiation neuroendocrine tumours radiological surveillance risk |
| title | Radiological surveillance in multiple endocrine neoplasia type 1: a double-edged sword? |
| title_full | Radiological surveillance in multiple endocrine neoplasia type 1: a double-edged sword? |
| title_fullStr | Radiological surveillance in multiple endocrine neoplasia type 1: a double-edged sword? |
| title_full_unstemmed | Radiological surveillance in multiple endocrine neoplasia type 1: a double-edged sword? |
| title_short | Radiological surveillance in multiple endocrine neoplasia type 1: a double-edged sword? |
| title_sort | radiological surveillance in multiple endocrine neoplasia type 1 a double edged sword |
| topic | radiation neuroendocrine tumours radiological surveillance risk |
| url | http://www.endocrineconnections.com/content/6/3/151.full |
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