Background: Neuroendocrine tumors (NET) are neoplasms that secrete peptides and neuroamines. For gastroenteropancreatic (GEP) NET, surgical resection represents the only curative option. Ten-year imaging surveillance programs are recommended due to long time-to-recurrence following resection. We performed retrospective chart review evaluating radiation exposure and practice patterns from surveillance of completely resected GEP NET. Methods: We performed a retrospective cohort study of cases with well-differentiated GEP NET from January 2005 to July 2020. Location of primary, modality of imaging, and duration of follow-up were collected. Dosimetry data was collected to calculate effective dose. Results: 62 cases were included with 422 surveillance scans performed. Cross-sectional imaging was used in 82% and functional imaging was used in 18% of scans. Mean number of scans per year was 1.25 (0.42–3). Mean total effective dose was 56.05 mSv (SD 45.56; 0 to 198 mSv) while mean total effective dose per year was 10.62 mSv (SD 9.35; 0 to 45 mSv). Over the recommended ten years of surveillance the estimated total effective dose was 106 mSv. Conclusions: Surveillance of completely resected GEP NET results in cumulative radiation doses in the range associated with secondary malignancy development. Strategies to minimize radiation exposure in surveillance should be considered in future guideline development.
背景：神经内分泌肿瘤（NET）是一类分泌肽类与神经胺类物质的肿瘤。对于胃肠胰神经内分泌肿瘤（GEP-NET）而言，手术切除是唯一可能根治的治疗手段。由于术后复发间隔期较长，通常建议进行为期十年的影像学监测。本研究通过回顾性病历分析，评估完全切除的GEP-NET患者在监测过程中的辐射暴露情况及临床实践模式。 方法：我们对2005年1月至2020年7月期间确诊的高分化GEP-NET病例进行回顾性队列研究。收集原发部位、影像学检查方式及随访时长等数据，并通过剂量学数据计算有效辐射剂量。 结果：研究共纳入62例患者，累计进行422次监测扫描。其中82%采用断层成像检查，18%采用功能成像检查。年均扫描次数为1.25次（范围0.42-3次）。患者接受监测期间的平均总有效剂量为56.05 mSv（标准差45.56；范围0-198 mSv），年均有效剂量为10.62 mSv（标准差9.35；范围0-45 mSv）。按建议的十年监测期估算，累计有效辐射剂量可达106 mSv。 结论：完全切除的GEP-NET患者在接受影像学监测期间，其累积辐射剂量已达到可能诱发继发性恶性肿瘤的风险范围。未来制定临床指南时应考虑采取降低监测期间辐射暴露的策略。
肿瘤(癌症)患者之家