European Radiology

, Volume 28, Issue 10, pp 4370–4378 | Cite as

Radiation burden and associated cancer risk for a typical population to be screened for lung cancer with low-dose CT: A phantom study

  • Kostas PerisinakisEmail author
  • Ioannis Seimenis
  • Antonis Tzedakis
  • Apostolos Karantanas
  • John Damilakis
Computed Tomography



To estimate (a) organ doses and organ-specific radiation-induced cancer risk from a single low-dose CT (LDCT) for lung cancer screening (LCS) and (b) the theoretical cumulative risk of radiation-induced cancer for a typical cohort to be subjected to repeated annual LCS LDCT.


Sex- and body size-specific organ dose data from scan projection radiography (SPR) and helical CT exposures involved in LCS 256-slice LDCT were determined using Monte Carlo methods. Theoretical life attributable risk (LAR) of radiogenic cancer from a single 256-slice chest LDCT at age 55–80 years and the cumulative LAR of cancer from repeated annual LDCT studies up to age 80 years were estimated and compared to corresponding nominal lifetime intrinsic risks (LIRs) of being diagnosed with cancer.


The effective dose from LCS 256-slice LDCT was estimated to be 0.71 mSv. SPR was found to contribute 6–12 % to the total effective dose from chest LDCT. The radiation-cancer LAR from a single LDCT study was found to increase the nominal LIR of cancer in average-size 55-year-old males and females by 0.008 % and 0.018 %, respectively. Cumulative radiogenic risk of cancer from repeated annual scans from the age of 55–80 years was found to increase the nominal LIR of cancer by 0.13 % in males and 0.30 % in females.


Modern scanners may offer sub-millisievert LCS LDCT. Cumulative radiation risk from repeated annual 256-slice LDCT LCS examinations was found to minimally aggravate the lifetime intrinsic cancer risk of a typical screening population.

Key Points

• Effective dose from lung cancer screening low-dose CT may be <1 mSv.

• Screening with modern low-dose CT minimally aggravates lifetime cancer induction intrinsic risk.

• Dosimetry of lung cancer screening low-dose CT should encounter the radiation burden from the localizing scan projection radiography.

• DLP method may underestimate effective dose from low-dose chest CT by 27 %.


Lung cancer Cancer screening Multidetector computed tomography Radiation exposure Radiation-induced cancer 



Body mass index


Computed tomography dose index


Dose-length product


International Commission on Radiological Protection




Life-attributable risk


Lung cancer screening


Low-dose CT


Life intrinsic risk




Scan projection radiograph



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Kostas Perisinakis.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required since the study was not on human subjects

Ethical approval

Not applicable.


• prospective

• experimental

• performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of Medical Physics, Medical SchoolUniversity of CreteCreteGreece
  2. 2.Medical Diagnostic Center ‘Ayios Therissos’NicosiaCyprus
  3. 3.Department of Medical Physics, Medical SchoolDemocritus University of ThraceAlexandroupolisGreece
  4. 4.Department of Medical PhysicsUniversity Hospital of HeraklionCreteGreece
  5. 5.Department of Radiology, Medical SchoolUniversity of CreteCreteGreece

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