“Nuclear Medicine Procedures in Women: Unappreciated Risks to Reproductive Organs?
Radiation exposure in imaging include CT, PET, and an increasing number of newer diagnostic and therapeutic radio-pharmaceuticals, used primarily in cancer diagnosis, staging, and treatment are associated with a theoretical increase in the risk of secondary cancer, with younger patients at higher risk than the elderly.
Women are particularly vulnerable to medical imaging radiation exposure, although the nature and extent of this vulnerability vary over time and depend on what type of imaging was performed. Accumulating evidence suggests that hormonal changes associated with the menstrual cycle are an underappreciated but avoidable source of vulnerability and risk to female reproductive organs, specifically ovaries, endometrium, and breasts.
While it can be argued that the risks of diagnostic nuclear medicine procedures using relatively short-lived isotopes could be viewed as mostly hypothetical, this is definitely not the case for radio-pharmaceuticals in use and under development for targeted radionuclide therapy, which use high-energy nuclides with longer half-life and are specifically designed to inflict direct cell damage.
Clinical and research nuclear medicine procedure on young women should be performed in the least susceptible phase of the menstrual cycle to improve the safety and the diagnostic accuracy of nuclear medicine procedures in women.
There is a need for new guidelines for radiotracer development and use, which are responsive to the greater risk to reproductive organs inherent in exposing reproductively competent women to administered radiopharmaceuticals”.
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