ArticleLa Radiologia medica2025
Evaluation of sustainable diagnostic approaches in metastatic breast cancer (MBC).
Article in La Radiologia medica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionAssessing bone metastases in metastatic breast cancer is challenging. Due to rising concerns over energy use and emissions, energy-efficient imaging is essential. This study aimed to compare three diagnostic imaging approaches used in therapy monitoring of MBC patients, evaluating both their environmental impact-quantified by energy consumption and related greenhouse gas emissions-and their biological cost, defined as patient exposure to ionizing radiation and contrast media volume.
methodsWe retrospectively analysed 70 patients with bone-dominant metastatic breast cancer who underwent WB-MRI (DL1) and either FDG-PET/CT (DL2) or bone scintigraphy (BS) with CT of chest, abdomen, and pelvis (CT-CAP) (DL3). We compared scan time, energy consumption, greenhouse gas emissions (kgCO2e), radiation dose, and contrast media usage across these diagnostic pathways. Energy consumption was calculated using protocol-defined active and idle phases, while biological exposure was assessed from institutional RIS-PACS records.
resultsDL1 had the highest energy consumption (10.36 ± 0.11 kWh/patient) and GHG emissions (2.53 ± 0.03 kgCO2e). DL2 showed moderate energy use (4.08 ± 0.38 kWh/patient) and GHG emissions (0.99 ± 0.09 kgCO2e), which significantly increased with repeat scans. DL3 exhibited the lowest environmental impact (7.60 ± 1.07 kWh; 1.85 ± 0.26 kgCO2e), though required multiple visits and higher contrast media and radiation doses.
conclusionWB-MRI offers a biologically safer alternative for treatment monitoring in metastatic breast cancer, yet its environmental footprint is substantial. FDG-PET/CT represents a more sustainable imaging option if repeated scans are minimized. Integrated imaging pathways and low-energy technologies should guide future diagnostic strategies.
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