Estimated radiation dose associated with cardiac CT angiography.
نویسندگان
چکیده
CONTEXT Cardiac computed tomography (CT) angiography (CCTA) has emerged as a useful diagnostic imaging modality in the assessment of coronary artery disease. However, the potential risks due to exposure to ionizing radiation associated with CCTA have raised concerns. OBJECTIVES To estimate the radiation dose of CCTA in routine clinical practice as well as the association of currently available strategies with dose reduction and to identify the independent factors contributing to radiation dose. DESIGN, SETTING, AND PATIENTS A cross-sectional, international, multicenter, observational study (50 study sites: 21 university hospitals and 29 community hospitals) of estimated radiation dose in 1965 patients undergoing CCTA between February and December 2007. Linear regression analysis was used to identify independent predictors associated with dose. MAIN OUTCOME MEASURE Dose-length product (DLP) of CCTA. RESULTS The median DLP of 1965 CCTA examinations performed at 50 study sites was 885 mGy x cm (interquartile range, 568-1259 mGy x cm), which corresponds to an estimated radiation dose of 12 mSv (or 1.2 x the dose of an abdominal CT study or 600 chest x-rays). A high variability in DLP was observed between study sites (range of median DLPs per site, 331-2146 mGy x cm). Independent factors associated with radiation dose were patient weight (relative effect on DLP, 5%; 95% confidence interval [CI], 4%-6%), absence of stable sinus rhythm (10%; 95% CI, 2%-19%), scan length (5%; 95% CI, 4%-6%), electrocardiographically controlled tube current modulation (-25%; 95% CI, -23% to -28%; applied in 73% of patients), 100-kV tube voltage (-46%; 95% CI, -42% to -51%; applied in 5% of patients), sequential scanning (-78%; 95% CI, -77% to -79%; applied in 6% of patients), experience in cardiac CT (-1%; 95% CI, -1% to 0%), number of CCTAs per month (0%; 95% CI, 0%-1%), and type of 64-slice CT system (for highest vs lowest dose system, 97%; 95% CI, 88%-106%). Algorithms for dose reduction were not associated with deteriorated diagnostic image quality in this observational study. CONCLUSIONS Median doses of CCTA differ significantly between study sites and CT systems. Effective strategies to reduce radiation dose are available but some strategies are not frequently used. The comparable diagnostic image quality may support an increased use of dose-saving strategies in adequately selected patients.
منابع مشابه
حفاظت پرتویی بیماران در سی تی آنژیوگرافی قلب
Introduction: Cardiac CT (Computed Tomography) angiography applies as a pre-exam method for evaluating the patients with medical problems in their cardiac arteries. Due to the high delivered dose in this imaging method, dose reduction techniques and imaging strategies that serve the images quality with minimum patient dose are the subjects for investigation and research studies. This study will...
متن کاملMultislice CT angiography in cardiac imaging. Part III: radiation risk and dose reduction.
With the introduction of 64- or more-slice computed tomography (CT) technology, multislice CT angiography has been increasingly used as a non-invasive modality for the diagnosis of coronary artery disease. Despite its potential advantages and promising clinical results, multislice CT angiography suffers from high radiation dose which contributes to radiation-induced malignancy in patients under...
متن کاملInfant Cardiac CT Angiography with 64-Slice and 256-Slice CT: Comparison of Radiation Dose and Image Quality Using a Pediatric Phantom
BACKGROUND The aims of this study were to investigate the image quality and radiation exposure of pediatric protocols for cardiac CT angiography (CTA) in infants under one year of age. METHODOLOGY/PRINCIPAL FINDINGS Cardiac CTA examinations were performed using an anthropomorphic phantom representing a 1-year-old child scanned with non-electrocardiogram-gated (NG), retrospectively electrocard...
متن کاملCoronary CT angiography: current status and continuing challenges.
Coronary CT angiography has been increasingly used in the diagnosis of coronary artery disease owing to rapid technological developments, which are reflected in the improved spatial and temporal resolution of the images. High diagnostic accuracy has been achieved with multislice CT scanners (64 slice and higher), and in selected patients coronary CT angiography is regarded as a reliable alterna...
متن کاملEffective radiation dose of three diagnostic tests in cardiology: single photon emission computed tomography, invasive coronary angiography and cardiac computed tomography angiography.
INTRODUCTION Diagnostic tests that use ionizing radiation play a central role in cardiology and their use has grown in recent years, leading to increasing concerns about their potential stochastic effects. The aims of this study were to compare the radiation dose of three diagnostic tests: single photon emission computed tomography (SPECT), invasive coronary angiography (ICA) and cardiac comput...
متن کاملEvaluation of cancer risk of the patients undergoing coronary angiography in Yazd, Iran
Background: Coronary angiography is a commonly performed diagnostic procedure with life saving benefits for the patient. However, this procedure involves relatively high radiation dose. The purpose of this study was to determine the average effective dose of patients undergoing coronary angiography and to estimate the associated radiation risk in terms of fatal malignancy. Materials an...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- JAMA
دوره 301 5 شماره
صفحات -
تاریخ انتشار 2009