BACKGROUND: Recent advances have led to a rapid increase in the number of computed tomography coronary angiography (CTCA) studies performed. Whereas several studies have reported the effective dose, there are no data available on cancer risk for current CTCA protocols. METHODS AND RESULTS: Effective and organ doses were estimated, by use of scanner-derived parameters and Monte Carlo methods, for 50 patients having 16-slice CTCA performed for clinical indications. Lifetime attributable risks were estimated with models developed in the National Academies' Biological Effects of Ionizing Radiation VII report. The effective dose of a complete CTCA averaged 9.5 mSv, whereas that of a complete study, including calcium scoring when indicated, averaged 11.7 mSv. Calcium scoring increased effective dose by 25%, whereas tube current modulation reduced it by 34% and was more effective at lower heart rates. Organ doses to the lungs and female breast were highest. The lifetime attributable risk of cancer incidence from CTCA averaged approximately 1 in 1,600 but varied widely among patients, being highest in younger women. For all patients, the greatest risk was from lung cancer. CONCLUSIONS: CTCA is associated with non-negligible risk of malignancy. Doses can be reduced by careful attention to scanning protocol.
BACKGROUND: Recent advances have led to a rapid increase in the number of computed tomography coronary angiography (CTCA) studies performed. Whereas several studies have reported the effective dose, there are no data available on cancer risk for current CTCA protocols. METHODS AND RESULTS: Effective and organ doses were estimated, by use of scanner-derived parameters and Monte Carlo methods, for 50 patients having 16-slice CTCA performed for clinical indications. Lifetime attributable risks were estimated with models developed in the National Academies' Biological Effects of Ionizing Radiation VII report. The effective dose of a complete CTCA averaged 9.5 mSv, whereas that of a complete study, including calcium scoring when indicated, averaged 11.7 mSv. Calcium scoring increased effective dose by 25%, whereas tube current modulation reduced it by 34% and was more effective at lower heart rates. Organ doses to the lungs and female breast were highest. The lifetime attributable risk of cancer incidence from CTCA averaged approximately 1 in 1,600 but varied widely among patients, being highest in younger women. For all patients, the greatest risk was from lung cancer. CONCLUSIONS: CTCA is associated with non-negligible risk of malignancy. Doses can be reduced by careful attention to scanning protocol.
Authors: Tobias F Jakobs; Christoph R Becker; Bernd Ohnesorge; Thomas Flohr; Christoph Suess; Uwe J Schoepf; Maximilian F Reiser Journal: Eur Radiol Date: 2002-02-21 Impact factor: 5.315
Authors: Peter Hunold; Florian M Vogt; Axel Schmermund; Jörg F Debatin; Gert Kerkhoff; Thomas Budde; Raimund Erbel; Klaus Ewen; Jörg Barkhausen Journal: Radiology Date: 2003-01 Impact factor: 11.105
Authors: Andrew J Einstein; Kevin W Moser; Randall C Thompson; Manuel D Cerqueira; Milena J Henzlova Journal: Circulation Date: 2007-09-11 Impact factor: 29.690
Authors: David J Brenner; Richard Doll; Dudley T Goodhead; Eric J Hall; Charles E Land; John B Little; Jay H Lubin; Dale L Preston; R Julian Preston; Jerome S Puskin; Elaine Ron; Rainer K Sachs; Jonathan M Samet; Richard B Setlow; Marco Zaider Journal: Proc Natl Acad Sci U S A Date: 2003-11-10 Impact factor: 11.205
Authors: E Maffei; C Martini; S De Crescenzo; T Arcadi; A Clemente; E Capuano; A Rossi; R Malagò; N Mollet; A Weustink; C Tedeschi; L La Grutta; S Seitun; A Igoren Guaricci; F Cademartiri Journal: Radiol Med Date: 2010-06-23 Impact factor: 3.469
Authors: Benjamin P Fahimian; Yunzhe Zhao; Zhifeng Huang; Russell Fung; Yu Mao; Chun Zhu; Maryam Khatonabadi; John J DeMarco; Stanley J Osher; Michael F McNitt-Gray; Jianwei Miao Journal: Med Phys Date: 2013-03 Impact factor: 4.071
Authors: C N De Cecco; V Buffa; S Fedeli; A Vallone; R Ruopoli; M Luzietti; V Miele; M Maurizi Enrici; F Musumeci; V David Journal: Radiol Med Date: 2010-10-27 Impact factor: 3.469