Pedro de Araújo Gonçalves1, Pedro Jerónimo Sousa2, Rita Calé3, Hugo Marques4, Miguel Borges dos Santos5, André Dias6, Hélder Dores5, Maria Salomé Carvalho5, António Ventosa5, Teresa Martins6, Rui Campante Teles5, Manuel Almeida5, Miguel Mendes5. 1. Serviço de Cardiologia, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; CEDOC - Chronic Diseases Research Center - Faculdade de Ciências Médicas-UNL, Lisboa, Portugal; Centro Cardiovascular, Hospital da Luz, Lisboa, Portugal. Electronic address: paraujogoncalves@yahoo.co.uk. 2. Serviço de Cardiologia, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; Centro Cardiovascular, Hospital da Luz, Lisboa, Portugal. 3. Serviço de Cardiologia, Hospital Garcia de Orta, Almada, Portugal. 4. Centro de lmagiologia, Hospital da Luz, Lisboa, Portugal. 5. Serviço de Cardiologia, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal. 6. Serviço de Medicina Nuclear, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
Abstract
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 computed tomography (cardiac CT) and their evolution over time, and to assess the influence of body mass index on radiation dose. METHODS: We assessed consecutive patients included in three prospective registries (SPECT, ICA and cardiac CT) over a period of two years. Radiation dose was converted to mSv and compared between the three registries. Differences over time were evaluated by comparing the first with the fourth semester. RESULTS: A total of 6196 exams were evaluated: 35% SPECT, 53% ICA and 22% cardiac CT. Mean radiation dose was 10.7±1.2 mSv for SPECT, 8.1±6.4 mSv for ICA, and 5.4±3.8 mSv for cardiac CT (p<0.001 for all). With regard to the radiation dose over time, there was a very small reduction in SPECT (10.7 to 10.5 mSv, p=0.004), a significant increase (25%) in ICA (7.0 to 8.8 mSv; p<0.001), and a significant reduction (29%) in cardiac CT (6.5 to 4.6 mSv, p<0.001). Obesity was associated with a significantly higher radiation dose in all three exams. CONCLUSIONS: Cardiac CT had a lower mean effective radiation dose than invasive coronary angiography, which in turn had a lower mean effective dose than SPECT. There was a significant increase in radiation doses in the ICA registry and a significant decrease in the cardiac CT registry over time.
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 computed tomography (cardiac CT) and their evolution over time, and to assess the influence of body mass index on radiation dose. METHODS: We assessed consecutive patients included in three prospective registries (SPECT, ICA and cardiac CT) over a period of two years. Radiation dose was converted to mSv and compared between the three registries. Differences over time were evaluated by comparing the first with the fourth semester. RESULTS: A total of 6196 exams were evaluated: 35% SPECT, 53% ICA and 22% cardiac CT. Mean radiation dose was 10.7±1.2 mSv for SPECT, 8.1±6.4 mSv for ICA, and 5.4±3.8 mSv for cardiac CT (p<0.001 for all). With regard to the radiation dose over time, there was a very small reduction in SPECT (10.7 to 10.5 mSv, p=0.004), a significant increase (25%) in ICA (7.0 to 8.8 mSv; p<0.001), and a significant reduction (29%) in cardiac CT (6.5 to 4.6 mSv, p<0.001). Obesity was associated with a significantly higher radiation dose in all three exams. CONCLUSIONS: Cardiac CT had a lower mean effective radiation dose than invasive coronary angiography, which in turn had a lower mean effective dose than SPECT. There was a significant increase in radiation doses in the ICA registry and a significant decrease in the cardiac CT registry over time.
Authors: A M Bucher; C N De Cecco; U J Schoepf; R Wang; F G Meinel; S R Binukrishnan; J V Spearman; T J Vogl; B Ruzsics Journal: Br J Radiol Date: 2014-08-19 Impact factor: 3.039