Cumulative Exposure to Ionizing Radiation from Diagnostic and Therapeutic Cardiac Imaging Procedures: A Population-Based Analysis

OBJECTIVES: The purpose of this study was to describe radiation exposure from cardiac imaging procedures over time in a general population. Cardiac imaging procedures frequently expose patients to ionizing radiation, but their contribution to effective doses of radiation in the general population is unknown.

METHODS: We used administrative claims to identify cardiac imaging procedures performed from 2005 to 2007 in 952,420 nonelderly insured adults in 5 U.S. health care markets. We estimated 3-year cumulative effective doses of radiation in millisieverts from these procedures We then calculated population-based annual rates of radiation exposure to effective doses ≤3 mSv/year (background level ofradiation from natural sources), >3 to 20 mSv/year, or >20 mSv/year (upper annual limit for occupational exposure averaged over 5 years).

RESULTS: A total of 90,121 (9.5%) individuals underwent at least 1 cardiac imaging procedure using radiation. Among patients who underwent ≥1 cardiac imaging procedures, the mean cumulative effective dose over 3 years was 16.4 mSv (range 1.5 to 189.5 mSv). Myocardial perfusion imaging accounted for 74% of the cumulative effective dose. Overall, 47.8% of cardiac imaging procedures were performed in physician offices; this proportion was higher for myocardial perfusion imaging (74.8%) and cardiac computed tomography studies (76.5%). The annual population-based rate of receiving an effective dose of >3 to 20 mSv/year was 89.0 per 1,000; and 3.3 per 1,000 for cumulative doses >20 mSv/year. Annual effective doses increased with age and were generally higher among men.

CONCLUSIONS: Cardiac imaging procedures lead to substantial radiation exposure and effective doses for many patients in the U.S.

PMID:

Posted in Computed Tomography, Invasive Imaging, Nuclear Imaging and tagged , , , .

2 Comments

  1. See also:

    Effective Radiation Dose, Time, and Contrast Medium to Measure Fractional Flow Reserve
    Argyrios Ntalianis, Catalina Trana, Olivier Muller, Fabio Mangiacapra, Aaron Peace, Carina De Backer, Liesbeth De Block, Eric Wyffels, Jozef Bartunek, Marc Vanderheyden, Alex Heyse, Frederic Van Durme, Luc Van Driessche, Jo De Jans, Guy R. Heyndrickx, William Wijns, Emanuele Barbato, and Bernard De Bruyne
    J Am Coll Cardiol Intv 2010;3 821-827
    http://interventions.onlinejacc.org/cgi/content/abstract/3/8/821

    AND

    More data linking cardiac imaging to high radiation exposure
    HeartWire.
    July 9, 2010. Reed Miller.

  2. There is an editorial comment accompanying the article.

    While both points of view are important and create the necessary attention that the use of radiation requires. The bottom line appears to continue to be clear: We need to have a better understanding of the radiation risks in patients. How much? When?

    In the meantime… ALARA.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>