OBJECTIVES: Available data on the radiation burden from coronary computed tomography (CT) angiography (CCTA) are mostly limited to effective dose estimates. This study provides individualized estimates of doses and associated life attributable risks of radiation-induced cancer in a clinical patient population undergoing 256-slice CCTA.
METHODS: Typical retrospectively and prospectively ECG-gated CCTA exposures in a 256-slice CT scanner were simulated on 52 patient-specific voxelized phantoms. Dose images depicting the dose deposition on the exposed region were generated, and normalized organ doses for all primarily irradiated radiosensitive organs were derived and correlated to patient body habitus. Lung, breast, and esophagus absorbed doses were then determined in 136 consecutive patients subjected to CCTA. Projected life attributable risks of radiation-induced cancer were estimated through the use of appropriate sex-, age- and organ-specific cancer risk factors and compared with corresponding nominal cancer risks. The total projected life attributable risk of radiogenic cancer after CCTA decreases steeply with age at exposure, and lung cancer constitutes the most probable detriment for both sexes.
RESULTS: The relative risks of lung cancer associated with prospectively ECG-gated CCTA were 1.0032 and 1.0008 for women and men, respectively. The mean total projected life attributable risks were estimated to be 24.9±7.4 and 71.5±30.0 per 100 000 women undergoing prospectively and retrospectively ECG-gated CCTA, respectively. The corresponding values for men were 7.3±1.3 and 31.4±5.0 per 100 000 patients.
CONCLUSIONS: The mean projected life attributable risks of radiation-induced cancer in a typical clinical patient cohort undergoing standard prospectively ECG-gated CCTA with a 256-slice scanner were found to inconsequentially increase the natural cancer incidence rates.
Lady Davis Carmel Medical Center
Latest posts by Ronen Rubinshtein (see all)
- Fractional Flow Reserve Calculation From 3-Dimensional Quantitative Coronary Angiography and TIMI Frame Count: A Fast Computer Model to Quantify the Functional Significance of Moderately Obstructed Coronary Arteries - September 4, 2014
- Iterative Model Reconstruction: Improved Image Quality of Low-Tube-Voltage Prospective ECG-Gated Coronary CT Angiography Images at 256-Slice CT - June 1, 2014
- Optimizing Image Contrast Display Improves Quantitative Stenosis Measurement in Heavily Calcified Coronary Arterial Segments on Coronary CT Angiography: A Proof-of-Concept and Comparison to Quantitative Invasive Coronary Angiography - May 12, 2014