Journal of Nuclear Cardiology

, Volume 15, Issue 2, pp 232–240

Radiation dose and cancer risk estimates in 16-slice computed tomography coronary angiography

  • Andrew J. Einstein
  • Javier Sanz
  • Santo Dellegrottaglie
  • Margherita Milite
  • Marc Sirol
  • Milena Henzlova
  • Sanjay Rajagopalan
Original Articles

DOI: 10.1016/j.nuclcard.2007.09.028

Cite this article as:
Einstein, A.J., Sanz, J., Dellegrottaglie, S. et al. J Nucl Cardiol (2008) 15: 232. doi:10.1016/j.nuclcard.2007.09.028

Abstract

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.

Key Words

Computed tomography coronary angiography effective dose radiation 

Copyright information

© American Society of Nuclear Cardiology 2008

Authors and Affiliations

  • Andrew J. Einstein
    • 1
    • 2
  • Javier Sanz
    • 3
    • 4
  • Santo Dellegrottaglie
    • 3
    • 4
  • Margherita Milite
    • 5
  • Marc Sirol
    • 3
    • 4
  • Milena Henzlova
    • 3
    • 4
  • Sanjay Rajagopalan
    • 6
  1. 1.Department of Medicine, Division of CardiologyColumbia University College of Physicians and SurgeonsNew York
  2. 2.Department of RadiologyColumbia University College of Physicians and SurgeonsNew York
  3. 3.Zena and Michael A. Wiener Cardiovascular InstituteThe Mount Sinai Medical CenterNew York
  4. 4.Marie-Josée and Henry R. Kravis Center for Cardiovascular HealthThe Mount Sinai Medical CenterNew York
  5. 5.Siemens Medical SolutionsForchheimGermany
  6. 6.Department of Medicine, Division of Cardiovascular MedicineThe Ohio State UniversityColumbus
  7. 7.Columbia University Medical CenterNew York

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