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Coronary calcium scans and radiation exposure in the multi-ethnic study of atherosclerosis

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Abstract

With the increasing use of coronary artery calcium (CAC) scoring to risk stratify asymptomatic patients for future cardiovascular events, there have been concerns raised regarding the theoretical risk of radiation exposure to this potentially large patient population. Newer CT protocols have sought to reduce radiation exposure without compromising image quality, but the reported radiation exposures in the literature remains widely variable (0.7–10.5 mSv). In this study, we report the radiation exposure of calcium scoring from our MESA cohort across several modern CT scanners with the aim of clarifying the radiation exposure of this imaging modality. To evaluate the mean effective doses of radiation, using dose length product, utilized for coronary artery calcium scoring in the MESA cohort, in an effort to understand estimated population quantity effective dose using individual measurements of scanner radiation output using current CT scanners. We reviewed effective dose in milliSieverts (mSv) for 3442 participants from the MESA cohort undergoing coronary artery calcium scoring, divided over six sites with four different modern CT scanners (Siemens64, Siemens Somatom Definition, GE64, and Toshiba 320). For effective dose calculation (milliSieverts, mSv), we multiplied the dose length product by conversion factor k (0.014). The mean effective dose amongst all participants was 1.05 mSv, a median dose of 0.95 mSV. The mean effective dose ranged from 0.74 to 1.26 across the six centers involved with the MESA cohort. The Siemens Somatom Definition scanner had effective dose of 0.53 (n = 123), Siemens 64 with 0.97 (n = 1684), GE 64 with 1.16 (n = 1219), and Toshiba 320 with 1.26 mSv (n = 416). Subgroup analysis by BMI, age, and gender showed no variability between scanners, gender, ages 45–74 years old, or BMI less than 30 kg/m2. Subjects over age 75 yo had a mean effective dose of 1.29 ± 0.31 mSv, while the <75 yo subgroup was 0.78 ± 0.09 mSv (p < 0.05). Effective doses in subjects with BMI > 40 kg/m2 was significantly greater than other subgroups, with mean dose of 1.47 ± 0.51 mSv (p < 0.01). Using contemporary CT scanners and protocols, the effective dose for coronary artery calcium is approximately 1 mSv, an estimate which is consistently lower than previously reported for CAC scanning, regardless of age, gender, and body mass index.

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Acknowledgments

This research was supported by R01 HL071739 and contracts N01-HC-95159 through N01-HC-95165 and N01 HC 95169 from the National Heart, Lung, and Blood Institute and the Multi-Ethnic Study of Atherosclerosis and Air Pollution, funded by the Environmental Protection Agency (EPA) Science to Achieve Results (STAR) Program (grant RD 831697). The authors thank the other investigators, the staff, and the participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org.

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  1. Los Angeles Biomedical Research Institute, 1124 W Carson Street, RB2, Torrance, CA, 90502, USA

    Bradley Messenger, Dong Li, Khurram Nasir, J. Jeffrey Carr, Ron Blankstein & Matthew J. Budoff

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  1. Bradley Messenger
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  2. Dong Li
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  3. Khurram Nasir
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  4. J. Jeffrey Carr
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  5. Ron Blankstein
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  6. Matthew J. Budoff
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Correspondence to Matthew J. Budoff.

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Conflict of interest

Matthew Budoff has received research grants from NIH and General Electric. No other author has conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and animal studies

This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Messenger, B., Li, D., Nasir, K. et al. Coronary calcium scans and radiation exposure in the multi-ethnic study of atherosclerosis. Int J Cardiovasc Imaging 32, 525–529 (2016). https://doi.org/10.1007/s10554-015-0799-3

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  • DOI: https://doi.org/10.1007/s10554-015-0799-3

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