Radiation exposure and coronary artery calcium scans in the society for heart attack prevention and eradication cohort
- 6 Downloads
Coronary artery calcium (CAC) scoring is used in asymptomatic patients to improve their clinically predicted risk for future cardiovascular events. Current CT protocols seek to reduce radiation exposure without diminishing image quality. Reported radiation exposure remains widely variable (0.8–5 mSv) depending on the type of protocol. In this study, we report the radiation exposure of CAC scoring from the Society for Heart Attack Prevention and Eradication (SHAPE) early detection program cohort sites, which spanned multiple centers using 64-MDCT (multi-detector computed tomography) scanners. We reviewed radiation exposure in milliSieverts (mSv) for 82,214 participants from the SHAPE early detection program cohort who underwent CAC scoring. This occurred over a 2.5-year period (2012–2014) divided among 33 sites in 7 countries with four different types 64-MDCT scanners. The effective radiation dose was reported as mSv. Mean radiation dosing amongst all 82,214 participants was 1.03 mSv, a median dose of 0.94 mSv. The mean radiation dose ranged from 0.76 to 1.31 mSv across the 33 sites involved with the SHAPE program cohort. Subgroup analysis by age, gender or body mass index (BMI) less than 30 kg/m2 showed no variability. Radiation dose in patients with BMI > 30 kg/m2 were significantly greater than other subgroups (µ = 1.96 mSv, p < 0.001). The use of 64-MDCT scanners and protocols provide the effective radiation dose for CAC scoring, which is approximately 1 mSv. This is consistently lower than previously reported for CAC scanning, regardless of scanner type, age or gender. In contrast, a greater BMI influenced mean radiation doses.
KeywordsCoronary artery calcium Radiation Cardiac computed tomography
Compliance with ethical standards
Conflict of interest
Matthew Budoff has received research grants from General Electric. No other author has conflicts of interest.
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.
Research involving human and animal rights
This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 2.Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, Foster E, Hlatky MA, Hodgson JM, Kushner FG, Lauer MS, Shaw LJ, Smith SC Jr, Taylor AJ, Weintraub WS, Wenger NK (2010) 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the american college of cardiology foundation/american heart association task force on practice guidelines. J Am Coll Cardiol 56:50–103CrossRefGoogle Scholar
- 3.Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, Goldberg AC, Gordon D, Levy D, Lloyd-Jones DM, McBride P, Schwartz JS, Shero ST, Smith SC Jr, Watson K, Wilson PWF (2014) ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol 63(25 Pt B):2889–2934CrossRefPubMedGoogle Scholar
- 8.Budoff MJ, Achenbach S, Blumenthal RS, Carr JJ, Goldin JG, Greenland P, Guerci AD, Lima JA, Rader DJ, Rubin GD, Shaw LJ, Wiegers SE, American Heart Association Committee on Cardiovascular Imaging and Intervention; American Heart Association Council on Cardiovascular Radiology and Intervention; American Heart Association Committee on Cardiac Imaging, Council on Clinical Cardiology (2006) Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation 114(16):1761–1791CrossRefPubMedGoogle Scholar
- 9.Voros S, Rivera JJ, Berman DS, Blankstein R, Budoff MJ, Cury RC, Desai MY, Dey D, Halliburton SS, Hecht HS, Nasir K, Santos RD, Shapiro MD, Taylor AJ, Valeti US, Young PM, Weissman G (2011) Guideline for minimizing radiation exposure during acquisition of coronary artery calcium scans with the use of multidetector computed tomography: a report by the Society for Atherosclerosis Imaging and Prevention Tomographic Imaging and Prevention Councils in collaboration with the Society of Cardiovascular Computed Tomography. Society for Atherosclerosis Imaging and Prevention Tomographic Imaging and Prevention Councils; Society of Cardiovascular Computed Tomography. J Cardiovasc Comput Tomogr 5(2):75–83CrossRefPubMedGoogle Scholar
- 12.Gerber T, Carr J, Arai A, Dixon R, Ferrari V, Gomes A, Heller G, McCollough C, McNitt-Gray M, Mettler F, Mieres J, Morin R, Yester M (2009) Ionizing radiation in cardiac imaging: a science advisory from the AHA committee on cardiac imaging of the council on clinical cardiology and committee on cardiovascular imaging and intervention of the council on cardiovascular radiology and intervention. Circulation 119(7):1056–1065CrossRefPubMedGoogle Scholar
- 16.Ceponiene I, Nakanishi R, Osawa K, Kanisawa M, Nezarat N, Rahmani S, Kissel K, Kim M, Jayawardena E, Broersen A, Kitslaar P, Budoff MJ (2017) Coronary artery calcium progression is associated with coronary plaque volume progression: results from a quantitative semiautomated coronary artery plaque analysis. JACC Cardiovasc Imaging. https://doi.org/10.1016/j.jcmg.2017.07.023 PubMedGoogle Scholar
- 17.Budoff MJ, Young R, Lopez VA, Kronmal RA, Nasir K, Blumenthal RS, Detrano RC, Bild DE, Guerci AD, Liu K, Shea S, Szklo M, Post W, Lima J, Bertoni A, Wong ND (2013) Progression of coronary calcium and incident coronary heart disease events: the multi-ethnic study of atherosclerosis. J Am Coll Cardiol 61(12):1231–1239CrossRefPubMedPubMedCentralGoogle Scholar
- 21.Nakazato R, Dey D, Gutstein A, Le ML, Cheng VY, Pimentel R, Paz W, Hayes SW, Thomson LE, Friedman JD, Berman DS (2009) Coronary artery calcium scoring using a reduced tube voltage and radiation dose protocol with dual-source computed tomography. J Cardiovasc Comput Tomogr 3:394–400CrossRefPubMedGoogle Scholar
- 23.Halliburton SS, Abbara S, Chen MY, Gentry R, Mahesh M, Raff GL, Shaw LJ, Hausleiter J (2011) Society of cardiovascular computed tomography. SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT. J Cardiovasc Comput Tomogr 5(4):198–224CrossRefPubMedPubMedCentralGoogle Scholar
- 27.ICRP Publication 103 (2007) The 2007 recommendations of the international commission on radiological protection. Ann ICRP 37:1–332Google Scholar