Advertisement

Journal of Nuclear Cardiology

, Volume 18, Issue 4, pp 566–569 | Cite as

Radiation exposure in diagnostic imaging—use, misuse, or abuse? Part I: The background and science of medical radiation

  • Kim Allan WilliamsSr.Email author
  • Kalyani Ballapuram
Review Article

Perspective on Medical Radiation for Medical Imaging

Diagnostic use of radiation has progressed from Wilhelm Roentgen’s image of his wife’s hand in 18951 to 4-dimensional images of cardiac anatomy, function, perfusion, and metabolism. Imaging is widely used in the twenty-first century, with growth stimulated by the clinical insights gained for patient care.

Cardiac imaging with nuclear medicine techniques and x-ray computed tomography (CT) results in the largest exposure of ionizing radiation to the US population. In fact there was a 700% increase in radiation exposure to patients from 1986 until 2006. Radiation exposure is increasing at rate of 5% per year with 25% collective dose.2,3 This includes CT growth at about 10% per year. Cardiac CT has accounted for 1.5% of radiation exposure, and is increasing gradually.

Among nuclear medicine studies, cardiac imaging represents 57% of the number of studies and 85% of the radiation dose. The frequency of these procedures increased by 10% or...

Keywords

Radiation Exposure Nuclear Cardiology Coronary Compute Tomography Angiography Cardiac Compute Tomography SPECT Myocardial Perfusion Imaging 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Glasser O. Wilhelm Conrad Roentgen and the early years of Roentgen rays. San Francisco, CA: Norman Publishing; 1993.Google Scholar
  2. 2.
    Gerber TC, Carr JJ, Arai AE, et al. Ionizing radiation in cardiac imaging: A science advisory from the American Heart Association 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 2009;119:1056-65.PubMedCrossRefGoogle Scholar
  3. 3.
    Brenner DJ, Hall EJ. Computed tomography: An increasing source of radiation exposure. N Engl J Med 2007;357:2277-84.PubMedCrossRefGoogle Scholar
  4. 4.
    Mettler FA Jr, Thomadsen BR, Bhargavan M, Gilley DB, Gray JE, Lipoti JA, et al. Medical radiation exposure in the U.S. in 2006: Preliminary results. Health Phys 2008;95:502-7.PubMedCrossRefGoogle Scholar
  5. 5.
    Brindis RG, Douglas PS, Hendel RC, et al. ACCF/ASNC appropriateness criteria for single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI): A report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group and the American Society of Nuclear Cardiology endorsed by the American Heart Association. J Am Coll Cardiol 2005;46:1587-605.PubMedCrossRefGoogle Scholar
  6. 6.
    Hendel RC, Berman DS, Di Carli MF, et al. ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 appropriate use criteria for cardiac radionuclide imaging: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine. J Am Coll Cardiol 2009;53:2201-29.PubMedCrossRefGoogle Scholar
  7. 7.
    Attix FH. Introduction to radiological physics and radiation dosimetry. New York, NY: Wiley; 1986. p. 20-34.CrossRefGoogle Scholar
  8. 8.
    Wackers FJ, Berman DS, Maddahi J, et al. Technetium-99m hexakis 2-methoxyisobutyl isonitrile: human biodistribution, dosimetry, safety, and preliminary comparison to thallium-201 for myocardial perfusion imaging. J Nucl Med 1989;30:301-11.PubMedGoogle Scholar
  9. 9.
    Thompson RC, Cullom SJ. Issues regarding radiation dosage of cardiac nuclear and radiography procedures. J Nucl Cardiol 2006;13:19-23.PubMedCrossRefGoogle Scholar
  10. 10.
  11. 11.
    Einstein AJ. Radiation protection of patients undergoing cardiac computed tomographic angiography. JAMA 2009;301:545-7.PubMedCrossRefGoogle Scholar
  12. 12.
    Bithell JF, Stewart AM. Pre-natal irradiation and childhood malignancy: A review of British data from the Oxford Survey. Br J Cancer 1975;31:271-87.PubMedCrossRefGoogle Scholar
  13. 13.
    Eisenberg MJ, Afilalo J, Lawler PR, et al. Cancer risk related to low-dose ionizing radiation from cardiac imaging in patients after acute myocardial infarction. CMAJ 2011;183:430-6. Epub 2011 Feb 7.PubMedCrossRefGoogle Scholar
  14. 14.
    Zanzonico P, Rothenberg LN, Strauss HW. Radiation exposure of computed tomography and direct intracoronary angiography: Risk has its reward. J Am Coll Cardiol 2006;47:1846-9.PubMedCrossRefGoogle Scholar
  15. 15.
    Mehta R, Ward RP, Chandra S, Agarwal R, Williams KA. Evaluation of the American College of Cardiology Foundation/American Society of Nuclear Cardiology appropriateness criteria for SPECT myocardial perfusion imaging. J Nucl Cardiol 2008;15:337-44.PubMedCrossRefGoogle Scholar
  16. 16.
    Gibbons RJ, Miller TD, Hodge D, et al. Application of appropriateness criteria to stress single-photon emission computed tomography sestamibi studies and stress echocardiograms in an academic medical center. J Am Coll Cardiol 2008;51:1283-9.PubMedCrossRefGoogle Scholar
  17. 17.
    Hendel RC, Cerqueira M, Douglas PS, et al. A multicenter assessment of the use of single-photon emission computed tomography myocardial perfusion imaging with appropriateness criteria. J Am Coll Cardiol 2010;55:156-62.PubMedCrossRefGoogle Scholar

Copyright information

© American Society of Nuclear Cardiology 2011

Authors and Affiliations

  1. 1.Division of Cardiology, Harper University HospitalWayne State University School of MedicineDetroitUSA
  2. 2.Department of MedicineWayne State UniversityDetroitUSA

Personalised recommendations