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

  • Original Articles
  • Published:
Journal of Nuclear Cardiology Aims and scope

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.

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Authors and Affiliations

  1. Department of Medicine, Division of Cardiology, Columbia University College of Physicians and Surgeons, New York, NY

    Andrew J. Einstein

  2. Department of Radiology, Columbia University College of Physicians and Surgeons, New York, NY

    Andrew J. Einstein

  3. Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Medical Center, New York, NY

    Javier Sanz, Santo Dellegrottaglie, Marc Sirol & Milena Henzlova

  4. Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, The Mount Sinai Medical Center, New York, NY

    Javier Sanz, Santo Dellegrottaglie, Marc Sirol & Milena Henzlova

  5. Siemens Medical Solutions, Forchheim, Germany

    Margherita Milite

  6. Department of Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio

    Sanjay Rajagopalan

Authors
  1. Andrew J. Einstein
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  2. Javier Sanz
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  3. Santo Dellegrottaglie
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  4. Margherita Milite
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  5. Marc Sirol
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  6. Milena Henzlova
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  7. Sanjay Rajagopalan
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Corresponding author

Correspondence to Andrew J. Einstein.

Additional information

This study was presented in part at the American College of Cardiology 55th Annual Scientific Session, Atlanta, Ga, March 13, 2006.

This work was supported in part by a National Institutes of Health/National Center for Research Resources Clinical and Translational Science Award (1 UL1 RR-24156-01).

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Einstein, A.J., Sanz, J., Dellegrottaglie, S. et al. Radiation dose and cancer risk estimates in 16-slice computed tomography coronary angiography. J Nucl Cardiol 15, 232–240 (2008). https://doi.org/10.1016/j.nuclcard.2007.09.028

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  • DOI: https://doi.org/10.1016/j.nuclcard.2007.09.028

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