Variability of radiation doses of cardiac diagnostic imaging tests: the RADIO-EVINCI study RADIationdOse subproject of the EVINCI studyReport as inadecuate




Variability of radiation doses of cardiac diagnostic imaging tests: the RADIO-EVINCI study RADIationdOse subproject of the EVINCI study - Download this document for free, or read online. Document in PDF available to download.

BMC Cardiovascular Disorders

, 17:63

Coronary artery disease

Abstract

BackgroundPatients with coronary artery disease can accumulate significant radiation dose through repeated exposures to coronary computed tomographic angiography, myocardial perfusion imaging with single photon emission computed tomography or positron emission tomography, and to invasive coronary angiography. Aim of the study was to audit radiation doses of coronary computed tomographic angiography, single photon emission computed tomography, positron emission tomography and invasive coronary angiography in patients enrolled in the prospective, randomized, multi-centre European study–EVINCI Evaluation of Integrated Cardiac Imaging for the Detection and Characterization of Ischemic Heart Disease.

MethodsWe reviewed 1070 tests 476 coronary computed tomographic angiographies, 85 positron emission tomographies, 310 single photon emission computed tomographies, 199 invasive coronary angiographies performed in 476 patients mean age 60 ± 9 years, 60% males enrolled in 12 centers of the EVINCI. The effective doses were calculated in milli-Sievert mSv as median, interquartile range IQR and coefficient of variation of the mean.

ResultsCoronary computed tomographic angiography 476 exams in 12 centers median effective dose was 9.6 mSv IQR = 13.2 mSv; single photon emission computed tomography 310 exams in 9 centers effective dose was 9.3 IQR = 2.8; positron emission tomography 85 in 3 centers effective dose 1.8 IQR = 1.6 and invasive coronary angiography 199 in 9 centers effective dose 7.4 IQR = 7.3. Inter-institutional variability was highest for invasive coronary angiography 100% and coronary computed tomographic angiography 54% and lowest for single photon emission computed tomography 20%. Intra-institutional variability was highest for invasive coronary angiography 121% and coronary computed tomographic angiography 115% and lowest for single photon emission computed tomography 14%.

ConclusionCoronary computed tomographic angiography and invasive coronary angiography doses vary substantially between and within centers. The variability in nuclear medicine procedures is substantially lower. The findings highlight the need to audit doses, to track cumulative exposures and to standardize doses for imaging techniques.

Trial registrationThe study protocol is available at https:-www.clinicaltrials.gov- ClinicalTrials.gov Identifier: NCT00979199. Information provided on September 16, 2009.

KeywordsMedical imaging Radiation dose exposure Effective dose CT AbbreviationsBMIBody mass index

CADCoronary artery disease

CCTACoronary computed tomographic angiography

CVCoefficient of variation

DLPDose length product

EEffective dose

EVINCIEvaluation of Integrated Cardiac Imaging for the Detection and Characterization of Ischemic Heart Disease

ICAInvasive coronary angiography

IQRInterquartile range

mGymilligray

mSvmilli-Sievert

PETPositron emission tomography

SPECTSingle photon emission computed tomography

WWeight





Author: Clara Carpeggiani - Eugenio Picano - Marco Brambilla - Claudio Michelassi - Juhani Knuuti - Philipp Kauffman - S. Richard 

Source: https://link.springer.com/







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