Variability of radiation doses of cardiac diagnostic imaging tests: the RADIO-EVINCI study (RADIationdOse subproject of the EVINCI study)

BMC Cardiovascular Disorders

Research Article

Claudio Michelassi¹  Clara Carpeggiani¹  Eugenio Picano¹  Danilo Neglia²  Marco Brambilla³  S. Richard Underwood⁴  Philipp Kauffman⁵  Juhani Knuuti⁶ 

[1] CNR Institute of Clinical Physiology, via Moruzzi, 1-56124, Pisa, Italy;Fondazione Toscana G. Monasterio, via Moruzzi, 1, Pisa, Italy;Medical Physics Department, University Hospital ‘Maggiore della Carità, Corso Mazzini, 18, 28100, Novara, Italy;National Heart and Lung Institute, Imperial College London, London, UK;Department of Nuclear Medicine, Royal Brompton and Harefield Hospitals, Sydney Street, SW3 6NP, London, UK;University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland;University of Turku and Turku University Hospital, Kinakvarngatan 4-8, 20520, Åbo, Finland;

关键词: Medical imaging;    Radiation dose exposure;    Effective dose;    CT;   

DOI  :  10.1186/s12872-017-0474-9

 received in 2016-11-05, accepted in 2017-01-16,  发布年份 2017

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© The Author(s). 2017