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CLINICAL RESEARCH: CARDIAC IMAGING

Comparison of Radiation Doses From Multislice Computed Tomography Coronary Angiography and Conventional Diagnostic Angiography

Duncan R. Coles, BSc, MB BS^_*, Mary A. Smail, MSc, Ian S. Negus, MSc, Peter Wilde, BSc, BM BCh, Martin Oberhoff, MD^_*, Karl R. Karsch, MD, FACC^_*,_* and Andreas Baumbach, MD^_*

^_* Department of Cardiology, Bristol Heart Institute, Bristol Royal Infirmary, Bristol, United Kingdom
Department of Medical Physics and Bioengineering, Bristol Heart Institute, Bristol Royal Infirmary, Bristol, United Kingdom
Department of Clinical Radiology, Bristol Heart Institute, Bristol Royal Infirmary, Bristol, United Kingdom.

Manuscript received April 16, 2005; revised manuscript received August 14, 2005, accepted November 16, 2005.

^_* Reprint requests and correspondence: Prof. Karl R. Karsch, Bristol Heart Institute, University of Bristol, Level 7, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, United Kingdom. (Email: K.R.Karsch{at}bristol.ac.uk).

OBJECTIVES: The aim of this study was to quantify and compare effective doses from conventional angiography and multislice computed tomography (MSCT) coronary angiography using a 16-slice scanner.

BACKGROUND: Multislice computed tomography is now a viable modality for cardiac imaging. However, for any diagnostic use of ionizing radiation, the risk to the patient must be considered and justified.

METHODS: Multislice computed tomography angiography and conventional angiography were used to assess 180 patients with suspected coronary artery disease. Estimates of effective dose were derived from exposure data recorded for each patient examination. For each modality, a comparable calculation technique was used, based on Monte Carlo modeling of the standard Cristy phantom.

RESULTS: In a subset of 91 directly comparable patients the mean effective dose for MSCT coronary angiography was 14.7 mSv (SD 2.2) and that for conventional angiography was 5.6 mSv (SD 3.6). A significant difference in effective dose was seen between the two protocols.

CONCLUSIONS: The mean effective dose for MSCT coronary angiography was significantly higher than that for conventional angiography. As MSCT cardiac scanners become increasingly available, operators must be aware of the radiation dose and the factors that affect it.

Abbreviations and Acronyms   CABG = coronary artery bypass graft   CCA = conventional coronary angiography   CT = computed tomography   CTDI = computed tomography dose index   DAP = dose-area product   DLP = dose-length product   MSCT = multislice computed tomography

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