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 |
|
This article has been cited by other articles:
|
|
|
|
 
K-R Chiou, W-C Huang, N-J Peng, Y-L Huang, S-H Hsiao, K-H Chen, and M-T Wu
Dual-phase multi-detector computed tomography assesses jeopardised and infarcted myocardium subtending infarct-related artery early after acute myocardial infarction
Heart,
September 15, 2009;
95(18):
1495 - 1501.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Dewey, E. Zimmermann, F. Deissenrieder, M. Laule, H.-P. Dubel, P. Schlattmann, F. Knebel, W. Rutsch, and B. Hamm
Noninvasive Coronary Angiography by 320-Row Computed Tomography With Lower Radiation Exposure and Maintained Diagnostic Accuracy: Comparison of Results With Cardiac Catheterization in a Head-to-Head Pilot Investigation
Circulation,
September 8, 2009;
120(10):
867 - 875.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Pontone, D. Andreini, A. L. Bartorelli, S. Cortinovis, S. Mushtaq, E. Bertella, A. Annoni, A. Formenti, E. Nobili, D. Trabattoni, et al.
Diagnostic accuracy of coronary computed tomography angiography: a comparison between prospective and retrospective electrocardiogram triggering.
J. Am. Coll. Cardiol.,
July 21, 2009;
54(4):
346 - 355.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. P. Kim, A. J. Einstein, and A. Berrington de Gonzalez
Coronary Artery Calcification Screening: Estimated Radiation Dose and Cancer Risk
Arch Intern Med,
July 13, 2009;
169(13):
1188 - 1194.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Bettencourt, J. Rocha, M. Carvalho, D. Leite, A. M. Toschke, B. Melica, L. Santos, A. Rodrigues, M. Goncalves, P. Braga, et al.
Multislice Computed Tomography in the Exclusion of Coronary Artery Disease in Patients With Presurgical Valve Disease
Circ Cardiovasc Imaging,
July 1, 2009;
2(4):
306 - 313.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
U. Hoffmann and F. Bamberg
Is Computed Tomography Coronary Angiography the Most Accurate and Effective Noninvasive Imaging Tool to Evaluate Patients With Acute Chest Pain in the Emergency Department?: CT Coronary Angiography Is the Most Accurate and Effective Noninvasive Imaging Tool for Evaluating Patients Presenting With Chest Pain to the Emergency Department
Circ Cardiovasc Imaging,
May 1, 2009;
2(3):
251 - 263.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Pflederer, L. Rudofsky, D. Ropers, S. Bachmann, M. Marwan, W. G. Daniel, and S. Achenbach
Image Quality in a Low Radiation Exposure Protocol for Retrospectively ECG-Gated Coronary CT Angiography
Am. J. Roentgenol.,
April 1, 2009;
192(4):
1045 - 1050.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Hausleiter, T. Meyer, F. Hermann, M. Hadamitzky, M. Krebs, T. C. Gerber, C. McCollough, S. Martinoff, A. Kastrati, A. Schomig, et al.
Estimated Radiation Dose Associated With Cardiac CT Angiography
JAMA,
February 4, 2009;
301(5):
500 - 507.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. H. Piers, R. Dikkers, T. P. Willems, B. J.G.L. de Smet, M. Oudkerk, F. Zijlstra, and R. A. Tio
Computed tomographic angiography or conventional coronary angiography in therapeutic decision-making
Eur. Heart J.,
December 1, 2008;
29(23):
2902 - 2907.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Miller, C. E. Rochitte, M. Dewey, A. Arbab-Zadeh, H. Niinuma, I. Gottlieb, N. Paul, M. E. Clouse, E. P. Shapiro, J. Hoe, et al.
Diagnostic Performance of Coronary Angiography by 64-Row CT
N. Engl. J. Med.,
November 27, 2008;
359(22):
2324 - 2336.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Maruyama, M. Takada, T. Hasuike, A. Yoshikawa, E. Namimatsu, and T. Yoshizumi
Radiation Dose Reduction and Coronary Assessability of Prospective Electrocardiogram-Gated Computed Tomography Coronary Angiography: Comparison With Retrospective Electrocardiogram-Gated Helical Scan
J. Am. Coll. Cardiol.,
October 28, 2008;
52(18):
1450 - 1455.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G BEDETTI, N BOTTO, M G ANDREASSI, C TRAINO, E VANO, and E PICANO
Cumulative patient effective dose in cardiology
Br. J. Radiol.,
September 1, 2008;
81(969):
699 - 705.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Bluemke, S. Achenbach, M. Budoff, T. C. Gerber, B. Gersh, L. D. Hillis, W. G. Hundley, W. J. Manning, B. F. Printz, M. Stuber, et al.
Noninvasive Coronary Artery Imaging: Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young
Circulation,
July 29, 2008;
118(5):
586 - 606.
[Full Text]
[PDF]
|
|
|
|
|
|
|
W T Roberts, J J Bax, and L C Davies
Cardiac CT and CT coronary angiography: technology and application
Heart,
June 1, 2008;
94(6):
781 - 792.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. M. Kramer
All High-Risk Patients Should Not Be Screened With Computed Tomographic Angiography
Circulation,
March 11, 2008;
117(10):
1333 - 1339.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. P. Earls, E. L. Berman, B. A. Urban, C. A. Curry, J. L. Lane, R. S. Jennings, C. C. McCulloch, J. Hsieh, and J. H. Londt
Prospectively Gated Transverse Coronary CT Angiography versus Retrospectively Gated Helical Technique: Improved Image Quality and Reduced Radiation Dose
Radiology,
March 1, 2008;
246(3):
742 - 753.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Schroeder, S. Achenbach, F. Bengel, C. Burgstahler, F. Cademartiri, P. de Feyter, R. George, P. Kaufmann, A. F. Kopp, J. Knuuti, et al.
Cardiac computed tomography: indications, applications, limitations, and training requirements: Report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology
Eur. Heart J.,
February 2, 2008;
29(4):
531 - 556.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Horiguchi, M. Kiguchi, C. Fujioka, Y. Shen, R. Arie, K. Sunasaka, and K. Ito
Radiation Dose, Image Quality, Stenosis Measurement, and CT Densitometry Using ECG-Triggered Coronary 64-MDCT Angiography: A Phantom Study
Am. J. Roentgenol.,
February 1, 2008;
190(2):
315 - 320.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Abdulla, S. Z. Abildstrom, O. Gotzsche, E. Christensen, L. Kober, and C. Torp-Pedersen
64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis
Eur. Heart J.,
December 2, 2007;
28(24):
3042 - 3050.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. M. Hurwitz, R. E. Reiman, T. T. Yoshizumi, P. C. Goodman, G. Toncheva, G. Nguyen, and C. Lowry
Radiation Dose from Contemporary Cardiothoracic Multidetector CT Protocols with an Anthropomorphic Female Phantom: Implications for Cancer Induction
Radiology,
December 1, 2007;
245(3):
742 - 750.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. B Meijboom, N. R Mollet, C. A Van Mieghem, A. C Weustink, F. Pugliese, N. van Pelt, F. Cademartiri, E. Vourvouri, P. de Jaegere, G. P Krestin, et al.
64-Slice CT coronary angiography in patients with non-ST elevation acute coronary syndrome
Heart,
November 1, 2007;
93(11):
1386 - 1392.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. J. Einstein, K. W. Moser, R. C. Thompson, M. D. Cerqueira, and M. J. Henzlova
Radiation Dose to Patients From Cardiac Diagnostic Imaging
Circulation,
September 11, 2007;
116(11):
1290 - 1305.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Ector, O. Dragusin, B. Adriaenssens, W. Huybrechts, R. Willems, H. Ector, and H. Heidbuchel
Obesity Is a Major Determinant of Radiation Dose in Patients Undergoing Pulmonary Vein Isolation for Atrial Fibrillation
J. Am. Coll. Cardiol.,
July 17, 2007;
50(3):
234 - 242.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. L. Hollingsworth, T. T. Yoshizumi, D. P. Frush, F. P. Chan, G. Toncheva, G. Nguyen, C. R. Lowry, and L. M. Hurwitz
Pediatric Cardiac-Gated CT Angiography: Assessment of Radiation Dose
Am. J. Roentgenol.,
July 1, 2007;
189(1):
12 - 18.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Inoue, T. Kobayashi, A. Morikawa, A. Taddio, C. D. Rose, G. F. Greil, W. J. Manning, J. W. Newburger, L. A. Sleeper, and J. C. Burns
Treatment of Kawasaki Disease
N. Engl. J. Med.,
June 28, 2007;
356(26):
2746 - 2748.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. F. Redberg
Computed Tomographic Angiography: More Than Just a Pretty Picture?
J. Am. Coll. Cardiol.,
May 8, 2007;
49(18):
1827 - 1829.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. R. Karsch, D. R. Coles, M. A. Smail, I. S. Negus, P. Wilde, M. Oberhoff, and A. Baumbach
Reply
J. Am. Coll. Cardiol.,
February 20, 2007;
49(7):
829 - 829.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. R. Conti
Comparing Radiation Doses From 2 Diagnostic Tests
J. Am. Coll. Cardiol.,
February 20, 2007;
49(7):
828 - 828.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Achenbach
Computed Tomography Coronary Angiography
J. Am. Coll. Cardiol.,
November 21, 2006;
48(10):
1919 - 1928.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. B. Meijboom, N. R. Mollet, C. A.G. Van Mieghem, J. Kluin, A. C. Weustink, F. Pugliese, E. Vourvouri, F. Cademartiri, A. J.J.C. Bogers, G. P. Krestin, et al.
Pre-Operative Computed Tomography Coronary Angiography to Detect Significant Coronary Artery Disease in Patients Referred for Cardiac Valve Surgery
J. Am. Coll. Cardiol.,
October 17, 2006;
48(8):
1658 - 1665.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. M. Burger, K. J. Murphy, L. C. Jordan, R. J. Tamargo, and P. Gailloud
Safety of Cerebral Digital Subtraction Angiography in Children: Complication Rate Analysis in 241 Consecutive Diagnostic Angiograms
Stroke,
October 1, 2006;
37(10):
2535 - 2539.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
