Rationale and design of the worldwide prospective multicenter registry on radiation dose estimates of cardiac CT angiography in daily practice in 2017 (PROTECTION VI) (original) (raw)
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Reduction in Radiation Exposure in Cardiovascular CT Imaging
European Heart Journal, 2018
Aims Advances of cardiac computed tomography angiography (CTA) have been developed for dose reduction, but their efficacy in clinical practice is largely unknown. This study was designed to evaluate radiation dose exposure and utilization of dose-saving strategies for contrast-enhanced cardiac CTA in daily practice.
2015
The aim of this study is to obtain Portuguese cardiac Computed Tomography (CT) Diagnostic Reference Levels (DRLs) and compare the effective dose values with other cardiac examinations performed in Portugal and international studies. Methods: CT dose values and chest anteroposterior diameter (direct measurement on the images) were retrospectively collected in four centres of excellence representing different regions of Portugal, in order to calculate the DRLs based on the 75 th percentile CT values. Results: The sample was composed by 108 individuals, without significant differences inchest diameter. Significant differences were found between local DRL's across the centres. The proposed DRL for cardiac CT is 32mGy. The obtained cardiac CT effective dose value is higher than a diagnostic angiography and similar to a cardiac angioplasty. Conclusions: The obtained dose values should be optimised. Procedures justification must be reconsidered and the radiation examinations risk must be analysed taking into account the clinical indications.
IOSR Journals , 2019
Background: Nowadaysamong non communicable diseases Coronary artery disease heads in both in mortality and morbidity.Its early detection and hence cure needs multimodal diagnostic tools CT scan being among the latest modality.The diagnostic value of conventional coronary angiography has been challenged by the emergence & fast growing use of a less invasive imaging technique, multislice computerised tomography (MSCT) angiography to avoid radiation hazard. From time to time ,the manufacturers have implemented strategies to reduce the radiation exposure and these include ECG-gated dose modulation, automated exposure control,lowering the tube voltage,& increasing the pitch value with the use of dual source CT scanners.The non-invasiveness of this technique being highly desirable replacing conventional invasive coronary angiography. Hence reducing risk of radiation exposure hence health care threats. Aim: The aim of our study was to assess & compare the radiation doses between the prospective & retrospective ECG-gated coronary CT angiography in CAD patients. Methods: We performed our study ,a prospective comparative study conducted in the Department of Radiodiagnosis & Imaging of a tertiary institute at Srinagar,Kashmir,India after taking due clearance from the Institutional Ethical Committee(IEC).Inclucluded Patients were low to intermediate risk for CAD and patients with high risk for CAD but were reluctant for undergoing an invasive procedure.99 patients were enrolled in the study for a total period of two years, underwent contrast-enhanced ECG-gated CT coronary angiography by either of the two methods. Results: In this study, we compared a new method of coronary CTA based on prospectively gated sequential axial acquisition(PGA CTA) with the retrospectively gated helical acquisition (RGH CTA) as the reference method in a total of 99 patients.We demonstrated an important and significant decrease in radiation dose by PGA CTA with an equivalent image quality and number of assessable segments compared with RGH CTA. Conclusion: with adequate preparation & careful patient selection, most patients can have a diagnostic CCTA exam with prospective gating &their effective radiation dose & subsequent risk of developing a radiationinduced malignancy can be greatly reduced. . Prospectively-gated acquisition (PGA CTA) has been specifically designed to reduce the of coronary CT angiography by limiting X-ray exposure to a brief predetermined diastole window & eliminating overlapping areas of exposure. Summary: Lower dose reduces the long-term risk to the patient of developing a radiation-induced malignancy. Consequently, reducing the radiation burden to the lowest level without compromising the diagnostic image quality should be the persistent goal for the radiologist.
Radiation dose at cardiac computed tomography: facts and fiction
Journal of thoracic imaging, 2010
Cardiac computed tomography (CT) dosimetry makes use of two radiation parameters: a volume CT dose index (CTDI) and a dose length product (DLP). The volume CTDI quantifies the intensity of the radiation used to perform CT examinations, whereas DLP quantifies the amount of radiation used. CTDI metrics can be converted into patient dose metrics by using dose/CTDI conversion factors. In cardiac CT imaging, these need to take into account the x-ray tube voltage, scan length, and scan region, as well as patient size. Organ doses to patients in cardiac CT can be converted into cancer risks when patient demographic factors are taken into account. A risk analysis of patients undergoing cardiac CT angiography at our institution showed that a majority (62%) were males, with a median age of approximately 60 years and a median weight of approximately 90 kg. The median DLP was approximately 1100 mGy cm, corresponding to an effective dose of approximately 29 mSv in normal-sized patients. The aver...
PloS one, 2016
This study aimed to measure the absorbed doses in selected organs for prospectively ECG-triggered coronary computed tomography angiography (CCTA) using five different generations CT scanners in a female adult anthropomorphic phantom and to estimate the effective dose (HE). Prospectively ECG-triggered CCTA was performed using five commercially available CT scanners: 64-detector-row single source CT (SSCT), 2 × 32-detector-row-dual source CT (DSCT), 2 × 64-detector-row DSCT and 320-detector-row SSCT scanners. Absorbed doses were measured in 34 organs using pre-calibrated optically stimulated luminescence dosimeters (OSLDs) placed inside a standard female adult anthropomorphic phantom. HE was calculated from the measured organ doses and compared to the HE derived from the air kerma-length product (PKL) using the conversion coefficient of 0.014 mSv∙mGy-1∙cm-1 for the chest region. Both breasts and lungs received the highest radiation dose during CCTA examination. The highest HE was rece...
Journal of Medical Imaging and Radiation Oncology, 2012
The purpose of this paper is to perform a systematic review on radiation dose reduction in coronary computed tomography (CT) angiography that is done using different generations of multidetector CT (MDCT) scanners ranging from four-slice to 320-slice CTs, and have different dose-saving techniques. The method followed was to search for references on coronary CT angiography (CTA) that had been published in English between 1998 and February 2011. The effective radiation dose reported in each study based on different generations of MDCT scanners was analysed and compared between the types of scanners, gender, exposure factors and scanning protocols. Sixty-six studies were eligible for inclusion in this analysis. The mean effective dose (ED) for MDCT angiography with retrospective electrocardiogram (ECG) gating without use of any dose-saving protocol was 6.0 Ϯ 2.8, 10.4 Ϯ 4.90 and 11.8 Ϯ 5.9 mSv for four-slice, 16-slice and 64-slice CTs, respectively. More dosesaving strategies were applied in recent CT generations including prospective ECG-gating protocols, application of lower tube voltage and tube current modulation to achieve a noteworthy dose reduction. Prospective ECGgating protocol was increasingly used in 64, 125, 256 and 320 slices with corresponding ED of 4.1 Ϯ 1.7, 3.6 Ϯ 0.4, 3.0 Ϯ 1.9 and 7.6 Ϯ 1.6 mSv, respectively. Lower tube voltage and tube current modulation were widely applied in 64-slice CT and resulted in significant dose reduction (P < 0.05). This analysis has shown that dose-saving strategies can substantially reduce the radiation dose in CT coronary angiography. The fact that more and more clinicians are opting for dose-saving strategies in CT coronary angiography indicates an increased awareness of risks associated with high radiation doses among them.