Assessment of Effective Dose Associated with Coronary Computed Tomography Angiography in Isfahan Province, Iran

Mohammadbagher Tavakoli, Reihane Faraji, Zahra Alirezeai, Zohre Nateghian

DOI: 10.4103/jmss.JMSS_22_17

Abstract


Computed tomography coronary angiography (CTCA) has generated a great interest over the
past two decades, due to its high diagnostic accuracy and effcacy in the assessment of patients
having coronary artery disease. This method is associated with high radiation dose and this has
raised serious concerns in the literature. Effective dose (E) is a single parameter meant to reflect
the relative risk from exposure to ionizing radiation. Therefore, it is necessary to calculate this
parameter to indicate ionizing radiation relative risk. The aim of this study was to calculate the
effective dose from 64‑slice CTCA in Isfahan. To calculate the effective dose, an ionization
chamber and a body phantom with diameter of 32 cm and length of 15 cm were used. CTCA
radiation conditions commonly used in two centers were applied for this work. For all scans,
computed tomography volume dose index (CTDIv), dose‑length product (DLP), and effective dose
were obtained using dose‑length‑product method. The obtained CTDIv, DLP, and effective dose
were compared in two centers, and mean, maximum, and minimum values of effective dose for
heart coronary CT angiography (CCTA) examinations and calcium score were compared with
other studies. The amount of average, maximum, and minimum effective doses for heart CCTA
examinations in two centers are 4.65 ± 0.06, 6.0489, and 3.492 mSv, respectively, and for calcium
score test are, 1.04 ± 0.04, 2.155, and 0.98 mSv, respectively. CTDIv, DLP, and effective dose
values did not show any signifcant difference in two centers. Although the effective dose of CTCA
and calcium score was lower than that of other studies, it is reasonable to reduce the effective dose
to the minimum possible value to reduce the risk of cancer associated with ionizing radiation. The
results of this study can be used to introduce the effective dose as a local diagnostic reference
dose (DRL) for CTCA examinations in Isfahan Province.

Keywords


Computed tomography volume dose index, coronary computed tomography angiography, dose length product, effective dose, local diagnostic reference dose, multidetector computed tomography scan

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References


Bahreyni Toossi MT, Bahrami M. Assessment of patient dose from CT examinations in Khorasan, Iran. Iran J Med Phys 2013;9:233-8.

Tavakoli MB, Heydari K, Jafari S. Evaluation of diagnostic reference levels for CT scan in Isfahan. Glob J Med Res Stud 2014;1:130-4.

Hoffmann U, Ferencik M, Cury RC, Pena AJ. Coronary CT angiography. J Nucl Med 2006;47:797-806.

Kopp AF, Schroeder S, Kuettner A, Baumbach A, Georg C, Kuzo R, et al. Non-invasive coronary angiography with high resolution multidetector-row computed tomography. Results in 102 patients. Eur Heart J 2002;23:1714-25.

Najafi M, Deevband MR, Ahmadi M, Kardan MR. Establishment of diagnostic reference levels for common multi-detector computed tomography examinations in Iran. Australas Phys Eng Sci Med 2015;38:603-9.

Hausleiter J, Meyer T, Hermann F, Hadamitzky M, Krebs M, Gerber TC, et al. Estimated radiation dose associated with cardiac CT angiography. JAMA 2009;301:500-7.

Husmann L, Valenta I, Gaemperli O, Adda O, Treyer V, Wyss CA, et al. Feasibility of low-dose coronary CT angiography: First experience with prospective ECG-gating. Eur Heart J 2008;29:191-7.

Foley S, McEntee M, Rainford L. Establishment of CT diagnostic reference levels in Ireland. The British journal of radiology. 2012;85:1390-7.

Origgi D, Vigorito S, Villa G, Bellomi M, Tosi G. Survey of computed tomography techniques and absorbed dose in Italian hospitals: A comparison between two methods to estimate the dose-length product and the effective dose and to verify fulfilment of the diagnostic reference levels. Eur Radiol 2006;16:227-37.

Hausleiter J, Meyer T, Hadamitzky M, Huber E, Zankl M, Martinoff S, et al. Radiation dose estimates from cardiac multislice computed tomography in daily practice: Impact of different scanning protocols on effective dose estimates. Circulation 2006;113:1305-10.

Earls JP, Berman EL, Urban BA, Curry CA, Lane JL, Jennings RS, et al. Prospectively gated transverse coronary CT angiography versus retrospectively gated helical technique: Improved image quality and reduced radiation dose. Radiology 2008;246:742-53.

Sabarudin A, Sun Z. Radiation dose measurements in coronary CT angiography. World J Cardiol 2013;5:459-64.

Salomon EJ, Barfett J, Willems PW, Geibprasert S, Bacigaluppi S, Krings T. Dynamic CT angiography and CT perfusion employing a 320 detector row CT. Clin Neuroradiol 2009;19:187-96.

Zelikman M, editor Calibration of thermoluminescent dosimeters placed inside the anthropomorphic phantom which is used for CT effective dose evaluation 2011: European Congress of Radiology 2012.

Christner JA, Kofl er JM, McCollough CH. Estimating effective dose for CT using dose-length product compared with using organ doses: Consequences of adopting International Commission on Radiological Protection publication 103 or dual-energy scanning. AJR Am J Roentgenol 2010;194:881-9.

Gorycki T, Lasek I, Kaminski K, Studniarek M. Evaluation of radiation doses delivered in different chest CT protocols. Pol J Radiol 2014;79:1-5.

Lee CH, Goo JM, Ye HJ, Ye SJ, Park CM, Chun EJ, et al. Radiation dose modulation techniques in the multidetector CT era: From basics to practice. Radiographics 2008;28:1451-9.

Tsapaki V, Rehani M. Dose management in CT facility. Biomed Imaging Interv J 2007;3:e43.

Brix G, Nagel HD, Stamm G, Veit R, Lechel U, Griebel J, et al. Radiation exposure in multi-slice versus single-slice spiral CT: Results of a nationwide survey. Eur Radiol 2003;13:1979-91.

Mori S, Nishizawa K, Kondo C, Ohno M, Akahane K, Endo M. Effective doses in subjects undergoing computed tomography cardiac imaging with the 256-multislice CT scanner. Eur J Radiol 2008;65:442-8.

Bauhs JA, Vrieze TJ, Primak AN, Bruesewitz MR, McCollough CH. CT dosimetry: Comparison of measurement techniques and devices. Radiographics 2008;28:245-53.

Gancheva M, Dyakov I, Vassileva J, Avramova-Cholakova S, Taseva D. Dosimetry methods for multi-detector computed tomography. Radiat Prot Dosimetry 2015;165:190-3.

Sahbaee P, Segars WP, Marin D, Nelson RC, Samei E. The effect of contrast material on radiation dose at CT: Part I. Incorporation of contrast material dynamics in anthropomorphic phantoms. Radiology 2017;283:739-48.

Paul J, Jacobi V, Bazrafshan B, Farshid P, Vogl T. Effect of contrast material on radiation dose in an adult cardiac dual-energy CT using retrospective ECG-gating. Health Phys 2013;105:156-64.

Palorini F, Origgi D, Granata C, Matranga D, Salerno S. Adult exposures from MDCT including multiphase studies: First Italian nationwide survey. Eur Radiol 2014;24:469-83.

Mafalanka F, Etard C, Rehel JL, Pesenti-Rossi D, Amrar-Vennier F, Baron N, et al. Establishment of diagnostic reference levels in cardiac CT in France: A need for patient dose optimisation. Radiat Prot Dosimetry 2015;164:116-9.

van der Molen AJ, Schilham A, Stoop P, Prokop M, Geleijns J. A national survey on radiation dose in CT in the Netherlands. Insights Imaging 2013;4:383-90.

Treier R, Aroua A, Verdun FR, Samara E, Stuessi A, Trueb PR. Patient doses in CT examinations in Switzerland: Implementation of national diagnostic reference levels. Radiat Prot Dosimetry 2010;142:244-54


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