Cardiac-Specific Conversion Factors to Estimate Radiation Effective Dose From Dose-Length Product in Computed Tomography

Trattner, Sigal; Halliburton, Sandra S.; Thompson, Carla M.; Xu, Yanping; Chelliah, Anjali; Jambawalikar, Sachin; Peng, Boyu; Peters, M. Robert; Jacobs, Jill E.; Ghesani, Munir; Jang, James J.; Al‐Khalidi, Hussein R.; Einstein, Andrew J.

doi:10.1016/j.jcmg.2017.06.006

Cited by 131 publications

(80 citation statements)

References 28 publications

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“…The patient factors obtained were heart rate (HR) and HR variability. The technical factors obtained included scanner type, number of sources, number of sections, section thickness, pixel spacing (distance between the center of the pixel in the x-y plane, which in turn is determined by the reconstructed field of view), temporal resolution, tube voltage, aortic attenuation, aortic noise, and effective radiation dose measured as the product of dose-length product times for conversion coefficient for the chest (K = 0.026 mSv/mGy•cm) (16). From the DICOM imaging data, aortic contrast material opacification was calculated as the mean attenuation (in Hounsfield units) within the aortic root volume extracted for FFR CT analysis, while image noise was measured as the standard deviation of Hounsfield units within the same volume of the aortic root.…”

Section: Discussionmentioning

confidence: 99%

Determinants of Rejection Rate for Coronary CT Angiography Fractional Flow Reserve Analysis

Weir‐McCall¹,

Baggiano²,

Torto³

et al. 2019

Radiology

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oronary artery disease is a major cause of mortality and morbidity, and its management consumes a large portion of health care budgets (1). Several noninvasive tests are commonly used as gatekeepers to invasive coronary angiography. Despite the frequent use of noninvasive functional stress testing, the prevalence of obstructive coronary artery disease at elective invasive coronary angiography is low (2,3). Coronary CT angiography is an alternative anatomically based imaging modality used to assess coronary artery disease. However, because of its limited positive predictive value, it can lead to increased downstream use of invasive coronary angiography (4-6). Recently, participant-specific coronary CT angiography data have been combined with computational fluid dynamic models, allowing for noninvasive determination of the fractional flow reserve derived from coronary CT angiography (FFR CT). This correlates well with invasive FFR and reduces rates of invasive coronary angiography use compared with coronary CT angiography alone (7,8). In these previous trials,

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Section: Discussionmentioning

confidence: 99%

Determinants of Rejection Rate for Coronary CT Angiography Fractional Flow Reserve Analysis

Weir‐McCall¹,

Baggiano²,

Torto³

et al. 2019

Radiology

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“…For calculating the effective dose from coronary CT, the dose-length product was obtained from the CT dose report and multiplied by a conversion coefficient value of 0.014 mSv•mGy −1 cm −1 . 17) The effective dose from the low-dose attenuation correction CT was calculated using the same method as that of cardiac CT with a conversion coefficient value of 4/12 https://e-jcvi.org https://doi.org/10.4250/jcvi.2019.0087…”

Section: Radiation Exposure From Hybrid Pet/ct Imagingmentioning

confidence: 99%

Diagnostic Value of Lesion-specific Measurement of Myocardial Blood Flow Using Hybrid PET/CT

Cho

Kim

Cho

et al. 2020

J Cardiovasc Imaging

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BACKGROUND: We evaluated whether lesion-specific measurement of myocardial blood flow (MBF) and flow reserve (MFR) by hybrid imaging of myocardial perfusion positron emission tomography (PET) and coronary computed tomography (CT) can provide additional diagnostic value. METHODS: Forty-three patients with stable angina underwent N-13 ammonia PET and coronary CT before invasive coronary angiography (CAG). The lesion-specific MBF was calculated from the average MBF of the myocardial segments downstream of a coronary stenosis using hybrid PET/CT images. The hyperemic MBF, resting MBF, and MFR were measured for the left anterior descending artery (LAD) using conventional and lesion-specific methods. The diagnostic accuracy was compared between the two methods for significant LAD stenoses (≥ 70% reference diameter on CAG). RESULTS: There were 19 significant LAD stenoses. The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy were 71%, 68%, 74%, 65%, and 70% for conventional hyperemic MBF (optimal cutoff = 2.15 mL/min/g), 79%, 63%, 74%, 65%, and 70% for conventional MFR (optimal cutoff = 1.82), 83%, 74%, 80%, 78%, and 80% for lesion-specific hyperemic MBF (optimal cutoff = 1.75 mL/min/g), and 79%, 79%, 83%, 75%, and 79% for lesion-specific MFR (optimal cutoff = 1.86), respectively. The lesion-specific measurement was more accurate and had a better linear correlation with anatomical stenosis severity for both hyperemic MBF and MFR. CONCLUSIONS: Lesion-specific measurement using hybrid PET/CT imaging showed significant improvement in the diagnostic accuracy of PET-measured hyperemic MBF and MFR.

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“…The most common conversion factor for adult chest CT is 0.014 mSv Á mGy 21 Á cm 21 [12], with values for children being greater. For CT examinations confined to the cardiac region, estimated conversion factors are greater, with an average value of 0.026 mSv Á mGy 21 Á cm 21 (13)(14)(15)(16)(17)(18).…”

Section: X-ray Ct Measures Of Effective Dosementioning

confidence: 99%

2018 ACC/HRS/NASCI/SCAI/SCCT Expert Consensus Document on Optimal Use of Ionizing Radiation in Cardiovascular Imaging—Best Practices for Safety and Effectiveness, Part 2: Radiological Equipment Operation, Dose‐Sparing Methodologies, Patient and Medical Personnel Protection

Hirshfeld¹,

Ferrari²,

Bengel

et al. 2018

Cathet Cardio Intervent

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The stimulus to create this document was the recognition that ionizing radiation-guided cardiovascular procedures are being performed with increasing frequency, leading to greater patient radiation exposure and, potentially, to greater exposure to clinical personnel. While the clinical benefit of these procedures is substantial, there is concern about the implications of medical radiation exposure. ACC leadership concluded that it is important to provide practitioners with an educational resource that assembles and interprets the current radiation knowledge base relevant to cardiovascular procedures. By applying this knowledge base, cardiovascular practitioners will be able to select procedures optimally, and minimize radiation exposure to patients and to clinical personnel. "Optimal Use of Ionizing Radiation in Cardiovascular Imaging - Best Practices for Safety and Effectiveness" is a comprehensive overview of ionizing radiation use in cardiovascular procedures and is published online. To provide the most value to our members, we divided the print version of this document into 2 focused parts. "Part I: Radiation Physics and Radiation Biology" addresses radiation physics, dosimetry and detrimental biologic effects. "Part II: Radiologic Equipment Operation, Dose-Sparing Methodologies, Patient and Medical Personnel Protection" covers the basics of operation and radiation delivery for the 3 cardiovascular imaging modalities (x-ray fluoroscopy, x-ray computed tomography, and nuclear scintigraphy). For each modality, it includes the determinants of radiation exposure and techniques to minimize exposure to both patients and to medical personnel.

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Cardiac-Specific Conversion Factors to Estimate Radiation Effective Dose From Dose-Length Product in Computed Tomography

Cited by 131 publications

References 28 publications

Determinants of Rejection Rate for Coronary CT Angiography Fractional Flow Reserve Analysis

Determinants of Rejection Rate for Coronary CT Angiography Fractional Flow Reserve Analysis

Diagnostic Value of Lesion-specific Measurement of Myocardial Blood Flow Using Hybrid PET/CT

2018 ACC/HRS/NASCI/SCAI/SCCT Expert Consensus Document on Optimal Use of Ionizing Radiation in Cardiovascular Imaging—Best Practices for Safety and Effectiveness, Part 2: Radiological Equipment Operation, Dose‐Sparing Methodologies, Patient and Medical Personnel Protection

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