Estimates of lifetime attributable risk of cancer after a single radiation exposure from 64-slice computed tomographic coronary angiography

Faletra, Francesco F.; D'Angeli, Ilaria; Klersy, Catherine; Averaimo, M.; Klimusina, Julija; Pasotti, Elena; Pedrazzini, Giovanni; Curti, Moreno; Carraro, C.; DiLiberto, R.; Moccetti, Tiziano; Auricchio, Angelo

doi:10.1136/hrt.2009.186973

Cited by 49 publications

(24 citation statements)

References 22 publications

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“…By contrast, the effective radiation dose in our study averaged 1.8±0.6 mSv as we used prospective ECG triggering to obtain low-dose CCTA. As the safety of radiation has evoked a vivid discussion on the risk-to-benefit ratio of CCTA,21 reduction of radiation dose is essential. This is particularly true for patient populations commonly referred for CCTA as their cardiac event risk is typically low.…”

Section: Discussionmentioning

confidence: 99%

Prognostic performance of low-dose coronary CT angiography with prospective ECG triggering

Buechel

Pazhenkottil

Herzog

et al. 2011

Heart

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Objective To assess the prognostic value of low-dose 64-slice coronary CT angiography (CCTA) using prospective ECG triggering in a patient population with known or suspected coronary artery disease (CAD). Design Longitudinal follow-up study. Setting Tertiary referral cardiac imaging centre. Patients 434 consecutive patients who were referred for evaluation of CAD by CCTA. Methods The presence, distribution and severity of coronary lesions (non-obstructive <50% vs obstructive 50% luminal narrowing) were recorded by low-dose prospective ECG-triggered CCTA for each patient. The prognostic value of low-dose CCTA to predict major adverse cardiac events, defined as cardiac death, non-fatal myocardial infarction, or the need for revascularisation, was assessed using multivariate Cox regression analysis. Each person was followed up by telephone interviews and/or on the basis of clinical records. Thirty-eight early revascularised patients were excluded from outcome analysis. Results Completely normal coronary arteries were documented in 171 patients (47%), while exclusively non-obstructive lesions were found in 66 (18%), and obstructive coronary lesions were diagnosed in 130 patients (35%). A mean follow-up of 47±16 weeks was obtained. The first-year event rate was 0% in patients with normal coronary arteries on CCTA but increased to 3% and 26% in patients with non-obstructive and obstructive coronary artery lesions, respectively. In multivariate Cox regression analysis, a significant predictor of events was the presence of obstructive or any coronary lesions. Mean effective radiation dose was 1.8±0.6 mSv. Conclusions These data document an excellent prognostic performance of low-dose CCTA. DOI: https://doi.org/10. 1136/hrt.2010.217638 Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-51131 Accepted Version Originally published at: Buechel, R R; Pazhenkottil, A P; Herzog, B A; Brueckner, M; Nkoulou, R; Ghadri, J R; Küest, S M; Wyss, C A; Husmann, L; Kaufmann, P A (2011). Prognostic performance of low-dose coronary CT angiography with prospective ECG triggering. Heart, 97 (17) AbstractObjective: To assess the prognostic value of low-dose 64-slice coronary CT angiography (CCTA) using prospective electrocardiogram (ECG) triggering in a patient population with known or suspected coronary artery disease (CAD).Design: Longitudinal follow-up study.Setting: Tertiary referral cardiac imaging centre.Patients: 405 consecutive patients who were referred for evaluation of CAD by CCTA. Methods:The presence, distribution and severity of coronary lesions (nonobstructive < 50% versus obstructive ≥ 50% luminal narrowing) were recorded by low-dose prospective ECG triggered CCTA for each patient. The prognostic value of low-dose CCTA to predict major adverse cardiac events (MACE), defined as cardiac death, non-fatal myocardial infarction (MI), or the need for revascularization, was assessed using multivariate Cox regression analysis. Each individual was followedup by t...

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Section: Discussionmentioning

confidence: 99%

Prognostic performance of low-dose coronary CT angiography with prospective ECG triggering

Buechel

Pazhenkottil

Herzog

et al. 2011

Heart

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“…In the present study, we used a prospective ECG-gating coronary 64-slice MDCT protocol to reduce radiation exposure. We recently published a comparison of 561 consecutive patients who were studied using this protocol and 188 patients who underwent retrospective ECG-gating MDCT with ECG-triggered dose modulation MDCT [39]. The radiation dose using this protocol ranged from 1.33 to 3.81 mSv, as compared to 10.34 to 18.97 mSv for the retrospective ECG-gating protocol.…”

Section: Discussionmentioning

confidence: 98%

Assessment of coronary stenosis, plaque burden and remodeling by multidetector computed tomography in patients referred for suspected coronary artery disease

Pedrazzini

D'Angeli

Vassalli

et al. 2011

Journal of Cardiovascular Medicine

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“…Recent reports underline the potential of MDCT to replace conventional coronary angiography for the diagnosis and follow-up of cardiac allograft vasculopathy in heart transplant recipients [5][6][7][8]10]. However, emerging data on exposure to ionising radiation from imaging procedures [27][28][29] and particularly the relatively high radiation dose related to cardiac CT [11,12,31], has raised concern among the medical community about keeping the radiation dose at minimum levels. In this sense, in the field of cardiac CT imaging, the appropriateness of using a prospectively ECG-triggered acquisition mode in selected groups of patients is being consistently encouraged.…”

Section: Discussionmentioning

confidence: 99%

Systolic prospectively ECG-triggered dual-source CT angiography for evaluation of the coronary arteries in heart transplant recipients

et al. 2011

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Estimates of lifetime attributable risk of cancer after a single radiation exposure from 64-slice computed tomographic coronary angiography

Abstract: This study provided an estimate of the LAR of cancer in middle-aged patients of both sexes after a single diagnostic CTCA, providing an easy-to-read table.

Cited by 49 publications

References 22 publications

Prognostic performance of low-dose coronary CT angiography with prospective ECG triggering

Prognostic performance of low-dose coronary CT angiography with prospective ECG triggering

Assessment of coronary stenosis, plaque burden and remodeling by multidetector computed tomography in patients referred for suspected coronary artery disease

Systolic prospectively ECG-triggered dual-source CT angiography for evaluation of the coronary arteries in heart transplant recipients

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