Radiation Dose to Patients From Cardiac Diagnostic Imaging

Einstein, Andrew J.; Moser, K; Thompson, Randall C.; Cerqueira, Manuel D.; Henzlova, Milena J.

doi:10.1161/circulationaha.107.688101

Cited by 724 publications

(518 citation statements)

References 66 publications

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“…The total effective radiation dose was calculated by multiplying the dose length product (provided by the scanner) times a conversion factor (0.017mSv/cGy/cm) as previously suggested [22]. All images were analyzed on an external workstation (AW 4.4, GE Healthcare).…”

Section: Data Acquisition and Image Analysismentioning

confidence: 99%

Validation of a new contrast material protocol adapted to body surface area for optimized low-dose CT coronary angiography with prospective ECG-triggering

Pazhenkottil

Husmann

Buechel

et al. 2010

Int J Cardiovasc Imaging

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Section: Data Acquisition and Image Analysismentioning

confidence: 99%

Validation of a new contrast material protocol adapted to body surface area for optimized low-dose CT coronary angiography with prospective ECG-triggering

Pazhenkottil

Husmann

Buechel

et al. 2010

Int J Cardiovasc Imaging

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“…Bolus tracking was performed with a region of interest (ROI) placed into the ascending aorta. All CTCA examinations were performed on a LightSpeed VCT XT scanner (GE Healthcare) with prospective ECG-triggering [6] [17]. Axial images for attenuation calculations were reconstructed with a slice thickness of 0.6 mm, using a standard medium softtissue convolution kernel.…”

Section: Ct Coronary Angiographymentioning

confidence: 99%

Determinants of vessel contrast in BMI-adapted low dose CT coronary angiography with prospective ECG-triggering

Herzog

Husmann

Valenta

et al. 2009

Int J Cardiovasc Imaging

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Methods: Seventy patients underwent low-dose CTCA using BMI-adapted tube parameters and a fixed contrast material bolus. Contrast to noise ratio (CNR) was calculated from contrast (between coronaries and perivascular tissue) and image noise (standard deviation of aortic attenuation). Cardiac output (CO) was calculated from gated 99m Tc-tetrofosmin-SPECT.Results: Mean radiation dose was 2.13 0.69mSv. Image noise was not affected by BMI (r=0.1, P=0.36), while CNR was inversely related to body surface area (BSA) (r= -0.5, P<0.001) and CO (r= -0.49, P<0.001). Conclusions:After successfully overcoming the impact of BMI on image noise by adapting tube parameters, CNR mainly depends on coronary vessel contrast. The latter reflects the dilution of the contrast material by blood volume and CO, which are both correlated to BSA. Therefore, BSA adapted contrast administration may help to compensate for this effect.

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“…No observable effects are present with K a,r < 2 Gy. Radiation skin burns are more common above 5 Gy, and significant tissue injury is possible with >15 Gy, particularly in patients who have received previous radiation, radiation from an X-ray source close to the skin entry site, or radiation from a nonmoving X-ray source [115]. In clinical practice, higher dose is tolerated before the occurrence of skin burn by radiation because of the multiple angles of imaging that reduce the radiation dose at any one skin site to subclinical levels.…”

Section: Managing Radiation Dosesmentioning

confidence: 99%

Staging of multivessel percutaneous coronary interventions: An expert consensus statement from the Society for Cardiovascular Angiography and Interventions

Blankenship

Moussa

Chambers

et al. 2011

Cathet Cardio Intervent

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Percutaneous coronary interventions (PCIs) to treat multivessel coronary artery disease (MVCAD) may involve single-vessel or multivessel interventions, performed in one or more stages. This consensus statement reviews factors that may influence choice of strategy and includes six recommendations to guide decisions regarding staging of PCI [1]. Every patient who undergoes PCI should receive optimal therapy for coronary disease, ideally before starting the procedure [2]. Multivessel PCI at the time of diagnostic catheterization should be considered only if informed consent included the risks and benefits of multivessel PCI and the risks and benefits of alternative treatments [3]. When considering multivessel PCI, the interventionist should develop a strategy regarding which stenoses to treat or evaluate, and their order, method, and timing. This strategy should maximize patient benefits, minimize patient risk, and consider the factors described in this article [4]. For planned multivessel PCI, additional vessel(s) should be treated only if the first vessel is treated successfully and if anticipated contrast and radiation doses and patient and operator conditions are favorable [5]. After the first stage of the planned multistage PCI, the need for subsequent PCI should be reviewed before it is performed [6]. Third party payers and quality auditors should recognize that multistage PCI for MVCAD is neither an indication of poor quality nor an attempt to increase reimbursement when performed according to recommendations in this article.V C 2011 Wiley Periodicals, Inc.

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Radiation Dose to Patients From Cardiac Diagnostic Imaging

Cited by 724 publications

References 66 publications

Validation of a new contrast material protocol adapted to body surface area for optimized low-dose CT coronary angiography with prospective ECG-triggering

Validation of a new contrast material protocol adapted to body surface area for optimized low-dose CT coronary angiography with prospective ECG-triggering

Determinants of vessel contrast in BMI-adapted low dose CT coronary angiography with prospective ECG-triggering

Staging of multivessel percutaneous coronary interventions: An expert consensus statement from the Society for Cardiovascular Angiography and Interventions

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