Division of Cardiology, Fondazione Cardiocentro Ticino, Via Tesserete 48, Lugano, Switzerland.
Heart. 2010 Jun;96(12):927-32. doi: 10.1136/hrt.2009.186973.
To estimate the life attributable risk (LAR) of cancer incidence over a wide range of dose radiation exposure and a large spectrum of possible diagnostic computed tomographic coronary angiography (CTCA) scenarios.
This study included 561 consecutive patients who underwent a successful prospective ECG-gating CTCA protocol (low-dose group) 64-slice CTCA and 188 patients who underwent retrospective ECG-gating CTCA with ECG-triggered dose modulation CTCA (high-dose group). LAR was computed, given the organ equivalent dose, for all cancers in both sexes. LAR was tabulated for each decile of dose-length product by 10-year age classes, separately for each sex.
Estimates of LAR of any cancer for an exposure at age < or =40 year were lower in males than in females for any given quantile. At age >/ or =50 years, LAR was similar between sexes only at the lowest exposure doses, whereas at higher dosage, it was, in general, higher for women. At the median age of this case series (62 years) and for a radiation exposure ranging from 1.33 to 3.81 mSv, LAR was 1 in 4329 (or 23.1 per 10(5) persons exposed) and 1 in 4629 (or 21.6 per 10(5) persons) in men and women, respectively. For an exposure ranging from 10.34 to 18.97 mSv at the same median age, the LAR of cancer incidence was 1 in 1336 (or 74.8 per 10(5) persons) in men and doubled (1 in 614 or 162.8 per 10(5) persons) in women.
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.
估算广泛剂量辐射暴露和大量可能的诊断性计算机断层冠状动脉造影（CTCA）情况下癌症发病的归因风险（LAR）。
这项研究包括 561 名连续接受成功的前瞻性心电图门控 CTCA 协议（低剂量组）64 层 CTCA 检查的患者和 188 名接受回顾性心电图门控 CTCA 检查的患者，后者采用心电图触发剂量调制 CTCA（高剂量组）。计算了所有男性和女性的所有癌症的器官当量剂量的 LAR。按 10 年年龄组和每个性别分别列出每个剂量长度乘积的 LAR 百分位数。
对于任何给定的百分位数，暴露年龄<或=40 岁的男性任何癌症的 LAR 估计值均低于女性。对于>或=50 岁的年龄组，仅在最低暴露剂量下，男女之间的 LAR 相似，而在较高剂量下，女性的 LAR 通常更高。在本病例系列的中位年龄（62 岁）和辐射暴露范围为 1.33 至 3.81 mSv 之间，男性和女性的 LAR 分别为 1/4329（或每 105 名暴露者中有 23.1 例）和 1/4629（或每 105 名暴露者中有 21.6 例）。在相同的中位年龄和 10.34 至 18.97 mSv 的辐射暴露范围内，男性的癌症发病率 LAR 为 1/1336（或每 105 名暴露者中有 74.8 例），而女性则增加一倍（1/614 或每 105 名暴露者中有 162.8 例）。
本研究提供了单次诊断性 CTCA 后中年男性和女性癌症 LAR 的估计值，并提供了易于阅读的表格。
