Medical Physics Department, Isfahan University of Medical Sciences, Isfahan, Iran.
Technology of Radiology Department, Isfahan University of Medical Sciences, Hezar jarib, Isfahan 8174473461, Iran.
AJR Am J Roentgenol. 2020 May;214(5):1131-1136. doi: 10.2214/AJR.19.21749. Epub 2020 Feb 25.
The purposes of this study were to determine organ and effective doses and to estimate the risk of exposure-induced cancer death (REID) associated with coronary CT angiography (CCTA) examinations. CCTA examinations were performed in three stages: calcium score, monitoring, and cardiac phases for all patients. Effective dose was calculated using two methods. The first was based on the scanner-derived dose-length product, and the second entailed use of an organ and effective dose calculator software application. Organ doses were calculated on the basis of the tissue weighting factors of International Commission on Radiation Protection report 103. REID values were assessed with a cancer risk estimator software application. The study included 185 patients (95 men, 90 women). For women, breast doses were high at 52.04 ± 14.08 mGy. The mean effective dose in the women was greater than that in the men (24.05 vs 16.30 mSv, < 0.05). The mean REID values in patients undergoing CCTA with a 64-MDCT scanner were 13.4 per 10,000 men (1 in 746) and 19.6 per 10,000 women (1 in 508). The REID values were considerably higher for the younger women. The results of this study will help referring physicians justify requesting CCTA examinations by considering their benefits for diagnosis on the one hand and awareness of the risk of radiation-induced cancer on the other. In the case of CCTA scans that are properly justified by clinical indication, patients and physicians should not be concerned about the radiation risks.
本研究旨在确定器官剂量和有效剂量,并评估与冠状动脉 CT 血管造影(CCTA)检查相关的受照射致癌死亡风险(REID)。对所有患者进行了三个阶段的 CCTA 检查:钙评分、监测和心脏期。有效剂量使用两种方法计算。第一种方法基于扫描仪衍生的剂量长度乘积,第二种方法涉及使用器官和有效剂量计算器软件应用程序。器官剂量是根据国际辐射防护委员会报告 103 的组织权重因子计算的。使用癌症风险估算软件应用程序评估 REID 值。该研究包括 185 名患者(95 名男性,90 名女性)。对于女性,乳房剂量高达 52.04 ± 14.08 mGy。女性的平均有效剂量大于男性(24.05 比 16.30 mSv,<0.05)。使用 64-MDCT 扫描仪进行 CCTA 的患者的平均 REID 值为每 10,000 名男性 13.4(1 例 746 例),每 10,000 名女性 19.6(1 例 508 例)。年轻女性的 REID 值明显更高。本研究的结果将帮助转诊医生在考虑诊断获益的同时,认识到辐射诱导癌症的风险,从而为他们进行 CCTA 检查提供依据。在临床指征适当的情况下进行 CCTA 扫描时,患者和医生不应担心辐射风险。