How Effective Is Effective Dose as a Predictor of Radiation Risk?

McCollough, Cynthia H.; Christner, Jodie A.; Kofler, James M.

doi:10.2214/ajr.09.4179

Cited by 143 publications

(111 citation statements)

References 32 publications

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“…Effective radiation dose from coronary CTA was calculated by multiplying the dose-length product (obtained from the scanner) and the overall organ weighing factor for the chest (k 5 0.014 mSv · [mGy · cm] 21 ) (18,19). Effective radiation dose from 480 MBq of 18 F-FDG was estimated at 9.1 mSv, using published data (20).…”

Section: Radiation Dose To Patientsmentioning

confidence: 99%

Coronary Arterial ¹⁸F-FDG Uptake by Fusion of PET and Coronary CT Angiography at Sites of Percutaneous Stenting for Acute Myocardial Infarction and Stable Coronary Artery Disease

Cheng¹,

Slomka²,

Meunier³

et al. 2012

J Nucl Med

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Whether 18 F-FDG PET can detect inflammation in the coronary arteries remains controversial. We examined 18 F-FDG uptake at the culprit sites of acute myocardial infarction (AMI) after percutaneous coronary stenting (PCS) by coregistering PET and coronary CT angiography (CTA). Methods: Twenty nondiabetic patients with AMI (median age, 62 y; 16 men and 4 women) and 7 nondiabetic patients with stable coronary artery disease (CAD; median age, 67 y; 4 men and 3 women) underwent 18 F-FDG PET and coronary CTA 1-6 d after PCS of culprit stenoses. After a low-carbohydrate dietary preparation and more than 12 h of fasting, 480 MBq of 18 F-FDG were injected, and PET images were acquired 3 h later. Helical CTA was performed on a dual-source scanner. Stent position on attenuation-correction noncontrast CT and CTA was used to fuse PET and CTA. Two experienced readers masked to patient data independently quantified maximum target-to-background ratio (maxTBR) at each PCS site. A maxTBR greater than 2.0 was the criterion for significant uptake. Results: Compared with stable CAD patients, more AMI patients exhibited a PCS site maxTBR greater than 2.0 (12/20 vs. 1/7, P 5 0.04). More AMI patients were active smokers (9/20 vs. 0/7 in stable CAD, P 5 0.03). After adjusting for baseline demographic differences, stent-myocardium distance, and myocardial 18 F-FDG uptake, presentation of AMI was positively associated with a PCS site maxTBR greater than 2.0 (odds ratio, 31.6; P 5 0.044). Prevalence of excess myocardial 18 F-FDG uptake was similar in both populations (8/20 AMI vs. 3/7 stable CAD, P 5 0.89). Conclusion: Systematic fusion of 18 F-FDG PET and coronary CTA demonstrated increased culprit site 18 F-FDG uptake more commonly in patients with AMI than in patients with stable CAD. However, this approach failed to detect increased signal at the culprit site in nearly half of AMI patients, highlighting the challenging nature of in vivo coronary artery plaque metabolic imaging. Nonetheless, our findings suggest that imaging of coronary artery inflammation is feasible, and further work evaluating 18 F-FDG uptake in high-risk coronary plaques prior to rupture would be of great interest.

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Section: Radiation Dose To Patientsmentioning

confidence: 99%

Coronary Arterial ¹⁸F-FDG Uptake by Fusion of PET and Coronary CT Angiography at Sites of Percutaneous Stenting for Acute Myocardial Infarction and Stable Coronary Artery Disease

Cheng¹,

Slomka²,

Meunier³

et al. 2012

J Nucl Med

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“…Nevertheless, the use of the effective dose to state the stochastic harm to patients from ionizing radiation is sometimes criticized (Valentin, 2007;McCollough et al, 2010;Pradhan et al, 2012). The effective dose is not expressed in terms of sex and age, while the REID values vary with age and gender (Clarke et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

Assessment of radiation risk to pediatric patients undergoing conventional X-ray examinations

Nahangi

Chaparian

2015

Radioprotection

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-Increasing concern has been expressed in the literature that the knowledge of physicians regarding the radiation risk values incurred during different radiological examinations is inadequate. This study determined the amount of organ doses and the radiation risks involved in pediatric radiology in terms of the age and sex of patients. The X-ray examinations of the chest, abdomen, pelvis and skull in patients of six age groups (newborn, 1-, 5-, 10-and 15-year-old, and adult) were investigated. Exposure data of 480 patients were collected from four radiology departments and then Entrance Skin Exposure (ESE) values for standard patients in the six age groups as well as five X-ray examinations were measured. By using these practical data, the risk of exposure-induced cancer death (REID) values were estimated based on the risk models of the BEIR VII committee. It was shown that the differences in REID values in male and female patients were statistically significant for the chest and pelvis X-ray examinations. The X-rays of the abdomen, chest and pelvis have the highest REID values in 15-, 10-and 15-year-old patients, respectively. The results obtained can help physicians to make suitable decisions about the execution and justification of every X-ray examination in the different age groups. This information will help to prevent either overestimation or underestimation of radiation risks.

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“…In general, the effective doses in each scanner were within the range of 4.0− 18.0 mSv reported in the literature for a full diagnostic helical chest CT examination [26]. However, it is of note that the same effective dose does not correspond to the same cancer risk [32], and this is evidenced by the significantly higher estimated whole-body risk using the scanner H1 compared with the scanner H3, which produced a higher effective dose. The higher estimated risk in female patients than in male patients is attributed to the additional risk of breast cancer together with the increased risk of lung cancer [18,25].…”

Section: Discussionmentioning

confidence: 69%

Radiation dose and cancer risk estimates in helical CT for pulmonary tuberculosis infections

Adeleye

Chetty

2017

Open Physics

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Abstract:The preference for computed tomography (CT) for the clinical assessment of pulmonary tuberculosis (PTB) infections has increased the concern about the potential risk of cancer in exposed patients. In this study, we investigated the correlation between cancer risk and radiation doses from different CT scanners, assuming an equivalent scan protocol. Radiation doses from three 16-slice units were estimated using the CT-Expo dosimetry software version 2.4 and standard CT scan protocol for patients with suspected PTB infections. The lifetime risk of cancer for each scanner was determined using the methodology outlined in the BEIR VII report. Organ doses were significantly different (P < 0.05) between the scanners. The calculated effective dose for scanner H2 is 34% and 37% higher than scanners H3 and H1 respectively. A high and statistically significant correlation was observed between estimated lifetime cancer risk for both male (r 2 = 0.943, P < 0.05) and female patients (r 2 = 0.989, P < 0.05). The risk variation between the scanners was slightly higher than 2% for all ages but was much smaller for specific ages for male and female patients (0.2% and 0.7%, respectively). These variations provide an indication that the use of a scanner optimizing protocol is imperative.

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How Effective Is Effective Dose as a Predictor of Radiation Risk?

Cited by 143 publications

References 32 publications

Coronary Arterial ¹⁸F-FDG Uptake by Fusion of PET and Coronary CT Angiography at Sites of Percutaneous Stenting for Acute Myocardial Infarction and Stable Coronary Artery Disease

Coronary Arterial ¹⁸F-FDG Uptake by Fusion of PET and Coronary CT Angiography at Sites of Percutaneous Stenting for Acute Myocardial Infarction and Stable Coronary Artery Disease

Assessment of radiation risk to pediatric patients undergoing conventional X-ray examinations

Radiation dose and cancer risk estimates in helical CT for pulmonary tuberculosis infections

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How Effective Is Effective Dose as a Predictor of Radiation Risk?

Cited by 143 publications

References 32 publications

Coronary Arterial 18F-FDG Uptake by Fusion of PET and Coronary CT Angiography at Sites of Percutaneous Stenting for Acute Myocardial Infarction and Stable Coronary Artery Disease

Coronary Arterial 18F-FDG Uptake by Fusion of PET and Coronary CT Angiography at Sites of Percutaneous Stenting for Acute Myocardial Infarction and Stable Coronary Artery Disease

Assessment of radiation risk to pediatric patients undergoing conventional X-ray examinations

Radiation dose and cancer risk estimates in helical CT for pulmonary tuberculosis infections

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Product

Resources

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Coronary Arterial ¹⁸F-FDG Uptake by Fusion of PET and Coronary CT Angiography at Sites of Percutaneous Stenting for Acute Myocardial Infarction and Stable Coronary Artery Disease

Coronary Arterial ¹⁸F-FDG Uptake by Fusion of PET and Coronary CT Angiography at Sites of Percutaneous Stenting for Acute Myocardial Infarction and Stable Coronary Artery Disease