Radiation Dose from Contemporary Cardiothoracic Multidetector CT Protocols with an Anthropomorphic Female Phantom: Implications for Cancer Induction

Hurwitz, Lynne M.; Reiman, Robert E.; Yoshizumi, Terry T.; Goodman, Philip C.; Toncheva, Greta; Nguyen, Giao; Lowry, Carolyn

doi:10.1148/radiol.2453062046

Cited by 215 publications

(156 citation statements)

References 19 publications

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“…This agrees with the published literature. [27][28][29] However, the average percentage difference between the two is 54.2%, which far exceeds figures quoted by Groves et al 27 of 18% and Hurwitz et al 29 of 25%. Criticisms of k state that the factors are based on old technology and old data; they are based on several scanners that were in use circa 1990 and the tissue-weighting factors used in their calculation are from ICRP 60.…”

Section: Discussionmentioning

confidence: 88%

Comparison of effective dose and lifetime risk of cancer incidence of CT attenuation correction acquisitions and radiopharmaceutical administration for myocardial perfusion imaging

Tootell

Szczepura²,

Hogg³

2014

BJR

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Cite this article as: Tootell AK, Szczepura K, Hogg P. Comparison of effective dose and lifetime risk of cancer incidence of CT attenuation correction acquisitions and radiopharmaceutical administration for myocardial perfusion imaging. Br J Radiol 2014;87:20140110. FULL PAPERComparison of effective dose and lifetime risk of cancer incidence of CT attenuation correction acquisitions and radiopharmaceutical administration for myocardial perfusion imaging Objective: To measure the organ dose and calculate effective dose from CT attenuation correction (CTAC) acquisitions from four commonly used gamma camera single photon emission CT/CT systems. Methods: CTAC dosimetry data was collected using thermoluminescent dosemeters on GE Healthcare's Infinia™ Hawkeye™ (GE Healthcare, Buckinghamshire, UK) four-and single-slice systems, Siemens Symbia™ T6 (Siemens Healthcare, Erlangen, Germany) and the Philips Precedence (Philips Healthcare, Amsterdam, Netherlands). Organ and effective dose from the administration of 99m Tc-tetrofosmin and 99m Tc-sestamibi were calculated using International Commission of Radiological Protection reports 80 and 106. Using these data, the lifetime biological risk was calculated. Results: The Siemens Symbia gave the lowest CTAC dose (1.8 mSv) followed by the GE Infinia Hawkeye single-slice (1.9 mSv), GE Infinia Hawkeye four-slice (2.5 mSv) and Philips Precedence v. 3.0. Doses were significantly lower than the calculated doses from radiopharmaceutical administration (11 and 14 mSv for 99m Tc-tetrofosmin and 99m Tc-sestamibi, respectively). Overall lifetime biological risks were lower, which suggests that using CTAC data posed minimal risk to the patient. Comparison of data for breast tissue demonstrated a higher risk than that from the radiopharmaceutical administration. Conclusion: CTAC doses were confirmed to be much lower than those from radiopharmaceutical administration. The localized nature of the CTAC exposure compared to the radiopharmaceutical biological distribution indicated dose and risk to the breast to be higher. Advances in knowledge: This research proved that CTAC is a comparatively low-dose acquisition. However, it has been shown that there is increased risk for breast tissue especially in the younger patients. As per legislation, justification is required and CTAC should only be used in situations that demonstrate sufficient net benefit.Single-photon emission CT (SPECT)/CT has become common place in clinical imaging, and a major role for CT is for the attenuation correction (AC) of SPECT data in myocardial perfusion imaging (MPI). 1,2 The benefits of CT attenuation correction (CTAC) in MPI are well known and many national and international professional organizations recommend its use to improve SPECT MPI diagnostic accuracy. 3,4 Associated with the CT acquisition is an additional radiation dose that is often considered to be low, yet very few articles quantify the dose and the associated risk.Effective dose is a useful figure that allows for a comparison between different tech...

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Section: Discussionmentioning

confidence: 88%

Comparison of effective dose and lifetime risk of cancer incidence of CT attenuation correction acquisitions and radiopharmaceutical administration for myocardial perfusion imaging

Tootell

Szczepura²,

Hogg³

2014

BJR

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“…As they are based on measurements in standard CT dose phantoms that are 16 or 32 cm in diameter. The effective dose is thought to correlate best with the overall stochastic radiation risk 15. The dose calculations based on CTDI or DLP are readily available indicators of the radiation dose in CT studies.…”

Section: Discussionmentioning

confidence: 99%

Relationship between the radiation doses at nonenhanced CT studies using different tube voltages and automatic tube current modulation during anthropomorphic phantoms of young children

Masuda

Funama

Kiguchi

et al. 2017

J Applied Clin Med Phys

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To compare the radiation dose and image noise of nonenhanced CT scans performed at 80, 100, and 120 kVp with tube current modulation (TCM) we used anthropomorphic phantoms of newborn, 1‐year‐old, and 5‐year‐old children. The noise index was set at 12. The image noise in the center of the phantoms at the level of the chest and abdomen was measured within a circumscribed region of interest. We measured the doses in individual tissues or organs with radio‐photoluminescence glass dosimeters for each phantom. Various tissues or organs were assigned and the radiation dose was calculated based on the international commission on radiological protection definition. With TCM the respective radiation dose at tube voltages of 80, 100, and 120 was 29.71, 31.60, and 33.79 mGy for the newborn, 32.00, 36.79, and 39.48 mGy for the 1‐year‐old, and 32.78, 38.11, and 40.85 mGy for the 5‐year‐old phantom. There were no significant differences in the radiation dose among the tube voltages and phantoms (P > 0.05). Our comparison of the radiation dose using anthropomorphic phantoms of young children showed that the radiation dose of nonenhanced CT performed at different tube voltages with TCM was not significantly different.

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“…It has been estimated that exposure of the breasts of women aged 35 years old to 10 mSv increases the risk of breast cancer by approximately 14 % over the background rate for the general population [94]. The lifetime excess relative risk of breast or lung cancer in girls and young women undergoing a single CTPA examination has been calculated to be 1.7 -5.5 % [95]. Although the risk resulting from an individual CTPA or lung scintigraphy is low, it should be considered that a substantial number of patients will undergo repetitive examinations for PE or other reasons during their lifetimes.…”

Section: Maternal Radiation Exposurementioning

confidence: 99%

Diagnosis of pregnancy-associated venous thromboembolism - position paper of the Working Group in Women’s Health of the Society of Thrombosis and Haemostasis (GTH)

Linnemann¹,

Scholz

Rott

et al. 2016

Vasa

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EpidemiologyVTE is a leading cause of maternal morbidity in the developed world and, in the case of PE, of mortality as well [1]. While the relative risk of VTE is greatly increased during pregnancy compared with that in non-pregnant women, the absolute risk remains low: estimates of the incidence of pregnancy-associated VTE have varied from 1:500 to 1:1500 pregnancies [2 -7]. The risk of VTE is approximately 5-fold greater in pregnant women than in non-pregnant women.Approximately 80 % of pregnancy-associated VTEs are isolated DVTs, and approximately 20 % are PEs or both DVTs and PEs [5]. Although a systematic review reported weighted event rates for DVT of 21.9 %, 33.7 % and 47.6 % for the fi rst, second and third trimesters, respectively [6], a recent study suggested that the risk might in fact increase exponentially over the duration of the pregnancy [7], with 12.4 % of VTEs diagnosed in the fi rst trimester, 15.3 % in the second trimester and 72.3 % in the third trimester. This detailed risk assessment for each gestational week demonstrated a 21-fold increased risk for the last two weeks before delivery [7]. Summary: Pregnancy and the postpartum period are associated with an increased risk of venous thromboembolism (VTE). Over the past decade, new diagnostic algorithms have been established, combining clinical probability, laboratory testing and imaging studies for the diagnosis of deep vein thrombosis (DVT) and pulmonary embolism (PE) in the non-pregnant population. However, there is no such generally accepted algorithm for the diagnosis of pregnancy-associated VTE. Studies establishing clinical prediction rules have excluded pregnant women, and prediction scores currently in use have not been prospectively validated in pregnancy or during the postpartum period. D-dimers physiologically increase throughout pregnancy and peak at delivery, so a negative D-dimer test result, based on the reference values of non-pregnant subjects, becomes unlikely in the second and third trimesters. Imaging studies therefore play a major role in confi rming suspected DVT or PE in pregnant women. Major concerns have been raised against radiologic imaging because of foetal radiation exposure, and doubts about the diagnostic value of ultrasound techniques in attempting to exclude isolated iliac vein thrombosis grow stronger as pregnancy progresses. As members of the Working Group in Women's Health of the Society of Thrombosis and Haemostasis (GTH), we summarise evidence from the available literature and aim to establish a more uniform strategy for diagnosing pregnancy-associated VTE. Review Diagnosis of pregnancy-associated

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Radiation Dose from Contemporary Cardiothoracic Multidetector CT Protocols with an Anthropomorphic Female Phantom: Implications for Cancer Induction

Abstract: EDs and organ doses from 64-detector CT are higher than those previously reported for adult cardiac and pulmonary CT angiography protocols. Risk for breast and lung cancer induction from these studies is greatest for the younger patient population.

Cited by 215 publications

References 19 publications

Comparison of effective dose and lifetime risk of cancer incidence of CT attenuation correction acquisitions and radiopharmaceutical administration for myocardial perfusion imaging

Comparison of effective dose and lifetime risk of cancer incidence of CT attenuation correction acquisitions and radiopharmaceutical administration for myocardial perfusion imaging

Relationship between the radiation doses at nonenhanced CT studies using different tube voltages and automatic tube current modulation during anthropomorphic phantoms of young children

Diagnosis of pregnancy-associated venous thromboembolism - position paper of the Working Group in Women’s Health of the Society of Thrombosis and Haemostasis (GTH)

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