Evaluation of radiation dose and risk to the patient from coronary angiography

Citation
D. Harrison et al., Evaluation of radiation dose and risk to the patient from coronary angiography, AUST NZ J M, 28(5), 1998, pp. 597-603
Citations number
17
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Journal title
AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE
ISSN journal
00048291 → ACNP
Volume
28
Issue
5
Year of publication
1998
Pages
597 - 603
Database
ISI
SICI code
0004-8291(199810)28:5<597:EORDAR>2.0.ZU;2-6
Abstract
Background: Coronary angiography is a commonly performed diagnostic procedu re with life saving benefits for the patient. However, because of its poten tial to deliver a high radiation dose, caution is warranted. Aim: The purpose of this study was to determine the effective dose to an av erage patient from coronary angiography, to estimate the associated radiati on risk in terms of fatal malignancy, and to examine ways effective dose ma y be reduced. Method: The dose-area product data from 210 examinations was used to determ ine the effective dose to the average patient by means of a commercially av ailable software programme. Subsequently, the effective dose was used to es timate radiation risk based on the population averaged probability coeffici ents given in ICRP 60 and contrasted against age-related risk coefficients from the NRPB. The components of effective dose and radiation risk were exa mined to identify the organs most at risk. Results: The average effective dose was found to be 3.4+/-1.3 mSv. The risk of fatal malignancy was estimated as 170 per million cases, or around one in 6000. The average lung dose was 14.7 mSv, with the risk of fatal lung ca ncer estimated as 125 per million cases or one in 8000. Conclusions: The average effective dose in this study was less than half th at of most other studies. The lung was identified as the critical organ and the estimated risk of fatal cancer amounted to an increase of 0.017% above the normal incidence for the general population. The study affirmed that u sing a reduced cine frame rate, low dose pulsed fluoroscopy, added copper f iltration and a conscious effort to reduce screening time can significantly reduce patient dose.