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.