Cumulative radiation exposure and cancer risk of patients with ischemic heart diseases from diagnostic and therapeutic imaging procedures

Eur J Radiol. 2013 Nov;82(11):1926-32. doi: 10.1016/j.ejrad.2013.07.015. Epub 2013 Aug 15.

Abstract

Objectives: To present a detailed analysis of the cumulative radiation exposure and cancer risk of patients with ischemic heart diseases (IHD) from diagnostic and therapeutic imaging.

Methods: For 1219 IHD patients, personal and examination data were retrieved from the information systems of a university hospital. For each patient, cumulative organ doses and the corresponding effective dose (E) resulting from all imaging procedures performed within 3 months before and 12 months after the date of the diagnosis were calculated. The cumulative lifetime attributable risk (LAR) of the patients to be diseased by radiation-related cancer was estimated using sex-, age-, and organ-specific risk models.

Results: Among the 3870 procedures performed in the IHD patients, the most frequent were radiographic examinations (52.4%) followed by coronary catheter angiographies and percutaneous cardiac interventions (41.3%), CT scans (3.9%), and perfusion SPECT (2.3%). 87% of patient exposure resulted from heart catheter procedures. E and LAR were significantly higher in males than females (average, 13.3 vs. 10.3 mSv and 0.09 vs. 0.07%, respectively). Contrary to the effective dose, the cancer risk decreased markedly for both sexes with increasing age.

Conclusions: Although IHD patients were partially exposed to considerable amounts of radiation, estimated LARs were small as compared to their baseline risk to develop cancer in the remaining life.

Keywords: Dosimetry; Imaging; Ischemic heart disease; Radiation risk.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Angiography / statistics & numerical data*
  • Body Burden
  • Comorbidity
  • Female
  • Germany / epidemiology
  • Humans
  • Incidence
  • Male
  • Myocardial Ischemia / diagnosis
  • Myocardial Ischemia / epidemiology*
  • Myocardial Ischemia / radiotherapy
  • Neoplasms, Radiation-Induced / epidemiology*
  • Radiation Dosage*
  • Radiometry / statistics & numerical data*
  • Radiotherapy / statistics & numerical data*
  • Risk Factors
  • Sex Distribution