Potential effects of low-dose average CT on cardiac implantable electronic devices

J Nucl Cardiol. 2019 Aug;26(4):1161-1165. doi: 10.1007/s12350-018-1186-y. Epub 2018 Jan 17.

Abstract

Background: Average CT has been shown to be more accurate than conventional helical CT in quantitation of the PET data. The risk of CT irradiation of a cardiac implantable electronic device (CIED) causing an adverse event is low and is generally outweighed by the clinical benefit of a medically indicated examination. However, irradiation of CIED over one breath cycle in cine CT scan for average CT could impose risks on a patient who is pacing dependent. The purpose of this study was to demonstrate that low-dose average CT can be safe for CIED.

Methods: A Medtronic CIED of model Protecta VR was submerged in a saline bath for a series of 4-s cine CT scans on a GE CT scanner programmed to deliver a 2-cm-wide radiation at a dose rate of 0.9 to 41.2 mGy/s to the CIED. The number of over-sensings was recorded as the interference of radiation to the CIED.

Results: Dose rates ≥ 1.9 mGy/s caused over-sensing. The higher the dose rate, the more over-sensings there were. The lowest dose rate of 0.9 mGy/s did not cause any over-sensing.

Conclusions: Low-dose average CT at 0.9 mGy/s can be safe for a CIED patient who is pacing dependent.

Keywords: PET/CT imaging; computed tomography (CT); myocardial perfusion imaging: PET.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Computer Simulation
  • Defibrillators, Implantable / adverse effects*
  • Equipment Design
  • Four-Dimensional Computed Tomography
  • Humans
  • Male
  • Pacemaker, Artificial / adverse effects*
  • Patient Safety
  • Reproducibility of Results
  • Risk
  • Thyroid Neoplasms / diagnostic imaging
  • Tomography, X-Ray Computed / adverse effects*