Reduction in radiation exposure in cardiovascular computed tomography imaging: Results from the PROspective multicenter registry on radiaTion dose Estimates of cardiac CT angIOgraphy in daily practice in 2017 (PROTECTION VI)

Research output: Contribution to journalArticle

PROTECTION VI investigator, Thomas J. Stocker, Simon Deseive, Jonathon Leipsic, Martin Hadamitzky, Marcus Y. Chen, Ronen Rubinshtein, Mathias Heckner, Jeroen J. Bax, Xiang Ming Fang, Erik Lerkevang Grove, John Lesser, Pál Maurovich-Horvat, James Otton, Sanghoon Shin, Gianluca Pontone, Hugo Marques, Benjamin Chow, Cesar Higa Nomura, Ramzi Tabbalat & 31 others Axel Schmermund, Joon Won Kang, Christopher Naoum, Melany Atkins, Eugenio Martuscelli, Steffen Massberg, Jörg Hausleiter, Patricia Carrascosa, Alejandro Deviggiano, John Magnussen, Anthony Kaplan, Gudrun Feuchtner, Fabian Plank, Kristof De Smet, Nico Buls, Roberto Caldeira Cury, Marcio Sommer Bittencourt, Roberto Nery Dantas, Philipp Blanke, Carl Chartrand-Lefebvre, Anne Chin, Gary Small, F. Claudio Silva, Z. Marcelo Godoy, Wang Jie, Alberto Cadena, Theodor Adla, Vojtech Suchanek, Kamilla Bech Pedersen, Jess Lambrechtsen, John J. Mahmarian

Aims Advances of cardiac computed tomography angiography (CTA) have been developed for dose reduction, but their efficacy in clinical practice is largely unknown. This study was designed to evaluate radiation dose exposure and utilization of dose-saving strategies for contrast-enhanced cardiac CTA in daily practice. Methods and results Sixty one hospitals from 32 countries prospectively enrolled 4502 patients undergoing cardiac CTA during one calendar month in 2017. Computed tomography angiography scan data and images were analysed in a central core lab and compared with a similar dose survey performed in 2007. Linear regression analysis was performed to identify independent predictors associated with dose. The most frequent indication for cardiac CTA was the evaluation of coronary artery disease in 89% of patients. The median dose-length product (DLP) of coronary CTA was 195 mGy∗cm (interquartile range 110-338 mGy∗cm). When compared with 2007, the DLP was reduced by 78% (P < 0.001) without an increase in non-diagnostic coronary CTAs (1.7% in 2007 vs. 1.9% in 2017 surveys, P = 0.55). A 37-fold variability in median DLP was observed between the hospitals with lowest and highest DLP (range of median DLP 57-2090 mGy∗cm). Independent predictors for radiation dose of coronary CTA were: body weight, heart rate, sinus rhythm, tube voltage, iterative image reconstruction, and the selection of scan protocols. Conclusion This large international radiation dose survey demonstrates considerable reduction of radiation exposure in coronary CTA during the last decade. However, the large inter-site variability in radiation exposure underlines the need for further site-specific training and adaptation of contemporary cardiac scan protocols.

Original languageEnglish (US)
Pages (from-to)3715-3723
Number of pages9
JournalEuropean heart journal
Volume39
Issue number41
DOIs
StatePublished - Nov 1 2018

PMID: 30165629

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Reduction in radiation exposure in cardiovascular computed tomography imaging : Results from the PROspective multicenter registry on radiaTion dose Estimates of cardiac CT angIOgraphy in daily practice in 2017 (PROTECTION VI). / PROTECTION VI investigator.

In: European heart journal, Vol. 39, No. 41, 01.11.2018, p. 3715-3723.

Research output: Contribution to journalArticle

Harvard

PROTECTION VI investigator 2018, 'Reduction in radiation exposure in cardiovascular computed tomography imaging: Results from the PROspective multicenter registry on radiaTion dose Estimates of cardiac CT angIOgraphy in daily practice in 2017 (PROTECTION VI)' European heart journal, vol. 39, no. 41, pp. 3715-3723. https://doi.org/10.1093/eurheartj/ehy546

APA

PROTECTION VI investigator (2018). Reduction in radiation exposure in cardiovascular computed tomography imaging: Results from the PROspective multicenter registry on radiaTion dose Estimates of cardiac CT angIOgraphy in daily practice in 2017 (PROTECTION VI). European heart journal, 39(41), 3715-3723. https://doi.org/10.1093/eurheartj/ehy546

Vancouver

PROTECTION VI investigator. Reduction in radiation exposure in cardiovascular computed tomography imaging: Results from the PROspective multicenter registry on radiaTion dose Estimates of cardiac CT angIOgraphy in daily practice in 2017 (PROTECTION VI). European heart journal. 2018 Nov 1;39(41):3715-3723. https://doi.org/10.1093/eurheartj/ehy546

Author

PROTECTION VI investigator. / Reduction in radiation exposure in cardiovascular computed tomography imaging : Results from the PROspective multicenter registry on radiaTion dose Estimates of cardiac CT angIOgraphy in daily practice in 2017 (PROTECTION VI). In: European heart journal. 2018 ; Vol. 39, No. 41. pp. 3715-3723.

BibTeX

@article{59375d1fd4d2412389d43edf9266e098,
title = "Reduction in radiation exposure in cardiovascular computed tomography imaging: Results from the PROspective multicenter registry on radiaTion dose Estimates of cardiac CT angIOgraphy in daily practice in 2017 (PROTECTION VI)",
abstract = "Aims Advances of cardiac computed tomography angiography (CTA) have been developed for dose reduction, but their efficacy in clinical practice is largely unknown. This study was designed to evaluate radiation dose exposure and utilization of dose-saving strategies for contrast-enhanced cardiac CTA in daily practice. Methods and results Sixty one hospitals from 32 countries prospectively enrolled 4502 patients undergoing cardiac CTA during one calendar month in 2017. Computed tomography angiography scan data and images were analysed in a central core lab and compared with a similar dose survey performed in 2007. Linear regression analysis was performed to identify independent predictors associated with dose. The most frequent indication for cardiac CTA was the evaluation of coronary artery disease in 89{\%} of patients. The median dose-length product (DLP) of coronary CTA was 195 mGy∗cm (interquartile range 110-338 mGy∗cm). When compared with 2007, the DLP was reduced by 78{\%} (P < 0.001) without an increase in non-diagnostic coronary CTAs (1.7{\%} in 2007 vs. 1.9{\%} in 2017 surveys, P = 0.55). A 37-fold variability in median DLP was observed between the hospitals with lowest and highest DLP (range of median DLP 57-2090 mGy∗cm). Independent predictors for radiation dose of coronary CTA were: body weight, heart rate, sinus rhythm, tube voltage, iterative image reconstruction, and the selection of scan protocols. Conclusion This large international radiation dose survey demonstrates considerable reduction of radiation exposure in coronary CTA during the last decade. However, the large inter-site variability in radiation exposure underlines the need for further site-specific training and adaptation of contemporary cardiac scan protocols.",
keywords = "Cardiac CT angiography, Dose-length product, Dose-saving strategies, Radiation dose exposure",
author = "{PROTECTION VI investigator} and Stocker, {Thomas J.} and Simon Deseive and Jonathon Leipsic and Martin Hadamitzky and Chen, {Marcus Y.} and Ronen Rubinshtein and Mathias Heckner and Bax, {Jeroen J.} and Fang, {Xiang Ming} and Grove, {Erik Lerkevang} and John Lesser and P{\'a}l Maurovich-Horvat and James Otton and Sanghoon Shin and Gianluca Pontone and Hugo Marques and Benjamin Chow and Nomura, {Cesar Higa} and Ramzi Tabbalat and Axel Schmermund and Kang, {Joon Won} and Christopher Naoum and Melany Atkins and Eugenio Martuscelli and Steffen Massberg and J{\"o}rg Hausleiter and Patricia Carrascosa and Alejandro Deviggiano and John Magnussen and Anthony Kaplan and Gudrun Feuchtner and Fabian Plank and {De Smet}, Kristof and Nico Buls and Cury, {Roberto Caldeira} and Bittencourt, {Marcio Sommer} and Dantas, {Roberto Nery} and Philipp Blanke and Carl Chartrand-Lefebvre and Anne Chin and Gary Small and {Claudio Silva}, F. and {Marcelo Godoy}, Z. and Wang Jie and Alberto Cadena and Theodor Adla and Vojtech Suchanek and Pedersen, {Kamilla Bech} and Jess Lambrechtsen and Mahmarian, {John J.}",
year = "2018",
month = "11",
day = "1",
doi = "10.1093/eurheartj/ehy546",
language = "English (US)",
volume = "39",
pages = "3715--3723",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "41",

}

RIS

TY - JOUR

T1 - Reduction in radiation exposure in cardiovascular computed tomography imaging

T2 - European Heart Journal

AU - PROTECTION VI investigator

AU - Stocker, Thomas J.

AU - Deseive, Simon

AU - Leipsic, Jonathon

AU - Hadamitzky, Martin

AU - Chen, Marcus Y.

AU - Rubinshtein, Ronen

AU - Heckner, Mathias

AU - Bax, Jeroen J.

AU - Fang, Xiang Ming

AU - Grove, Erik Lerkevang

AU - Lesser, John

AU - Maurovich-Horvat, Pál

AU - Otton, James

AU - Shin, Sanghoon

AU - Pontone, Gianluca

AU - Marques, Hugo

AU - Chow, Benjamin

AU - Nomura, Cesar Higa

AU - Tabbalat, Ramzi

AU - Schmermund, Axel

AU - Kang, Joon Won

AU - Naoum, Christopher

AU - Atkins, Melany

AU - Martuscelli, Eugenio

AU - Massberg, Steffen

AU - Hausleiter, Jörg

AU - Carrascosa, Patricia

AU - Deviggiano, Alejandro

AU - Magnussen, John

AU - Kaplan, Anthony

AU - Feuchtner, Gudrun

AU - Plank, Fabian

AU - De Smet, Kristof

AU - Buls, Nico

AU - Cury, Roberto Caldeira

AU - Bittencourt, Marcio Sommer

AU - Dantas, Roberto Nery

AU - Blanke, Philipp

AU - Chartrand-Lefebvre, Carl

AU - Chin, Anne

AU - Small, Gary

AU - Claudio Silva, F.

AU - Marcelo Godoy, Z.

AU - Jie, Wang

AU - Cadena, Alberto

AU - Adla, Theodor

AU - Suchanek, Vojtech

AU - Pedersen, Kamilla Bech

AU - Lambrechtsen, Jess

AU - Mahmarian, John J.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Aims Advances of cardiac computed tomography angiography (CTA) have been developed for dose reduction, but their efficacy in clinical practice is largely unknown. This study was designed to evaluate radiation dose exposure and utilization of dose-saving strategies for contrast-enhanced cardiac CTA in daily practice. Methods and results Sixty one hospitals from 32 countries prospectively enrolled 4502 patients undergoing cardiac CTA during one calendar month in 2017. Computed tomography angiography scan data and images were analysed in a central core lab and compared with a similar dose survey performed in 2007. Linear regression analysis was performed to identify independent predictors associated with dose. The most frequent indication for cardiac CTA was the evaluation of coronary artery disease in 89% of patients. The median dose-length product (DLP) of coronary CTA was 195 mGy∗cm (interquartile range 110-338 mGy∗cm). When compared with 2007, the DLP was reduced by 78% (P < 0.001) without an increase in non-diagnostic coronary CTAs (1.7% in 2007 vs. 1.9% in 2017 surveys, P = 0.55). A 37-fold variability in median DLP was observed between the hospitals with lowest and highest DLP (range of median DLP 57-2090 mGy∗cm). Independent predictors for radiation dose of coronary CTA were: body weight, heart rate, sinus rhythm, tube voltage, iterative image reconstruction, and the selection of scan protocols. Conclusion This large international radiation dose survey demonstrates considerable reduction of radiation exposure in coronary CTA during the last decade. However, the large inter-site variability in radiation exposure underlines the need for further site-specific training and adaptation of contemporary cardiac scan protocols.

AB - Aims Advances of cardiac computed tomography angiography (CTA) have been developed for dose reduction, but their efficacy in clinical practice is largely unknown. This study was designed to evaluate radiation dose exposure and utilization of dose-saving strategies for contrast-enhanced cardiac CTA in daily practice. Methods and results Sixty one hospitals from 32 countries prospectively enrolled 4502 patients undergoing cardiac CTA during one calendar month in 2017. Computed tomography angiography scan data and images were analysed in a central core lab and compared with a similar dose survey performed in 2007. Linear regression analysis was performed to identify independent predictors associated with dose. The most frequent indication for cardiac CTA was the evaluation of coronary artery disease in 89% of patients. The median dose-length product (DLP) of coronary CTA was 195 mGy∗cm (interquartile range 110-338 mGy∗cm). When compared with 2007, the DLP was reduced by 78% (P < 0.001) without an increase in non-diagnostic coronary CTAs (1.7% in 2007 vs. 1.9% in 2017 surveys, P = 0.55). A 37-fold variability in median DLP was observed between the hospitals with lowest and highest DLP (range of median DLP 57-2090 mGy∗cm). Independent predictors for radiation dose of coronary CTA were: body weight, heart rate, sinus rhythm, tube voltage, iterative image reconstruction, and the selection of scan protocols. Conclusion This large international radiation dose survey demonstrates considerable reduction of radiation exposure in coronary CTA during the last decade. However, the large inter-site variability in radiation exposure underlines the need for further site-specific training and adaptation of contemporary cardiac scan protocols.

KW - Cardiac CT angiography

KW - Dose-length product

KW - Dose-saving strategies

KW - Radiation dose exposure

UR - http://www.scopus.com/inward/record.url?scp=85055827031&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055827031&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehy546

DO - 10.1093/eurheartj/ehy546

M3 - Article

VL - 39

SP - 3715

EP - 3723

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 41

ER -

ID: 45684306