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Cardiac Tests Are Big Radiation Source

July 12, 2010
Written by: , Filed in: Cardiac Imaging, Diagnostic Imaging, Practice Management
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Nearly 1 in 10 American adults younger than 65 underwent heart imaging that exposed them to radiation from 2005 through 2007, according to a new study involving more than 950,000 adults in five U.S. health-care markets.

Is this a problem? Frustratingly enough, we don’t know. As the study says, “The public health and clinical implications of radiation exposure from cardiac imaging are not easily determined.” It goes on to acknowledge: “Of course, radiation exposure from cardiac imaging procedures may be worth the risk for many patients.”

The study results appear online in the Journal of the American College of Cardiology. An accompanying editorial warns “that the entire premise that radiation doses from medical testing causes cancers remains hypothetical.” High levels of ionizing radiation have been shown to cause cancer and death, but “the relationship between low-dose medical imaging and harm has never been established,” the editorial says.

Still, the amount of U.S. radiation exposure just from cardiac imaging seems startling. Most of the patients in the study who had radiation exposure “had more than the background radiation we get just by living in the U.S., from radon, from the food we eat, from cosmic rays,” study coauthor Andrew Einstein, MD, PhD, told HealthDay. “That means their main source of radiation is not radon, not cosmic rays, but tests.” Dr. Einstein is director of cardiac computed tomography research at Columbia University Medical Center in New York.

Among the patients who received at least one cardiac imaging procedure, the mean cumulative effective dose over the study’s three years was 16.4 millisieverts (mSv). That’s more than annual natural background radiation exposure, which is less than 3 mSv, but less than the 20 mSv upper annual limit for occupational exposure.

The study did note that because it did not have specific per-patient measurements, it had to estimate radiation doses. And the accompanying editorial said the study used outdated figures that are significantly higher than current clinical practice.

Dr. Einstein told HealthDay:

We didn’t look at the appropriateness of these tests. It may well be the case that, for the majority of these patients, the benefits of cardiac testing outweigh the risks.

Nevertheless, the study concludes: “Better strategies to minimize the radiation exposure from cardiac imaging procedures should be encouraged.”

Related seminar: Imaging Advances: Abdominal, Thoracic, Skeletal

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