Assessment of Effective Dose Associated with Coronary Computed Tomography Angiography in Isfahan Province, Iran

Abstract

Computed tomography coronary angiography (CTCA) has generated a great interest over the past two decades, due to its high diagnostic accuracy and efficacy in the assessment of patients having coronary artery disease. This method is associated with high radiation dose and this has raised serious concerns in the literature. Effective dose (E) is a single parameter meant to reflect the relative risk from exposure to ionizing radiation. Therefore, it is necessary to calculate this parameter to indicate ionizing radiation relative risk. The aim of this study was to calculate the effective dose from 64-slice CTCA in Isfahan. To calculate the effective dose, an ionization chamber and a body phantom with diameter of 32 cm and length of 15 cm were used. CTCA radiation conditions commonly used in two centers were applied for this work. For all scans, computed tomography volume dose index (CTDIv), dose-length product (DLP), and effective dose were obtained using dose-length-product method. The obtained CTDIv, DLP, and effective dose were compared in two centers, and mean, maximum, and minimum values of effective dose for heart coronary CT angiography (CCTA) examinations and calcium score were compared with other studies. The amount of average, maximum, and minimum effective doses for heart CCTA examinations in two centers are 4.65 +/- 0.06, 6.0489, and 3.492 mSv, respectively, and for calcium score test are, 1.04 +/- 0.04, 2.155, and 0.98 mSv, respectively. CTDIv, DLP, and effective dose values did not show any significant difference in two centers. Although the effective dose of CTCA and calcium score was lower than that of other studies, it is reasonable to reduce the effective dose to the minimum possible value to reduce the risk of cancer associated with ionizing radiation. The results of this study can be used to introduce the effective dose as a local diagnostic reference dose (DRL) for CTCA examinations in Isfahan Province.