Skip to main content Accessibility help
×
Home

Patient cumulative radiation exposure in interventional cardiology

  • M.-O. Bernier (a1), S. Jacob (a1), C. Maccia (a2), O. Bar (a3), O. Catelinois (a4), D. Blanchard (a3) and D. Laurier (a1)...

Abstract

Interventional cardiology procedures can involve potentially high doses of radiation to the patients. Stochastic effects of ionising radiation – radiation-induced cancers in the long term – may occur. We analysed clinical characteristics and dosimetric data in a population of patients undergoing interventional cardiology. In all, 1 591 patients who had undergone coronarography and/or angioplasty in the course of a year at the Saint-Gatien Clinic in Tours (France) were included. Information on patients’ individual clinical characteristics and Dose-Area Product values were collected. Organ doses to the lung, oesophagus, bone marrow and breast were mathematically evaluated. The median age of patients was 70 years. Their median cumulative dose-area product value was 48.4 Gy.cm2 for the whole year and the median effective dose was 9.7 mSv. The median organ doses were 41 mGy for the lung, 31 mGy for the oesophagus, 10 mGy for the bone marrow and 4 mGy for the breast. Levels of doses close to the heart appear to be rather high in the case of repeated interventional cardiology procedures. Clinical characteristics should be taken into account when planning epidemiological studies on potential radiation-induced cancers.

Copyright

References

Hide All
[1]Axelsson, B., Khalil, C., Lidegran, M., Schuwert, P., Mortensson, W. (1999) Estimating the effective dose to children undergoing heart investigations – a phantom study, Br. J. Radiol. 72, 378-383.
[2]Bahreyni Toossi, M.T., Zare, H., Bayani, S., Esmaili, S. (2008) Organ and effective doses of patients arising from coronary angiography and percutaneous transluminal coronary angioplasty at two hospitals in Mashhad-Iran, Radiat. Prot. Dosim. 128, 363-366.
[3]Betsou, S., Efstathopoulos, E.P., Katritsis, D., Faulkner, K., Panayiotakis, G. (1998) Patient radiation doses during cardiac catheterization procedures, Br. J. Radiol. 71, 634-639.
[4]Bogaert, E., Bacher, K., Thierens, H. (2008) A large-scale multicentre study in Belgium of dose area product values and effective doses in interventional cardiology using contemporary X-ray equipment, Radiat. Prot. Dosim. 128, 312-323.
[5]Boice, J.D. Jr., Morin, M.M., Glass, A.G., Friedman, G.D., Stovall, M., Hoover, R.N, Fraumeni, J.F. Jr. (1991) Diagnostic X-ray procedures and risk of leukemia, lymphoma, and multiple myeloma, Jama 265, 1290-1294.
[6]Charles, M.A., Basdevant, A., Eschwege, E. (2002) Prévalence de l'obésité de l'adulte en France : la situation en 2000, Ann. Endocrinol. (Paris) 63, 154-158.
[7]Cusma, J.T., Bell, M.R., Wondrow, M.A., Taubel, J.P., Holmes, D.R. Jr. (1999) Real-time measurement of radiation exposure to patients during diagnostic coronary angiography and percutaneous interventional procedures, J. Am. Coll. Cardiol. 33, 427-435.
[8]Delichas, M.G., Psarrakos, K., Molyvda-Athanassopoulou, E., Giannoglou, G., Hatziioannou, K., Papanastassiou, E. (2003) Radiation doses to patients undergoing coronary angiography and percutaneous transluminal coronary angioplasty, Radiat. Prot. Dosim. 103, 149-154.
[9]Doody, M.M., Lonstein, J.E., Stovall, M., Hacker, D.G., Luckyanov, N., Land, C.E. (2000) Breast cancer mortality following diagnostic X-rays: findings from the US Scoliosis cohort study, Spine 25, 2052-2063.
[10]Efstathopoulos, E.P., Karvouni, E., Kottou, S., Tzanalaridou, E., Korovesis, S., Giazitzoglou, E., Katritsis, D.G. (2004) Patient dosimetry during coronary interventions: a comprehensive analysis, Am. Heart J. 147, 468-475.
[11]Faulkner, K., Vano, E. (2001) Deterministic effects in interventional radiology, Radiat. Prot. Dosim. 94, 95-98.
[12]Girerd, X., Mourad, J.J., Vaisse, B., Poncelet, P., Mallion, J.M., Herpin, D. (2003) Estimation du nombre des sujets traités pour une hypertension, un diabète ou une hyperlipidémie en France : étude FLAHS 2002, Arch. Mal. Coeur Vaiss. 96, 750-753.
[13]Gourdy, P., Ruidavets, J.B., Ferrieres, J., Ducimetiere, P., Amouyel, P., Arveiler, D., Cottel, D., Lamamy, N., Bingham, A., Hanaire-Broutin, H. (2001) Prevalence of type 2 diabetes and impaired fasting glucose in the middle-aged population of three French regions – The MONICA study 1995-97, Diabetes Metab. 27, 347-358.
[14]Guilbert P., Gauthier A. (2006) Baromètre Santé 2005, INPES.
[15] Harrison, D., Ricciardello, M., Collins, L. (1998) Evaluation of radiation dose and risk to the patient from coronary angiography, Aust. N. Z. J. Med. 28, 597-603.
[16]Howe, G.R. (1995) Lung cancer mortality between 1950 and 1987 after exposure to fractionated moderate-dose-rate ionizing radiation in the Canadian fluoroscopy cohort study and a comparison with lung cancer mortality in the Atomic Bomb survivors study, Radiat. Res. 142, 295-304.
[17]Infante-Rivard, C., Mathonnet, G., Sinnett, D. (2000) Risk of childhood leukemia associated with diagnostic irradiation and polymorphisms in DNA repair genes, Environ. Health Persp. 108, 495-498.
[18]Journy N., Sinno-Tellier S., Maccia C., Le Tertre A., Eilstein D., Pagès P., Pirard P., Donadieu J., Bar O. (2011) Main clinical, therapeutic and technical factors related to patient's maximum skin dose in interventional cardiology procedures, Br. J. Radiol., in press.
[19]Katritsis, D., Efstathopoulos, E., Betsou, S., Korovesis, S., Faulkner, K., Panayiotakis, G., Webb-Peploe, M.M. (2000) Radiation exposure of patients and coronary arteries in the stent era: A prospective study, Catheter Cardiovasc. Interv. 51, 259-264.
[20] Lambe, M., Hall, P., Granath, F., Sadr Azodi, O., Nilsson, T. (2005) Coronary angioplasty and cancer risk: a population-based cohort study in Sweden, Cardiovasc. Intervent. Radiol. 28, 36-38.
[21]Le Tourneau, T., Blanchard, D., Lablanche, J.M., Monassier, J.P., Morice, M.C., Cribier, A., Meier, P., Puel, J. (2002) Évolution de la cardiologie interventionnelle en France au cours de la dernière décennie (1991-2000), Arch. Mal. Coeur Vaiss. 95, 1188-1194.
[22]Malisan, M.R., Padovani, R., Faulkner, K., Malone, J.F., Vano, E., Jankowski, J., Kosunen, A. (2008) Proposal for a patient database on cardiac interventional exposures for epidemiological studies, Radiat. Prot. Dosim. 129, 96-99.
[23]McLaughlin, J.R., Kreiger, N., Sloan, M.P., Benson, L.N., Hilditch, S., Clarke, E.A. (1993) An historical cohort study of cardiac catheterization during childhood and the risk of cancer, Int. J. Epidemiol. 22, 584-591.
[24] Meinert, R., Kaletsch, U., Kaatsch, P., Schuz, J., Michaelis, J. (1999) Associations between childhood cancer and ionizing radiation: results of a population-based case-control study in Germany, Cancer Epidemiol. Biomarkers Prev. 8, 793-799.
[25]Modan, B., Keinan, L., Blumstein, T., Sadetzki, S. (2000) Cancer following cardiac catheterization in childhood, Int. J. Epidemiol. 29, 424-428.
[26]National Research Council of the National Academies (2006) Commitee to assess Health Risks from Exposure to Low Levels of Ionizing Radiations; Nuclear and Radiation Studies Board, Division on Earth and Life Studies, Health Risks From Exposure to Low Levels of Ionizing Radiations: BEIRVII Phase 2, 2006, Washington DC: The National Academies Press.
[27]Pattee, P.L., Johns, P.C., Chambers, R.J. (1993) Radiation risk to patients from percutaneous transluminal coronary angioplasty, J. Am. Coll. Cardiol. 22, 1044-1051.
[28]Preston, D.L., Ron, E., Tokuoka, S., Funamoto, S., Nishi, N., Soda, M., Mabuchi, K., Kodama, K. (2007) Solid cancer incidence in atomic bomb survivors: 1958-1998, Radiat. Res. 168, 1-64.
[29]Preston, D.L., Shimizu, Y., Pierce, D.A., Suyama, A., Mabuchi, K. (2003) Studies of mortality of atomic bomb survivors. Report 13: Solid cancer and noncancer disease mortality: 1950-1997, Radiat. Res. 160, 381-407.
[30]Rassow, J., Schmaltz, A.A., Hentrich, F., Streffer, C. (2000) Effective doses to patients from paediatric cardiac catheterization, Br. J. Radiol. 73, 172-183.
[31] Ricordeau, P., Weill, A., Vallier, N., Bourrel, R., Fender, P., Allemand, H. (2000) L'épidémiologie du diabète en France métropolitaine. Diabetes Metab. 26, Suppl 6, 11-24.
[32] Ruiz-Cruces, R., Perez-Martinez, M., Tort Ausina, I., Munoz, V., Martinez-Morillo, M., Diez de los Rios, A. (2000) Organ doses, detriment and genetic risk from interventional vascular procedures in Malaga (Spain), Eur. J. Radiol. 33, 14-23.
[33]Smith, I.R., Rivers, J.T. (2008) Measures of radiation exposure in cardiac imaging and the impact of case complexity, Heart Lung. Circ. 17, 224-231.
[34]Tapiovaara M., Lakkisto M., Seromaa, A. (1997) PCXMC, a PC-based Monte Carlo program for calculating patient doses in medical x-ray examinations, Stuk-A139.
[35]UNSCEAR (2006) United Nations Scientific Committee on the Effects of Atomic Radiation, Health Phys. 79, 314.
[36]van Domburg, R.T., Foley, D.P., de Feyter, P.J., van der Giessen, W., van den Brand, M.J., Serruys, P.W. (2001) Long-term clinical outcome after coronary balloon angioplasty: identification of a population at low risk of recurrent events during 17 years of follow-up, Eur. Heart J. 22, 934-941.
[37]Vano, E., Goicolea, J., Galvan, C., Gonzalez, L., Meiggs, L., Ten, J.I., Macaya, C. (2001) Skin radiation injuries in patients following repeated coronary angioplasty procedures, Br. J. Radiol. 74, 1023-1031.

Keywords

Patient cumulative radiation exposure in interventional cardiology

  • M.-O. Bernier (a1), S. Jacob (a1), C. Maccia (a2), O. Bar (a3), O. Catelinois (a4), D. Blanchard (a3) and D. Laurier (a1)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed