Cumulative radiation exposure and cancer risk of patients with ischemic heart diseases from diagnostic and therapeutic imaging procedures

ObjectivesTo present a detailed analysis of the cumulative radiation exposure and cancer risk of patients with ischemic heart diseases (IHD) from diagnostic and therapeutic imaging.MethodsFor 1219 IHD patients, personal and examination data were retrieved from the information systems of a university hospital. For each patient, cumulative organ doses and the corresponding effective dose (E¯) resulting from all imaging procedures performed within 3 months before and 12 months after the date of the diagnosis were calculated. The cumulative lifetime attributable risk (LAR¯) of the patients to be diseased by radiation-related cancer was estimated using sex-, age-, and organ-specific risk models.ResultsAmong the 3870 procedures performed in the IHD patients, the most frequent were radiographic examinations (52.4%) followed by coronary catheter angiographies and percutaneous cardiac interventions (41.3%), CT scans (3.9%), and perfusion SPECT (2.3%). 87% of patient exposure resulted from heart catheter procedures. E¯ and LAR¯ were significantly higher in males than females (average, 13.3 vs. 10.3 mSv and 0.09 vs. 0.07%, respectively). Contrary to the effective dose, the cancer risk decreased markedly for both sexes with increasing age.ConclusionsAlthough IHD patients were partially exposed to considerable amounts of radiation, estimated LAR¯s were small as compared to their baseline risk to develop cancer in the remaining life.