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ESC supports 'appropriate' use of nuclear imaging technology
Date:3/23/2010

unless you recruited millions of subjects and followed them for the rest of their lifetimes," said Knuuti, adding that the current risk estimates have been derived from studies of atomic bomb survivors.

One study that helps put the risk of imaging into perspective suggests that living with a smoker (i.e. being a passive smoker) causes a 20 times higher risk of fatal cancer(4) than undergoing one CCTA scan (10 mSv). Another study suggests that the risk of having a fatal pedestrian traffic accident is three times higher than the risk of developing fatal cancer after one CCTA scan(5).

Cancer risks also need be considered in relation to the patient's age at the time of undergoing the investigation. "For patients with chest pain over the age of 60 years the radiation risks involved are unlikely to have consequences since it takes anyway decades to develop potential adverse events," said Knuuti, adding that the estimated risks would be greater for younger patients.

The way forward, said Knuuti, is to introduce strategies that reduce the radiation dose received by patients undergoing investigations. The PROTECTION 1 study, for example, showed that reducing the tube voltage from 120 kV to 100 kV resulted in a 53 % reduction in the median radiation dose for CCTA(6) "In the last five years the radiation dose from CCTA has been reduced from 20 to 30 mSv to 1-5 mSv. So the current dose is much lower than these papers are leading us to believe," he added.

Furthermore, additional efforts need to be undertaken to ensure appropriate use of imaging tests in different patient populations. "Studies undertaken in the US have suggested that one third of tests are being undertaken in patients where there is not a good indication," said Knuuti.

NOTES: Imaging Technology background

In the late 1990s cardiac computed tomography angiography (CCTA) emerged as a non invasive diagnostic test for coronary artery disease. The technolo
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Contact: ESC Press Office
press@escardio.org
33-049-294-8627
European Society of Cardiology
Source:Eurekalert

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