title: Low-dose cardiac imaging: reducing exposure but not accuracy.
abstract: Cardiac imaging techniques that use ionizing radiation have become an integral part of current cardiology practice. However, concern has arisen that ionizing radiation exposure, even at the low levels used for medical imaging, is associated with the risk of cancer. From a single diagnostic cardiac imaging procedure, such risks are low. On a population basis, however, malignancies become more likely on account of stochastic effects being more probable as the number of procedures performed increases. In light of this, and owing to professional and industrial commitment to the as low as reasonably achievable (ALARA) principle, over the last decade major strides have been made to reduce radiation dose in cardiac imaging. Dose-reduction strategies have been most pronounced in cardiac computed tomography. This was important since computed tomography has rapidly become a widely used diagnostic alternative to invasive coronary angiography, and initial protocols were associated with relatively high radiation exposures. Advances have also been made in nuclear cardiology and in invasive coronary angiography, and these reductions in patient exposure have all been achieved with maintenance of image quality and accuracy. Improvements in imaging camera technology, image acquisition protocols and image processing have lead to reductions in patient radiation exposure without compromising imaging diagnostic accuracy.
authors.affiliation: Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario K1Y 4W7, Canada. gsmall@ottawaheart.ca
authors.forename: Gary R
authors.initials: GR
authors.lastname: Small
authors.forename: Benjamin J W
authors.initials: BJ
authors.lastname: Chow
authors.forename: Terrence D
authors.initials: TD
authors.lastname: Ruddy
mesh_terms: D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods; D057791:Cardiac Imaging Techniques / Q000009:adverse effects / Q000379:methods*; D002318:Cardiovascular Diseases / Q000175:diagnosis; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods; D005471:Fluoroscopy / Q000009:adverse effects / Q000379:methods; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D061214:Patient Safety; D011839:Radiation, Ionizing; D015899:Tomography, Emission-Computed, Single-Photon / Q000009:adverse effects / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000379:methods