title: The appropriate and justified use of medical radiation in cardiovascular imaging: a position document of the ESC Associations of Cardiovascular Imaging, Percutaneous Cardiovascular Interventions and Electrophysiology.
abstract: The benefits of cardiac imaging are immense, and modern medicine requires the extensive and versatile use of a variety of cardiac imaging techniques. Cardiologists are responsible for a large part of the radiation exposures every person gets per year from all medical sources. Therefore, they have a particular responsibility to avoid unjustified and non-optimized use of radiation, but sometimes are imperfectly aware of the radiological dose of the examination they prescribe or practice. This position paper aims to summarize the current knowledge on radiation effective doses (and risks) related to cardiac imaging procedures. We have reviewed the literature on radiation doses, which can range from the equivalent of 1-60 milliSievert (mSv) around a reference dose average of 15 mSv (corresponding to 750 chest X-rays) for a percutaneous coronary intervention, a cardiac radiofrequency ablation, a multidetector coronary angiography, or a myocardial perfusion imaging scintigraphy. We provide a European perspective on the best way to play an active role in implementing into clinical practice the key principle of radiation protection that: 'each patient should get the right imaging exam, at the right time, with the right radiation dose'.
authors.affiliation: Institute of Clinical Physiology, CNR, Pisa, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Picano
authors.forename: Eliseo
authors.initials: E
authors.lastname: Vañó
authors.forename: Madan M
authors.initials: MM
authors.lastname: Rehani
authors.forename: Alberto
authors.initials: A
authors.lastname: Cuocolo
authors.forename: Lluis
authors.initials: L
authors.lastname: Mont
authors.forename: Vicente
authors.initials: V
authors.lastname: Bodi
authors.forename: Olivier
authors.initials: O
authors.lastname: Bar
authors.forename: Carlo
authors.initials: C
authors.lastname: Maccia
authors.forename: Luc
authors.initials: L
authors.lastname: Pierard
authors.forename: Rosa
authors.initials: R
authors.lastname: Sicari
authors.forename: Sven
authors.initials: S
authors.lastname: Plein
authors.forename: Heiko
authors.initials: H
authors.lastname: Mahrholdt
authors.forename: Patrizio
authors.initials: P
authors.lastname: Lancellotti
authors.forename: Juhani
authors.initials: J
authors.lastname: Knuuti
authors.forename: Hein
authors.initials: H
authors.lastname: Heidbuchel
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.forename: Luigi P
authors.initials: LP
authors.lastname: Badano
mesh_terms: D057791:Cardiac Imaging Techniques / Q000009:adverse effects*; D002309:Cardiology; D002648:Child; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007258:Informed Consent; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology; D011296:Prenatal Diagnosis / Q000009:adverse effects; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology; D011835:Radiation Protection / Q000379:methods / Q000592:standards; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects; D019564:Unnecessary Procedures
keywords: Cancer; Cardiovascular disease; Imaging; Radiation; Radiological protection; Risk