title: Establishment of diagnostic reference levels in cardiac CT in France: a need for patient dose optimisation.
abstract: The objective of this study was to propose diagnostic reference levels (DRLs) for coronary computed tomography angiography (CCTA), in the context of a large variability in patient radiation dose, and the lack of European recommendations. Volume Computed Tomography Dose Index (CTDIvol) and dose-length product (DLP) were collected from 460 CCTAs performed over a 3-month period at eight French hospitals. CCTAs (∼50 per centre) were performed using the routine protocols of the centres, and 64- to 320-detector CT scanners. ECG gating was prospective (n = 199) or retrospective (n = 261). The large gap in dose between these two modes required to propose specific DRLs: 26 and 44 mGy for CTDIvol, and 370 and 970 mGy cm for DLP, respectively. This study confirms the large variability in patient doses during CCTA and underlines the need for the optimisation of cardiac acquisition protocols. Availability of national DRLs should be mandatory in this setting.
authors.affiliation: Institut de Radioprotection et de Sureté Nucléaire, PRP-HOM/SER, BP17, Fontenay-aux-Roses 92262, France.
authors.forename: F
authors.initials: F
authors.lastname: Mafalanka
authors.affiliation: Institut de Radioprotection et de Sureté Nucléaire, PRP-HOM/SER, BP17, Fontenay-aux-Roses 92262, France cecile.etard@irsn.fr.
authors.forename: C
authors.initials: C
authors.lastname: Etard
authors.affiliation: Institut de Radioprotection et de Sureté Nucléaire, PRP-HOM/SER, BP17, Fontenay-aux-Roses 92262, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Rehel
authors.affiliation: Clinique Ambroise Paré, Neuilly-sur-Seine, France.
authors.forename: D
authors.initials: D
authors.lastname: Pesenti-Rossi
authors.affiliation: Hôpital Sud-Francilien, Corbeil-Essonnes, France.
authors.forename: F
authors.initials: F
authors.lastname: Amrar-Vennier
authors.affiliation: Hôpital Mignot, Le Chesnay, France.
authors.forename: N
authors.initials: N
authors.lastname: Baron
authors.affiliation: Centre Hospitalier Universitaire, Poitiers, France.
authors.forename: L
authors.initials: L
authors.lastname: Christiaens
authors.affiliation: Hôpital Mignot, Le Chesnay, France.
authors.forename: R
authors.initials: R
authors.lastname: Convers-Domart
authors.affiliation: Centre Hospitalier Universitaire, Lyon, France.
authors.forename: D
authors.initials: D
authors.lastname: Defez
authors.affiliation: Centre Hospitalier Universitaire, Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Douek
authors.affiliation: Hôpital Bichat, AP-HP, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Gaxotte
authors.affiliation: Hôpital Mignot, Le Chesnay, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Georges
authors.affiliation: Hôpital Bichat, AP-HP, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Leygnac
authors.affiliation: Hôpital Bichat, AP-HP, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Ou
authors.affiliation: Centre de Cardiologie du Nord, Saint-Denis, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Sablayrolles
authors.affiliation: Hôpital Lariboisière, AP-HP, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Salvat
authors.affiliation: Hôpital Bichat, AP-HP, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Schouman-Claeys
authors.affiliation: Hôpital Lariboisière, AP-HP, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Sirol
authors.affiliation: Institut de Radioprotection et de Sureté Nucléaire, PRP-HOM/SER, BP17, Fontenay-aux-Roses 92262, France.
authors.forename: B
authors.initials: B
authors.lastname: Aubert
mesh_terms: D017023:Coronary Angiography / Q000592:standards* / Q000706:statistics & numerical data*; D011829:Radiation Dosage; D011874:Radiometry / Q000592:standards* / Q000706:statistics & numerical data*; D012016:Reference Values; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000592:standards* / Q000706:statistics & numerical data*