title: Comprehensive assessment of radiation dose estimates for the CORE320 study.
abstract: OBJECTIVE. The purpose of this study was to comprehensively study estimated radiation doses for subjects included in the main analysis of the Combined Non-invasive Coronary Angiography and Myocardial Perfusion Imaging Using 320 Detector Computed Tomography (CORE320) study ( ClinicalTrials.gov identifier NCT00934037), a clinical trial comparing combined CT angiography (CTA) and perfusion CT with the reference standard catheter angiography plus myocardial perfusion SPECT. SUBJECTS AND METHODS. Prospectively acquired data on 381 CORE320 subjects were analyzed in four groups of testing related to radiation exposure. Radiation dose estimates were compared between modalities for combined CTA and perfusion CT with respect to covariates known to influence radiation exposure and for the main clinical outcomes defined by the trial. The final analysis assessed variations in radiation dose with respect to several factors inherent to the trial. RESULTS. The mean radiation dose estimate for the combined CTA and perfusion CT protocol (8.63 mSv) was significantly (p < 0.0001 for both) less than the average dose delivered from SPECT (10.48 mSv) and the average dose from diagnostic catheter angiography (11.63 mSv). There was no significant difference in estimated CTA-perfusion CT radiation dose for subjects who had false-positive or false-negative results in the CORE320 main analyses in a comparison with subjects for whom the CTA-perfusion CT findings were in accordance with the reference standard SPECT plus catheter angiographic findings. CONCLUSION. Radiation dose estimates from CORE320 support clinical implementation of a combined CT protocol for assessing coronary anatomy and myocardial perfusion.
authors.affiliation: 1 Department of Radiology, Applied Imaging Science Laboratory, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Rybicki
authors.forename: Richard T
authors.initials: RT
authors.lastname: Mather
authors.forename: Kanako K
authors.initials: KK
authors.lastname: Kumamaru
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Brinker
authors.forename: Marcus Y
authors.initials: MY
authors.lastname: Chen
authors.forename: Christopher
authors.initials: C
authors.lastname: Cox
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Matheson
authors.forename: Marc
authors.initials: M
authors.lastname: Dewey
authors.forename: Marcelo F
authors.initials: MF
authors.lastname: DiCarli
authors.forename: Julie M
authors.initials: JM
authors.lastname: Miller
authors.forename: Jacob
authors.initials: J
authors.lastname: Geleijns
authors.forename: Richard T
authors.initials: RT
authors.lastname: George
authors.forename: Narinder
authors.initials: N
authors.lastname: Paul
authors.forename: John
authors.initials: J
authors.lastname: Texter
authors.forename: Andrea
authors.initials: A
authors.lastname: Vavere
authors.forename: Tan Swee
authors.initials: TS
authors.lastname: Yaw
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
authors.forename: Melvin E
authors.initials: ME
authors.lastname: Clouse
mesh_terms: D065638:Absorption, Radiation; D000368:Aged; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014915:Whole-Body Counting / Q000706:statistics & numerical data*
keywords: CT; SPECT; coronary angiography; coronary vessels; radiation dose