Patient selection essential for computed tomography coronary angiography.
OBJECTIVE
Computed tomography coronary angiography (CTCA) has become a commonly used imaging modality in patients with suspected anginal symptoms but also in asymptomatic populations. This practice has raised concerns due to potential high radiation exposure in terms of adequate benefit to risk profile.


METHODS
Demographics and CTCA scan details were collected from a consecutive series of 586 patients referred to a single community radiology practice for a CTCA.


RESULTS
Of the 586 patients, 271 (46.2%) were women. Mean age was 58.3 standard deviation (SD) 12.2, range 15-90 years, body mass index (BMI) 28.6 SD 5.9 kg/m(2), and heart rate 60 SD 10 beats per minute. Mean total radiation was 4.79 SD 3.45 mSv (range 0.64-31.34). The mean radiation exposure in the lowest quartile of BMI and heart rate were 3.01 SD 1.84 mSv and 3.95 SD 2.72 mSv, compared to the highest 7.32 SD 3.51 mSv and 6.20 SD 4.38 mSv (p for trend <0.0001 in both).


CONCLUSIONS
The radiation exposure in this consecutive series of patients is low in general but patient selection for CTCA imaging appears to be paramount. Patients with a high BMI and especially with high heart rate receive a higher dose of radiation.
a The George Institute for Global Health , Sydney , NSW , Australia ;|b Heart Centre, The University of Turku , Turku , Finland ;
Juuso I
JI
Blomster
c Castlereagh Imaging , Westmead , Sydney , Australia ;
John
J
O'Rourke
d Department of Cardiology , Westmead Hospital , Sydney , Australia ;
Preeti
P
Choudhary
c Castlereagh Imaging , Westmead , Sydney , Australia ;|d Department of Cardiology , Westmead Hospital , Sydney , Australia ;
Aravinda
A
Thiagalingam
d Department of Cardiology , Westmead Hospital , Sydney , Australia ;
Pramesh
P
Kovoor
c Castlereagh Imaging , Westmead , Sydney , Australia ;
Julian
J
Adler
a The George Institute for Global Health , Sydney , NSW , Australia ;|e Department of Cardiology , Royal Perth Hospital , Perth , Australia.
Graham S
GS
Hillis
a The George Institute for Global Health , Sydney , NSW , Australia ;|c Castlereagh Imaging , Westmead , Sydney , Australia ;|d Department of Cardiology , Westmead Hospital , Sydney , Australia ;
Clara K
CK
Chow
D000328:Adult; D000368:Aged; D001315:Australia; D015992:Body Mass Index; D000072226:Computed Tomography Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000592:standards*; D011870:Radiologic Health / Q000592:standards; D013223:Statistics as Topic
Computed tomography coronary angiography; coronary artery disease; diagnostic imaging