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Risk assessment for potential radiation-induced cancer afterlung and bone marrow exposure during interventional cardiology procedures

Published online by Cambridge University Press:  01 November 2012

S. Jacob ,
O. Bar ,
O. Catelinois ,
C. Maccia ,
D. Laurier  and
M.-O. Bernier
S. Jacob
Affiliation:
Institut de radioprotection et de sûreté nucléaire, PRP-HOM, SRBE, Laboratory of Epidemiology, 31 avenue de la Division Leclerc, 92260 Fontenay-aux-Roses, France
O. Bar
Affiliation:
Clinique Saint Gatien, 8 place de la Cathédrale, 37000 Tours, France
O. Catelinois
Affiliation:
Institut de Veille Sanitaire, 12 rue du Val d'Osne, 94410 Saint-Maurice, France
C. Maccia
Affiliation:
Centre d’Assurance de qualité des Applications Technologiques dans le domaine de la Santé, 43 boulevard Maréchal Joffre, 92340 Bourg-La-Reine, France
D. Laurier
Affiliation:
Institut de radioprotection et de sûreté nucléaire, PRP-HOM, SRBE, Laboratory of Epidemiology, 31 avenue de la Division Leclerc, 92260 Fontenay-aux-Roses, France
M.-O. Bernier
Affiliation:
Institut de radioprotection et de sûreté nucléaire, PRP-HOM, SRBE, Laboratory of Epidemiology, 31 avenue de la Division Leclerc, 92260 Fontenay-aux-Roses, France
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Abstract

Interventional cardiology procedures (ICPs), while providing important benefits topatients, also contribute to their radiation exposure, in particular for the organssurrounding the heart. This paper addresses the issue of radiation exposure to the lungand bone marrow related to coronary interventions in terms of organ doses for coronaryangiography (CA) and percutaneous transluminal coronary angioplasty (PTCA), and riskassessment of potential radiation-induced cancer. Dosimetric information on 2095 ICPs fromFrench patients was collected. The median lung dose for CA alone was 34 mGy for men and 22mGy for women and the median bone marrow dose was 8 mGy and 4 mGy, respectively; doseswere slightly higher for CA and ad hoc PTCA and nearly twice as high forCA and elective PTCA. Based on the French national mortality registry and BiologicalEffects of Ionising Radiation VII models, spontaneous and radiation-induced lung cancersand leukaemia were estimated. For men and women aged at least 60 years old at the firstICP, excess risk of potentially fatal cancers attributable to radiation ranged from 0.4%to 4%. This study provides evidence of the potential risk of radiation-induced cancerafter an ICP. The limitations of such calculations are due to the difficulty of takinginto account patients’ possibly shorter life expectancy than in the general population,linked to their comorbidities and coronary disease. Nevertheless, risk estimates can beused to illustrate the beneficial role of optimisation of doses delivered to thepatient.

Keywords

interventional cardiology proceduresorgan dosesradiation-induced cancerrisk assessmentepidemiology
Type
Research Article
Information
Radioprotection , Volume 48 , Issue 2 , April 2013 , pp. 203 - 213
Copyright
© EDP Sciences, 2013

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