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Patient cumulative radiation exposurein interventional cardiology

Published online by Cambridge University Press:  21 March 2012

M.-O. Bernier ,
S. Jacob ,
C. Maccia ,
O. Bar ,
O. Catelinois ,
D. Blanchard  and
D. Laurier
M.-O. Bernier
Affiliation:
Institut de radioprotection et de sûreté nucléaire (IRSN), DRPH, SRBE, LEPID, Fontenay-aux-Roses, France
S. Jacob
Affiliation:
Institut de radioprotection et de sûreté nucléaire (IRSN), DRPH, SRBE, LEPID, Fontenay-aux-Roses, France
C. Maccia
Affiliation:
Centre d’assurance de qualité des applications technologiques dans le domaine de la santé (CAATS), Bourg-la-Reine, France
O. Bar
Affiliation:
Clinique Saint-Gatien, Tours, France
O. Catelinois
Affiliation:
Institut de veille sanitaire, St Maurice, France
D. Blanchard
Affiliation:
Clinique Saint-Gatien, Tours, France
D. Laurier
Affiliation:
Institut de radioprotection et de sûreté nucléaire (IRSN), DRPH, SRBE, LEPID, Fontenay-aux-Roses, France
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Abstract

Interventional cardiology procedures can involve potentiallyhigh doses of radiation to the patients. Stochastic effects of ionisingradiation – radiation-induced cancers in the long term – may occur.We analysed clinical characteristics and dosimetric data in a populationof patients undergoing interventional cardiology. In all, 1 591patients who had undergone coronarography and/or angioplasty inthe course of a year at the Saint-Gatien Clinic in Tours (France)were included. Information on patients’ individual clinical characteristicsand Dose-Area Product values were collected. Organ doses to thelung, oesophagus, bone marrow and breast were mathematically evaluated.The median age of patients was 70 years. Their median cumulativedose-area product value was 48.4 Gy.cm2 for the wholeyear and the median effective dose was 9.7 mSv. The median organdoses were 41 mGy for the lung, 31 mGy for the oesophagus, 10 mGyfor the bone marrow and 4 mGy for the breast. Levels of doses closeto the heart appear to be rather high in the case of repeated interventionalcardiology procedures. Clinical characteristics should be takeninto account when planning epidemiological studies on potential radiation-inducedcancers.

Keywords

Interventional cardiologyexposure to ionising radiationpatientsepidemiologydosimetry
Type
Research Article
Information
Radioprotection , Volume 47 , Issue 1 , January 2012 , pp. 93 - 103
Copyright
© EDP Sciences, 2012

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References

Axelsson, B., Khalil, C., Lidegran, M., Schuwert, P., Mortensson, W. (1999) Estimating the effective dose to children undergoing heart investigations – a phantom study, Br. J. Radiol. 72, 378-383.Google ScholarPubMed
Bahreyni Toossi, M.T., Zare, H., Bayani, S., Esmaili, S. (2008) Organ and effective doses of patients arising from coronary angiography and percutaneous transluminal coronary angioplasty at two hospitals in Mashhad-Iran, Radiat. Prot. Dosim. 128, 363-366.Google ScholarPubMed
Betsou, S., Efstathopoulos, E.P., Katritsis, D., Faulkner, K., Panayiotakis, G. (1998) Patient radiation doses during cardiac catheterization procedures, Br. J. Radiol. 71, 634-639.Google ScholarPubMed
Bogaert, E., Bacher, K., Thierens, H. (2008) A large-scale multicentre study in Belgium of dose area product values and effective doses in interventional cardiology using contemporary X-ray equipment, Radiat. Prot. Dosim. 128, 312-323.Google ScholarPubMed
Boice, J.D. Jr., Morin, M.M., Glass, A.G., Friedman, G.D., Stovall, M., Hoover, R.N, Fraumeni, J.F. Jr. (1991) Diagnostic X-ray procedures and risk of leukemia, lymphoma, and multiple myeloma, Jama 265, 1290-1294.Google ScholarPubMed
Charles, M.A., Basdevant, A., Eschwege, E. (2002) Prévalence de l'obésité de l'adulte en France : la situation en 2000, Ann. Endocrinol. (Paris) 63, 154-158.Google Scholar
Cusma, J.T., Bell, M.R., Wondrow, M.A., Taubel, J.P., Holmes, D.R. Jr. (1999) Real-time measurement of radiation exposure to patients during diagnostic coronary angiography and percutaneous interventional procedures, J. Am. Coll. Cardiol. 33, 427-435.Google ScholarPubMed
Delichas, M.G., Psarrakos, K., Molyvda-Athanassopoulou, E., Giannoglou, G., Hatziioannou, K., Papanastassiou, E. (2003) Radiation doses to patients undergoing coronary angiography and percutaneous transluminal coronary angioplasty, Radiat. Prot. Dosim. 103, 149-154.Google ScholarPubMed
Doody, M.M., Lonstein, J.E., Stovall, M., Hacker, D.G., Luckyanov, N., Land, C.E. (2000) Breast cancer mortality following diagnostic X-rays: findings from the US Scoliosis cohort study, Spine 25, 2052-2063.Google Scholar
Efstathopoulos, E.P., Karvouni, E., Kottou, S., Tzanalaridou, E., Korovesis, S., Giazitzoglou, E., Katritsis, D.G. (2004) Patient dosimetry during coronary interventions: a comprehensive analysis, Am. Heart J. 147, 468-475.Google ScholarPubMed
Faulkner, K., Vano, E. (2001) Deterministic effects in interventional radiology, Radiat. Prot. Dosim. 94, 95-98.Google ScholarPubMed
Girerd, X., Mourad, J.J., Vaisse, B., Poncelet, P., Mallion, J.M., Herpin, D. (2003) Estimation du nombre des sujets traités pour une hypertension, un diabète ou une hyperlipidémie en France : étude FLAHS 2002, Arch. Mal. Coeur Vaiss. 96, 750-753.Google Scholar
Gourdy, P., Ruidavets, J.B., Ferrieres, J., Ducimetiere, P., Amouyel, P., Arveiler, D., Cottel, D., Lamamy, N., Bingham, A., Hanaire-Broutin, H. (2001) Prevalence of type 2 diabetes and impaired fasting glucose in the middle-aged population of three French regions – The MONICA study 1995-97, Diabetes Metab. 27, 347-358.Google ScholarPubMed
Guilbert P., Gauthier A. (2006) Baromètre Santé 2005, INPES.
Harrison, D., Ricciardello, M., Collins, L. (1998) Evaluation of radiation dose and risk to the patient from coronary angiography, Aust. N. Z. J. Med. 28, 597-603.Google ScholarPubMed
Howe, G.R. (1995) Lung cancer mortality between 1950 and 1987 after exposure to fractionated moderate-dose-rate ionizing radiation in the Canadian fluoroscopy cohort study and a comparison with lung cancer mortality in the Atomic Bomb survivors study, Radiat. Res. 142, 295-304.Google Scholar
Infante-Rivard, C., Mathonnet, G., Sinnett, D. (2000) Risk of childhood leukemia associated with diagnostic irradiation and polymorphisms in DNA repair genes, Environ. Health Persp. 108, 495-498.Google ScholarPubMed
Journy N., Sinno-Tellier S., Maccia C., Le Tertre A., Eilstein D., Pagès P., Pirard P., Donadieu J., Bar O. (2011) Main clinical, therapeutic and technical factors related to patient's maximum skin dose in interventional cardiology procedures, Br. J. Radiol., in press.
Katritsis, D., Efstathopoulos, E., Betsou, S., Korovesis, S., Faulkner, K., Panayiotakis, G., Webb-Peploe, M.M. (2000) Radiation exposure of patients and coronary arteries in the stent era: A prospective study, Catheter Cardiovasc. Interv. 51, 259-264.Google ScholarPubMed
Lambe, M., Hall, P., Granath, F., Sadr Azodi, O., Nilsson, T. (2005) Coronary angioplasty and cancer risk: a population-based cohort study in Sweden, Cardiovasc. Intervent. Radiol. 28, 36-38.Google ScholarPubMed
Le Tourneau, T., Blanchard, D., Lablanche, J.M., Monassier, J.P., Morice, M.C., Cribier, A., Meier, P., Puel, J. (2002) Évolution de la cardiologie interventionnelle en France au cours de la dernière décennie (1991-2000), Arch. Mal. Coeur Vaiss. 95, 1188-1194.Google Scholar
Malisan, M.R., Padovani, R., Faulkner, K., Malone, J.F., Vano, E., Jankowski, J., Kosunen, A. (2008) Proposal for a patient database on cardiac interventional exposures for epidemiological studies, Radiat. Prot. Dosim. 129, 96-99.Google ScholarPubMed
McLaughlin, J.R., Kreiger, N., Sloan, M.P., Benson, L.N., Hilditch, S., Clarke, E.A. (1993) An historical cohort study of cardiac catheterization during childhood and the risk of cancer, Int. J. Epidemiol. 22, 584-591.Google ScholarPubMed
Meinert, R., Kaletsch, U., Kaatsch, P., Schuz, J., Michaelis, J. (1999) Associations between childhood cancer and ionizing radiation: results of a population-based case-control study in Germany, Cancer Epidemiol. Biomarkers Prev. 8, 793-799.Google ScholarPubMed
Modan, B., Keinan, L., Blumstein, T., Sadetzki, S. (2000) Cancer following cardiac catheterization in childhood, Int. J. Epidemiol. 29, 424-428.Google ScholarPubMed
National Research Council of the National Academies (2006) Commitee to assess Health Risks from Exposure to Low Levels of Ionizing Radiations; Nuclear and Radiation Studies Board, Division on Earth and Life Studies, Health Risks From Exposure to Low Levels of Ionizing Radiations: BEIRVII Phase 2, 2006, Washington DC: The National Academies Press.
Pattee, P.L., Johns, P.C., Chambers, R.J. (1993) Radiation risk to patients from percutaneous transluminal coronary angioplasty, J. Am. Coll. Cardiol. 22, 1044-1051.Google ScholarPubMed
Preston, D.L., Ron, E., Tokuoka, S., Funamoto, S., Nishi, N., Soda, M., Mabuchi, K., Kodama, K. (2007) Solid cancer incidence in atomic bomb survivors: 1958-1998, Radiat. Res. 168, 1-64.Google ScholarPubMed
Preston, D.L., Shimizu, Y., Pierce, D.A., Suyama, A., Mabuchi, K. (2003) Studies of mortality of atomic bomb survivors. Report 13: Solid cancer and noncancer disease mortality: 1950-1997, Radiat. Res. 160, 381-407.Google ScholarPubMed
Rassow, J., Schmaltz, A.A., Hentrich, F., Streffer, C. (2000) Effective doses to patients from paediatric cardiac catheterization, Br. J. Radiol. 73, 172-183.Google ScholarPubMed
Ricordeau, P., Weill, A., Vallier, N., Bourrel, R., Fender, P., Allemand, H. (2000) L'épidémiologie du diabète en France métropolitaine. Diabetes Metab. 26, Suppl 6, 11-24.Google Scholar
Ruiz-Cruces, R., Perez-Martinez, M., Tort Ausina, I., Munoz, V., Martinez-Morillo, M., Diez de los Rios, A. (2000) Organ doses, detriment and genetic risk from interventional vascular procedures in Malaga (Spain), Eur. J. Radiol. 33, 14-23.Google Scholar
Smith, I.R., Rivers, J.T. (2008) Measures of radiation exposure in cardiac imaging and the impact of case complexity, Heart Lung. Circ. 17, 224-231.Google Scholar
Tapiovaara M., Lakkisto M., Seromaa, A. (1997) PCXMC, a PC-based Monte Carlo program for calculating patient doses in medical x-ray examinations, Stuk-A139.
UNSCEAR (2006) United Nations Scientific Committee on the Effects of Atomic Radiation, Health Phys. 79, 314.
van Domburg, R.T., Foley, D.P., de Feyter, P.J., van der Giessen, W., van den Brand, M.J., Serruys, P.W. (2001) Long-term clinical outcome after coronary balloon angioplasty: identification of a population at low risk of recurrent events during 17 years of follow-up, Eur. Heart J. 22, 934-941.Google ScholarPubMed
Vano, E., Goicolea, J., Galvan, C., Gonzalez, L., Meiggs, L., Ten, J.I., Macaya, C. (2001) Skin radiation injuries in patients following repeated coronary angioplasty procedures, Br. J. Radiol. 74, 1023-1031.Google ScholarPubMed