Cancerogenesis Risks between 64 and 320 Row Detector CT for Coronary CTA Screening.
Atif N Khan, Faisal Khosa, Boris Nikolic, Waqas Shuaib, Pei-Jan Paul Lin, Mohammad K Khan
Departments of Radiology, BIDMC, Harvard Medical School, Boston, MA, Emory University Hospital Atlanta, GA, Albert Einstein Medical Center, Philadelphia, PA, Virginia Commonwealth University, Richmond, VA, USA
Date of Submission: 11-Jan-2014, Date of Acceptance: 28-Jan-2014, Date of Web Publication: 29-Apr-2014.
Objectives: This study compares cancerogenesis risks posed by the 64 row detector and the 320 row detector computed tomography scanners used during coronary computed tomography angiography (CCTA) following decennial screening guidelines. Material and Methods: Data of the radiation absorbed after CCTA by lung, thyroid, and female breast in patients between 50 and 70 years of age obtained from prior published literature for the 64 row CT scanner were compared with data from our study using 320 row detector CT scanner. Data from the 64 row and the 320 row detector CT scanners was used to determine lifetime attributable risks (LAR) of cancer based on the biological effects of ionizing radiation (BEIR) VII report. Results: The relative reduction of LAR (%) for 50-, 60-, and 70-year-old patients undergoing scanning with the 320 row detector CT scanner was 30% lower for lung, and more than 50% lower for female breast when compared with results from 64 row detector CT scanner. The use of 320 row detector CT would result in a combined cumulative cancer incidence of less than 1/500 for breast in women and less than 1/1000 for lung in men; By comparison, this is much lower than other more common risk factors: 16-fold for lung cancer in persistent smokers, 2-fold for breast cancer with a first degree family member history of breast cancer, and 10-fold for thyroid cancer with a family member with thyroid cancer. Decennial screening would benefit at least 355,000 patients from sudden cardiac death each year, 94% of whom have significant coronary artery disease, with at least one stenosis >75%. LAR for thyroid cancer was negligible for both scanners. Conclusion: Lung and female breast LAR reductions with 320 row detector compared with 64 row detector CT are substantial, and the benefits would outweigh increased cancer risks with decennial screening in the age group of 50-70 years.
Rami Abazid, Osama Smettei, Sawsan Sayed, Fahad Al Harby, Abdullah Al Habeeb, Hanaa Al Saqqa, Salma Mergania and Joseph B. Selvanayagam (2015) Objective and subjective image quality with prospectively gated versus ECG-controlled tube current modulation using 256-slice computed tomographic angiography. Journal of the Saudi Heart Association27(4):256. doi: 10.1016/j.jsha.2015.03.009
Jason Kinnin, Tarek N. Hanna, Marc Jutras, Babar Hasan, Rick Bhatia and Faisal Khosa (2019) Top 100 Cited articles on Radiation Exposure in Medical Imaging: A Bibliometric Analysis. Current Problems in Diagnostic Radiology48(4):368. doi: 10.1067/j.cpradiol.2018.03.005
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