Guideline for minimizing radiation exposure during acquisition of coronary artery calcium scans with the use of multidetector computed tomography

A report by the Society for Atherosclerosis Imaging and Prevention Tomographic Imaging and Prevention Councils in collaboration with the Society of Cardiovascular Computed Tomography.

Szilard Voros, Juan J. Rivera, Daniel S. Berman, Ron Blankstein, Matthew J. Budoff, Ricardo C. Cury, Milind Y. Desai, Damini Dey, Sandra S. Halliburton, Harvey S. Hecht, Khurram Nasir, Raul D. Santos, Michael D. Shapiro, Allen J. Taylor, Uma S. Valeti, Phillip M. Young, Gaby Weissman

Research output: Contribution to journalArticle

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Abstract

Coronary artery calcium (CAC) scanning is an important tool for risk stratification in intermediate-risk, asymptomatic subjects without previous coronary disease. However, the clinical benefit of improved risk prediction needs to be balanced against the risk of the use of ionizing radiation. Although there is increasing emphasis on the need to obtain CAC scans at low-radiation exposure to the patient, very few practical documents exist to aid laboratories and health care professionals on how to obtain such low-radiation scans.The Tomographic Imaging Council of the Society for Atherosclerosis Imaging and Prevention, in collaboration with the Prevention Council and the Society of Cardiovascular Computed Tomography, created a task force and writing group to generate a practical document to address parameters that can be influenced by careful attention to image acquisition.Patient selection for CAC scanning should be based on national guidelines. It is recommended that laboratories performing CAC examinations monitor radiation exposure (dose-length-product [DLP]) and effective radiation dose (E) in all patients. DLP should be <200 mGy × cm; E should average 1.0-1.5 mSv and should be <3.0 mSv. On most scanner platforms, CAC imaging should be performed in an axial mode with prospective electrocardiographic triggering, using tube voltage of 120 kVp. Tube current should be carefully selected on the basis of patient size, potentially using chest lateral width measured on the topogram. Scan length should be limited for the coverage of the heart only.When patients and imaging parameters are selected appropriately, CAC scanning can be performed with low levels of radiation exposure.

Original languageEnglish (US)
Pages (from-to)75-83
Number of pages9
JournalJournal of Cardiovascular Computed Tomography
Volume5
Issue number2
DOIs
StatePublished - Mar 2011

Fingerprint

Multidetector Computed Tomography
Atherosclerosis
Coronary Vessels
Tomography
Guidelines
Calcium
Radiation
Advisory Committees
Ionizing Radiation
Patient Selection
Coronary Disease
Radiation Exposure
Thorax
Delivery of Health Care

Keywords

  • Coronary artery calcium
  • Guideline
  • Multidetector CT
  • Radiation dose
  • Radiation exposure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Guideline for minimizing radiation exposure during acquisition of coronary artery calcium scans with the use of multidetector computed tomography : A report by the Society for Atherosclerosis Imaging and Prevention Tomographic Imaging and Prevention Councils in collaboration with the Society of Cardiovascular Computed Tomography. / Voros, Szilard; Rivera, Juan J.; Berman, Daniel S.; Blankstein, Ron; Budoff, Matthew J.; Cury, Ricardo C.; Desai, Milind Y.; Dey, Damini; Halliburton, Sandra S.; Hecht, Harvey S.; Nasir, Khurram; Santos, Raul D.; Shapiro, Michael D.; Taylor, Allen J.; Valeti, Uma S.; Young, Phillip M.; Weissman, Gaby.

In: Journal of Cardiovascular Computed Tomography, Vol. 5, No. 2, 03.2011, p. 75-83.

Research output: Contribution to journalArticle

Voros, Szilard ; Rivera, Juan J. ; Berman, Daniel S. ; Blankstein, Ron ; Budoff, Matthew J. ; Cury, Ricardo C. ; Desai, Milind Y. ; Dey, Damini ; Halliburton, Sandra S. ; Hecht, Harvey S. ; Nasir, Khurram ; Santos, Raul D. ; Shapiro, Michael D. ; Taylor, Allen J. ; Valeti, Uma S. ; Young, Phillip M. ; Weissman, Gaby. / Guideline for minimizing radiation exposure during acquisition of coronary artery calcium scans with the use of multidetector computed tomography : A report by the Society for Atherosclerosis Imaging and Prevention Tomographic Imaging and Prevention Councils in collaboration with the Society of Cardiovascular Computed Tomography. In: Journal of Cardiovascular Computed Tomography. 2011 ; Vol. 5, No. 2. pp. 75-83.
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abstract = "Coronary artery calcium (CAC) scanning is an important tool for risk stratification in intermediate-risk, asymptomatic subjects without previous coronary disease. However, the clinical benefit of improved risk prediction needs to be balanced against the risk of the use of ionizing radiation. Although there is increasing emphasis on the need to obtain CAC scans at low-radiation exposure to the patient, very few practical documents exist to aid laboratories and health care professionals on how to obtain such low-radiation scans.The Tomographic Imaging Council of the Society for Atherosclerosis Imaging and Prevention, in collaboration with the Prevention Council and the Society of Cardiovascular Computed Tomography, created a task force and writing group to generate a practical document to address parameters that can be influenced by careful attention to image acquisition.Patient selection for CAC scanning should be based on national guidelines. It is recommended that laboratories performing CAC examinations monitor radiation exposure (dose-length-product [DLP]) and effective radiation dose (E) in all patients. DLP should be <200 mGy × cm; E should average 1.0-1.5 mSv and should be <3.0 mSv. On most scanner platforms, CAC imaging should be performed in an axial mode with prospective electrocardiographic triggering, using tube voltage of 120 kVp. Tube current should be carefully selected on the basis of patient size, potentially using chest lateral width measured on the topogram. Scan length should be limited for the coverage of the heart only.When patients and imaging parameters are selected appropriately, CAC scanning can be performed with low levels of radiation exposure.",
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