Reduction in radiation exposure in cardiovascular computed tomography imaging: results from the PROspective multicenter registry on radiaTion dose Estimates of cardiac CT angIOgraphy iN daily practice in 2017 (PROTECTION VI).
Stocker TJ., Deseive S., Leipsic J., Hadamitzky M., Chen MY., Rubinshtein R., Heckner M., Bax JJ., Fang X-M., Grove EL., Lesser J., Maurovich-Horvat P., Otton J., Shin S., Pontone G., Marques H., Chow B., Nomura CH., Tabbalat R., Schmermund A., Kang J-W., Naoum C., Atkins M., Martuscelli E., Massberg S., Hausleiter J., PROTECTION VI investigators None.
AIMS: Advances of cardiac computed tomography angiography (CTA) have been developed for dose reduction, but their efficacy in clinical practice is largely unknown. This study was designed to evaluate radiation dose exposure and utilization of dose-saving strategies for contrast-enhanced cardiac CTA in daily practice. METHODS AND RESULTS: Sixty one hospitals from 32 countries prospectively enrolled 4502 patients undergoing cardiac CTA during one calendar month in 2017. Computed tomography angiography scan data and images were analysed in a central core lab and compared with a similar dose survey performed in 2007. Linear regression analysis was performed to identify independent predictors associated with dose. The most frequent indication for cardiac CTA was the evaluation of coronary artery disease in 89% of patients. The median dose-length product (DLP) of coronary CTA was 195 mGy*cm (interquartile range 110-338 mGy*cm). When compared with 2007, the DLP was reduced by 78% (P