Cumulative exposure to ionizing radiation from diagnostic and therapeutic cardiac imaging procedures: a population-based analysis

J Am Coll Cardiol. 2010 Aug 24;56(9):702-11. doi: 10.1016/j.jacc.2010.05.014. Epub 2010 Jul 9.


Objectives: The purpose of this study was to describe radiation exposure from cardiac imaging procedures over time in a general population.

Background: Cardiac imaging procedures frequently expose patients to ionizing radiation, but their contribution to effective doses of radiation in the general population is unknown.

Methods: We used administrative claims to identify cardiac imaging procedures performed from 2005 to 2007 in 952,420 nonelderly insured adults in 5 U.S. health care markets. We estimated 3-year cumulative effective doses of radiation in millisieverts from these procedures We then calculated population-based annual rates of radiation exposure to effective doses < or =3 mSv/year (background level of radiation from natural sources), >3 to 20 mSv/year, or >20 mSv/year (upper annual limit for occupational exposure averaged over 5 years).

Results: A total of 90,121 (9.5%) individuals underwent at least 1 cardiac imaging procedure using radiation. Among patients who underwent > or =1 cardiac imaging procedures, the mean cumulative effective dose over 3 years was 23.1 mSv (range 1.5 to 543.7 mSv). Myocardial perfusion imaging accounted for 74% of the cumulative effective dose. Overall, 47.8% of cardiac imaging procedures were performed in physician offices; this proportion was higher for myocardial perfusion imaging (74.8%) and cardiac computed tomography studies (76.5%). The annual population-based rate of receiving an effective dose of >3 to 20 mSv/year was 89.0 per 1,000; and 3.3 per 1,000 for cumulative doses >20 mSv/year. Annual effective doses increased with age and were generally higher among men.

Conclusions: Cardiac imaging procedures lead to substantial radiation exposure and effective doses for many patients in the U.S.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Angioplasty, Balloon, Coronary / statistics & numerical data
  • Cardiac Catheterization / statistics & numerical data
  • Diagnostic Imaging / adverse effects
  • Diagnostic Imaging / statistics & numerical data*
  • Female
  • Heart / diagnostic imaging
  • Heart Diseases / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Radiation, Ionizing
  • Radiography / statistics & numerical data*
  • Radionuclide Angiography / statistics & numerical data
  • Radionuclide Imaging / statistics & numerical data*
  • United States