Cancer Risk from Imaging Radiation in Ischemic Heart Disease

Prof. Dr. Gunnar Brix Division of Medical and Occupational Radiation Protection Federal Office for Radiation Protection Institut für Med. Strahlenhygiene 85764 Neuherberg MedicalResearch.com:
Prof. Dr. Gunnar Brix

Division of Medical and Occupational Radiation Protection
Federal Office for Radiation Protection
Institut für Med. Strahlenhygiene
85764 Neuherberg
MedicalResearch.com: What are the main findings of the study?

Answer: We investigated the cumulative radiation exposure and cancer risk of more than 1200 patients with ischemic heart diseases (IHD) from diagnostic and therapeutic imaging procedures performed 3 month before and 12 month after the date of diagnosis. The major findings were:

  • ­ 87% of patient exposure resulted from heart catheter procedures.
  • ­ The average cumulative effective dose was 13.3 mSv in males and 10.3 mSv in females. The highest dose was nearly 100 mSv.
  • ­ The estimated average attributable life-time risk of male and female patients to develop a radiation-induced cancer in their remaining life was 0.09 % and 0.07 %, respectively. This correspond to 1 excess cancer in about 1100 male and 1400 female IHD patients. The highest risk was 0.9 %.
  • ­ The effective dose is inadequate to characterize individual radiation risks, since neither the age nor the sex of the patient is taken into account. According to our results, cancer risks can vary by a factor of more than 10 for comparable values of the effective dose.

MedicalResearch.com: Were any of the findings unexpected?

Answer: Although IHD patients were partially exposed to considerable amounts of radiation, the estimated radiation risks were small – primarily due to the higher age of the patients.

MedicalResearch.com: What should clinicians and patients take away from this study?

Answer: The cancer risk related to IHD-specific diagnostic and therapeutic imaging procedures are small as compared to the baseline cancer risk as well as to the expected lethality risk from an insufficient, alternative (surgery) or even lacking treatment of the life-threatening disease. Nevertheless indications for imaging procedures in IHD patients have to be strictly limited to patients who will probably benefit from the procedures, and any effort has to be undertaken to optimize the procedures in order to reduce patient exposure.

MedicalResearch.com: What further research do you recommend as a result of your study?

Answer: To determine the cumulative radiation exposure and risk of IHD patients over a considerably longer period than one year.

Citation:

Cumulative radiation exposure and cancer risk of patients with ischemic heart diseases from diagnostic and therapeutic imaging procedures

Eur J Radiol. 2013 Nov;82(11):1926-1932. doi: 10.1016/j.ejrad.2013.07.015.
Epub 2013 Aug 15.

Brix G, Berton M, Nekolla E, Lechel U, Schegerer A, Süselbeck T, Fink C.

Department of Medical and Occupational Radiation Protection, Federal Office for Radiation Protection, Ingoldstädter Landstraße 1, D-85764 Oberschleissheim, Germany.