Related Experiment Video
Updated: Sep 27, 2025
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Gender based lung cancer risks for symptomatic coronary artery disease patients undergone cardiac CT
Entesar Zawam Dalah1,2, Abdulmunhem Obaideen3, Sabaa Anam2
1Department of Diagnostic Imaging, HQ Dubai Health Authority, Dubai, UAE.
Insights
This study quantifies lung cancer risk in coronary artery disease patients undergoing CT scans. Enhanced Coronary Computed Tomography Angiography (CCTA) and Computed Tomography Calcium Scoring (CTCS) yield different radiation doses, with higher risks observed in females and younger individuals.
Area of Science:
- Radiology and Imaging
- Radiation Oncology
- Cardiovascular Disease
Background:
- Coronary Artery Disease (CAD) patients often require diagnostic imaging.
- Computed Tomography (CT) examinations, including Coronary Computed Tomography Angiography (CCTA) and Computed Tomography Calcium Scoring (CTCS), involve ionizing radiation.
- Estimating the lifetime attributable risk (LAR) of cancer from these procedures is crucial for patient safety.
Purpose of the Study:
- To estimate the lifetime attributable risk (LAR) of lung cancer incidence in symptomatic Coronary Artery Disease (CAD) patients.
- To compare the effective dose (E) and organ doses (ODs) between enhanced Coronary Computed Tomography Angiography (CCTA) and unenhanced Computed Tomography Calcium Scoring (CTCS).
- To identify factors influencing radiation-induced lung cancer risk in this patient cohort.
Main Methods:
- Retrospective analysis of CCTA and CTCS data from 87 confirmed CAD adult patients.
- Calculation of patient effective dose (E) and organ doses (ODs) using CT-EXPO software.
- Statistical analysis including Pearson correlation and Wilcoxon unpaired t-test to compare doses.
- Estimation of organ-specific LARs following BEIR VII guidance using organ-equivalent dose-to-risk conversion factors.
Main Results:
- A significant statistical difference (p<0.0001) in effective dose (E) was found between CTCS and CCTA.
- CCTA had a greater scan length (17.5 ± 2.9 cm) compared to CTCS (15 ± 2 cm).
- Elevated organ doses were observed for the esophagus and thymus in both procedures, with CTCS having lower organ doses than CCTA.
- Lifetime attributable risk (LAR) for lung cancer was higher in females than males, and notably greater for females, younger patients, and those undergoing combined CCTA and CTCS scans.
- Tube modulation methods and scan parameters contribute to patient dose, with mAs being the most significant factor.
Conclusions:
- Significant differences in radiation dose exist between CCTA and CTCS, impacting lifetime attributable risk (LAR) of lung cancer.
- Female patients, younger individuals, and those receiving combined scans face a higher radiation-induced lung cancer risk.
- Optimizing scan parameters, particularly mAs, is critical for minimizing patient radiation dose and associated risks in CAD patients undergoing CT imaging.
Abstract:
We estimate the lifetime attributable risk (LAR) of lung cancer incidence in symptomatic Coronary Artery Disease (CAD) patients receiving enhanced Coronary Computed Tomography Angiography (CCTA) and the unenhanced Computed Tomography Calcium Scoring (CTCS) examination. Retrospective analysis has been made of CCTA and CTCS data collected for 87 confirmed CAD adult patients. Patient effective dose (E) and organ doses (ODs) were calculated using CT-EXPO. Statistical correlation and the differences between E and ODs in enhanced CCTA and unenhanced CTCS were calculated using the Pearson coefficient and Wilcoxon unpaired t-test. Following BEIR VII report guidance, organ-specific LARs for the cohort were estimated using the organ-equivalent dose-to-risk conversion factor for numbers of cases per 100,000 patients exposed to low doses of 0.1 Gy. Significant statistical difference (p<0.0001) is found between E obtained for CTCS and that of CCTA. The scan length was found to be greater in CCTA (17.5 ± 2.9 cm) compared to that for CTCS (15 ± 2 cm). More elevated values of dose were noted for the esophagus (4.2 ± 2.15 mSv) and thymus (9.6 ± 2.54 mSv) for both CTCS and CCTA. CTCS organ doses were lower than that of CCTA. Per 100,000 patients, female cumulative doses are seen to give rise to greater lung cancer LARs compared to that for males, albeit with risk varying significantly, noticeably greater for females, younger patients and combined CCTA and CTCS scans. While scan parameters and tube-modulation methods clearly contribute to patient dose, mAs offers by far the greater contribution.
More Related Videos
08:05Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
06:16Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Related Concept Videos
01:28Imaging Studies for Cardiovascular System V: CT
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:30Coronary Artery Disease I: Introduction
01:30Coronary Artery Disease III: Clinical Manifestations
01:30Radiological Investigation I: X-ray and CT