Cardiac diagnostic imaging technique of myocardial perfusion imaging often involves multiple testing, which results in a high cumulative estimated radiation dose in patients.
The study has been published in the November 17 issue of
JAMA and is being released early online because it is being presented at the American Heart Association's annual meeting.
Use of medical imaging has grown rapidly in recent years, but along with the potential benefits has come an increase in the amount of ionizing radiation associated with many such tests and the accompanying potential risks of cancer. "Although much attention has been paid to radiation from computed tomography (CT) scans, a recent study demonstrated that the single test with the highest radiation burden, accounting for 22 percent of cumulative effective dose from medical sources, is myocardial perfusion imaging (MPI). Volume of MPI increased from less than 3 million procedures in the United States in 1990 to 9.3 million in 2002, and it is now estimated to account for more than 10 percent of the entire cumulative effective dose to the U.S. population from all sources, excluding radiotherapy," according to background information in the article. Few data are available to characterize the total radiation burden received over an extended period by patients undergoing MPI.
Andrew J. Einstein, M.D., Ph.D., of Columbia University Medical Center and New York-Presbyterian Hospital, New York, and colleagues analyzed procedures involving ionizing radiation received by a group of patients who received MPI to evaluate the total numbers of MPI examinations, other tests involving radiation, cumulative effective doses of radiation, and clinical indications for testing and repeat testing. The study included 1,097 patients undergoing MPI during the first 100 days of 2006 (January 1-April 10) at Columbia University Medical Center. The researchers evaluated all preceding medical imaging procedures involving ionizing radiation undergone beginning October 1988, and all subsequent procedures through June 2008, at the center.