SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT

Abstract

Over the last few years, computed tomography (CT) has developed into a standard clinical test for a variety of cardiovascular conditions. The emergence of cardiovascular CT during a period of dramatic increase in radiation exposure to the population from medical procedures and heightened concern about the subsequent potential cancer risk has led to intense scrutiny of the radiation burden of this new technique. This has hastened the development and implementation of dose reduction tools and prompted closer monitoring of patient dose. In an effort to aid the cardiovascular CT community in incorporating patient-centered radiation dose optimization and monitoring strategies into standard practice, the Society of Cardiovascular Computed Tomography has produced a guideline document to review available data and provide recommendations regarding interpretation of radiation dose indices and predictors of risk, appropriate use of scanner acquisition modes and settings, development of algorithms for dose optimization, and establishment of procedures for dose monitoring.

Figure 1

Example of flow chart to optimize radiation exposure for coronary CT angiography with the use of the ALARA principle. “Aggressive” ECG-based tube current modulation refers to use of a narrow window of high tube current and selection of the minimum tube current available outside the window. “Conservative” ECG-based tube current modulation describes the use of a wider window of high tube current and, possibly, the selection of a higher minimum tube current value.