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dc.contributor.authorHamilton-Craig, Christian R
dc.contributor.authorTandon, Karman
dc.contributor.authorKwan, Bianca
dc.contributor.authorDeBoni, Karen
dc.contributor.authorBurley, Chris
dc.contributor.authorWesley, Allan J
dc.contributor.authorO'Rourke, Rachael
dc.contributor.authorNeill, Johanne
dc.contributor.authorBranch, Kelley R
dc.date.accessioned2019-11-18T23:50:10Z
dc.date.available2019-11-18T23:50:10Z
dc.date.issued2019
dc.identifier.issn2051-3895
dc.identifier.doi10.1002/jmrs.358
dc.identifier.urihttp://hdl.handle.net/10072/389185
dc.description.abstractIntroduction: Coronary CT Angiography (CCTA) is a rapidly increasing technique for coronary imaging; however, it exposes patients to ionising radiation. We examined the impact of dose reduction techniques using ECG‐triggering, kVp/mAs reduction and high‐pitch modes on radiation exposure in a large Australian tertiary CCTA service. Methods: Data on acquisition modes and dose exposure were prospectively collected on all CCTA scans from November 2009 to March 2014 at an Australian tertiary care centre. A dose reduction algorithm was developed using published techniques and implemented with education of medical staff, radiographers and referrers. Associations of CCTA acquisition to radiation over time were analysed with multivariate regression. Specificity in positive CCTA was assessed by correlation with invasive coronary angiography. Results: 3333 CCTAs were analysed. Mean radiation dose decreased from 8.4 mSv to 5.3, 4.4, 3.7, 2.9 and 2.8 mSv (P < 0.001) per year. Patient characteristics were unchanged. Dose reduction strategies using ECG‐triggering, kVp/mAs reduction accounted for 91% of the decrease. High‐pitch scanning reduced dose by an additional 9%. Lower dose was independently related to lower kVp, heart rate, tube current modulation, BMI, prospective triggering and high‐pitch mode (P < 0.01). CCTA specificity remained unchanged despite dose reduction. Conclusion: Implementation of evidence‐based CCTA dose reduction algorithm and staff education programme resulted in a 67% reduction in radiation exposure, while maintaining diagnostic specificity. This approach is widely applicable to clinical practice for the performance of CCTA.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherWiley Online
dc.publisher.placeUnited Kingdom
dc.relation.ispartofjournalJournal of Medical Radiation Sciences
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchOncology and Carcinogenesis
dc.subject.fieldofresearchcode1103
dc.subject.fieldofresearchcode1112
dc.subject.keywordscardiovascular computed tomography
dc.subject.keywordscoronary CT
dc.subject.keywordseducation
dc.subject.keywordsprospectively triggered coronary CT
dc.subject.keywordsradiation dose
dc.titleCoronary CT radiation dose reduction strategies at an Australian Tertiary Care Center - improvements in radiation exposure through an evidence-based approach
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationHamilton-Craig, CR; Tandon, K; Kwan, B; DeBoni, K; Burley, C; Wesley, AJ; O'Rourke, R; Neill, J; Branch, KR, Coronary CT radiation dose reduction strategies at an Australian Tertiary Care Center - improvements in radiation exposure through an evidence-based approach., Journal of Medical Radiation Sciences, 2019
dcterms.dateAccepted2019-08-25
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/
dc.date.updated2019-11-14T04:26:45Z
dc.description.versionVersion of Record (VoR)
gro.description.notepublicThis publication has been entered into Griffith Research Online as an Advanced Online Version.
gro.rights.copyright© 2019 The Authors and State of Queensland Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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gro.griffith.authorHamilton-Craig, Christian


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