Nicholas R Jarvis, Ellen C Meltzer, Jon C Tilburt, Lyndsay A Kandi, Yu-Hui H Chang, Elisabeth S Lim, Timothy J Ingall, Michael A Howard, Chad M Teven
Ethics Education in U.S. Allopathic Medical Schools: A National Survey of Medical School Deans and Ethics Course Directors
The Journal of clinical ethics
cardiac computed tomography ct angiography ccta emerged useful diagnostic imaging modality assessment coronary artery disease however potential risks due exposure ionizing radiation associated ccta raised concernsto estimate radiation dose ccta routine clinical practice well association currently available strategies dose reduction identify independent factors contributing radiation dosea crosssectional international multicenter observational study 50 study sites 21 university hospitals 29 community hospitals estimated radiation dose 1965 patients undergoing ccta february december 2007 linear regression analysis used identify independent predictors associated dosedoselength product dlp cctathe median dlp 1965 ccta examinations performed 50 study sites 885 mgy x cm interquartile range 5681259 mgy x cm corresponds estimated radiation dose 12 msv 12 x dose abdominal ct study 600 chest xrays high variability dlp observed study sites range median dlps per site 3312146 mgy x cm independent factors associated radiation dose patient weight relative effect dlp 5 95 confidence interval ci 46 absence stable sinus rhythm 10 95 ci 219 scan length 5 95 ci 46 electrocardiographically controlled tube current modulation 25 95 ci 23 28 applied 73 patients 100kv tube voltage 46 95 ci 42 51 applied 5 patients sequential scanning 78 95 ci 77 79 applied 6 patients experience cardiac ct 1 95 ci 1 0 number cctas per month 0 95 ci 01 type 64slice ct system highest vs lowest dose system 97 95 ci 88106 algorithms dose reduction associated deteriorated diagnostic image quality observational studymedian doses ccta differ significantly study sites ct systems effective strategies reduce radiation dose available strategies frequently used comparable diagnostic image quality may support increased use dosesaving strategies adequately selected patients