Worldwide Radiation Dose in Coronary Artery Disease Diagnostic Imaging

How does radiation dose from cardiac diagnostic testing vary worldwide?In this cross-sectional study in 101 countries including 19 302 patients, radiation doses varied significantly between imaging tests and among patients receiving the same tests across centers, regions, and country income strata. This was especially pronounced for coronary computed tomography angiography, for which median dose in low- and lower-middle–income countries was more than 280% of that in high-income countries and median dose in Africa was more than 500% of that in Western Europe.Current radiation doses for cardiac testing exceeded 9 mSv for 21% of patients undergoing nuclear cardiology studies and for 44% undergoing coronary computed tomography angiography, identifying critical needs for training, standardized protocols, and updated equipment to reduce radiation worldwide.

Corresponding Author: Andrew J. Einstein, MD, PhD, Seymour, Paul, and Gloria Milstein Division of Cardiology, Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, 622 W 168th St, PH 10-203, New York, NY 10032 (andrew.einstein@columbia.edu).

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