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CT scans and radiation exposure

Posted Aug 26 2008 4:17pm 2 Comments

The NY Times ran an article called

With Rise in Radiation Exposure, Experts Urge Caution on Tests at

“This is an absolutely sentinel event, a wake-up call,” said Dr. Fred A. Mettler Jr., principal investigator for the study, by the National Council on Radiation Protection. “Medical exposure now dwarfs that of all other sources.”

Where do CT heart scans fall?

Let's first take a look at exposure measured for different sorts of tests:

Typical effective radiation dose values

Computed tomography Milliseverts (mSv)

Head CT 1 – 2 mSv

Pelvis CT 3 – 4 mSv

Chest CT 5 – 7 mSv

Abdomen CT 5 – 7 mSv

Abdomen/pelvis CT 8 – 11 mSv

Coronary CT angiography 5 – 12 mSv

Non-CT Milliseverts (mSv)

Hand radiograph Less than 0.1 mSv

Chest radiograph Less than 0.1 mSv

Mammogram 0.3 – 0.6 mSv

Barium enema exam 3 – 6 mSv

Coronary angiogram 5 – 10 mSv

Sestamibi myocardial perfusion (per injection) 6 – 9 mSv

Thallium myocardial perfusion (per injection) 26 – 35 mSv

Source: Cynthia H. McCullough, Ph.D., Mayo Clinic, Rochester, MN

If you have a heart scan on an EBT device, then your exposure is 0.5-0.6 mSv, roughly the same as a mammogram or several standard chest x-rays.

A heart scan on a 16- or 64-slice multidetector device, your exposure is around 1.0-2.0 mSv, about the same as 2-3 mammograms, though dose can vary with this technology depending on how it is performed (gated to the EKG, device settings, etc.)

CT coronary angiography presents a different story. This is where radiation really escalates and puts the radiation exposure issue in the spotlight. As Dr. Cynthia McCullough's chart shows above, the radiation exposure with CT coronary angiograms is 5-12 mSv, the equivalent of 100 chest x-rays or 20 mammograms. Now that's a problem.

The exposure is about the same for a pelvic or abdominal CT. The problem is that some centers are using CT coronary angiograms as screening procedures and even advocating their use annually . This is where the alarm needs to be sounded. These tests, as wonderful as the information and image quality can be, are not screening tests. Just like a pelvic CT, they are diagnostic tests done for legimate medical questions. They are not screening tests to be applied broadly and used year after year.

Always be mindful of your radiation exposure, as the NY Times article rightly advises. However, don't be so frightened that you are kept from obtaining truly useful information from, for instance, a CT heart scan (not angiography) at a modest radiation cost.

Detail on radiation exposure with CT coronary angiograms on multidetector devices can be found at Hausleiter J, Meyer T, Hadamitzyky M et al. Radiation Dose Estimates From Cardiac Multislice Computed Tomography in Daily Practice: Impact of Different Scanning Protocols on Effective Dose Estimates. Circulation 2006;113:1305-1310 , one of several studies on this issue.

Comments (2)
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can someone please tell me how much radiation exposurer on cscan for head, for hips and pelvic performed total 3 cscans. thanks haus
radiation how much cs on head, cscan on hips, cscan on pelvis?
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