AbstractID: 10013 Title: Radiation Safety and Risk Management
Estimating cancer risk attributable to Computed Tomography Coronary Angiography.
Assessment of radiation related health risks in patients undergoing diagnostic x-ray imaging, such as Computed Tomography Coronary Angiography (CTCA), routinely focuses on single risk factors, such as radiation risks, and is therefore often inaccurate.
A comprehensive method, based on multiple-decrement life tables, is capable of integration of all relevant characteristics of specific patient populations, including the associated multiple risk factors. This will be illustrated by comparing CTCA and coronary angiography (CAG). Acute risks, such as procedure related mortality in
CAG, will be assessed aagainst latee risks, such as radiation risks associated with
CTCA and CAG. Risk assessment based on life tables that represent age and gender related functions pertaining to mortality will be presented. Mortality from radiation exposure and excess mortality from the disease and complications were included. The
BEIR VII risk model was used to estimate long-term mortality related to radiation exposure. All risks were expressed as reduction of life expectancy. Under clinical conditions, the acute risk of mortality from heart catheterization in CAG, although small (0.1%), substantially exceeds radiation risks from either CAG (5mSv) or coronary CT angiography (15mSv).
Even more comprehensive assessment of patient safety, including radiation but also other risks, can be achieved by application of methodologies from the scientific field of Medical Decision Making, such as the application of disability-adjusted life expectancies and model based approaches for assessment of the efficacy of CTCA
(such as Bayesian Networks and Influence Diagrams).