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Study reveals very high cumulative estimated effective doses to patients undergoing MPI

August 17, 2015

The primary reason for testing was chest pain, breathing difficulty, or both in 66.8 percent of examinations. More than 80 percent of initial and 90 percent of repeat MPI examinations were performed in patients with known cardiac disease or symptoms consistent with it. Of 1,097 patients undergoing index MPI, 38.6 percent underwent additional MPI studies. For this group of patients undergoing multiple MPIs, the median cumulative estimated effective dose was 121 mSv.

Patients undergoing multiple MPI examinations were significantly more likely to be older and male. Men and white patients had higher cumulative estimated effective doses.

"Our study reveals very high cumulative estimated effective doses to many patients undergoing MPI, and especially to patients undergoing repeat MPI testing. More than 30 percent of patients received a cumulative estimated effective dose of more than 100 mSv, a level at which there is little controversy over the potential for increased cancer risks," the authors write. "Efforts are needed to decrease this high cumulative dose and its potential attendant risks."

They add that "although the high cumulative doses observed are certainly a matter of concern and an important target for improvement, these doses should not be viewed in isolation but rather within the clinical context where radiation risk for a specific patient is balanced against potential benefits."

Source JAMA