Worldwide Radiation Dose in Coronary Artery Disease Diagnostic Imaging

作者：Andrew J. Einstein, Michelle C. Williams, Jonathan Weir-McCall, Leslee J. Shaw, Ganesan Karthikeyan, Nathan Better, João V. Vítola, RODRIGO JULIO CERCI, Sharmila Dorbala, Salah E. Bouyoucef, A D Choi, Gianluca Pontone, Elgin Özkan, Le Yang, Luca Bremner, Michelle Castillo, Yosef A Cohen, Eli Malkovskiy, Ismaila Ayoola, Anna Veduta, Danylo Yurystovskyi, Y Pynda, Thomas N. B. Pascual, Peter Knoll, M Dondi, D Paez, INCAPS 4 Investigators Group, Juan Lopez-Mattei, Purvi Parwani, Edward Nicol, Chiara Bucciarelli-Ducci, Artan Goda, Ervina Shirka, Roxana Campisi, Tomás Vita, Kim Taubman, John Younger, Christian Loewe, S. Mirzaei, Shankar Biswas, Azamal Kabir Sharker, Stéphane Carlier, Salgado Ra, Tim Van den Wyngaert, Amela Begić, Nejra Latic, Marina Garcheva-Tsacheva, Metodi Mihaylov, Stéphane Sanou, Rob Beanlands, Benjamin Chow, Teresa Massardo, Tamara Palavecino, Jesus Urbina, Xiaoli Zhang, Claudia T. Gutierrez Villamil, Alejandro Zuluaga Santamaria, Maja Ilić Tomaš, Slavica Kovačić, Yamilé Marcos Gutiérrez, Amalia Peix, Leonel Torres Aroche, Savvas Frangos, Milena J. Henzlova, L. Gormsen, Bjarne Nørgaard, Kasper Kyhl, Mayra Sanchez Velez, Adel Hassan Allam, Ilona Muoni, Daniel Zewdneh Solomon, Farzana Bano, Juhani Knuuti, Cecile Etard, F. Hyafil, Tamar Vakhtangadze, Jan Bucerius, Dewey Marc, Nii Boye Hammond, Κωνσταντίνος Κούσκουρας, Maria Koutelou, Francisco De Leon, Carla Gonzalez, Pál Maurovich-Horvat, Priya Jagia, Chetan Patel, Erwin Affandi, Majid Assadi, Amjad Al-Badr, Julie L. O'Brien, Yoav Arnson, Ronen Rubinshtein, Roberta Assente, Kakuya Kitagawa, Takashi Kudo, Akram Al‐Ibraheem, Waleed Mahafzah, Tairkhan Dautov, Khalid Makhdomi, Rose Nyabanda, Marika Kalniņa, Ilze Priedīte, Mohamad Haidar, Donatas Vajauskas, Noor Khairiah A. Karim, Mohd Fazrin Mohd Rohani, Luise Reichmuth, Anthony Samuel, Mohammad Aaftaab, Erick Alexanderson Rosas, Lilia M. Sierra-Galán, Filippo Civaia, Marc Faraggi, Aicha Aouad, Sara El Issami, Dipankar Prajapati, Alexander Van Rosendael, Heinz Verbene, Rachelle Steyn, Niels Van Pelt, Emeka Udezue, Venjamin Majstorov, Trond Velde Bogsrud, Humoud Al Dhuhli, Zabah Jawa, Shazia Fatima, Carlos Cruz, Katia Medina, Juan Antonio Urquiaga, Jolanta Kunikowska, Jacek Kwieciński, Nuno Bettencourt, Keon Kang, Byoung Wook Wook Choi, Mihaela Raluca Mititelu, Lala Radu, Alexey Ansheles, Valentin Sinitsyn, Ahmed Al Jizeeri, Mirvat Alasnag, Dragana Šobić Šaranović, Radosav Vidaković, Felix Keng, Maros Ferencik, Tadeja Poropat Flerin, Monika Štalc, Mike Sathekge, Mboyo Di Tamba Vangu, James Warwick, Amelia Jiménez Heffernan, M.A. Mañé Martínez, Ellen Ostenfeld, Kristian Valind, Ronny R. Buechel, Christoph Gräni, Tausi Kassim Patrick, Patrick Ngoya, Benjapa Khiewvan, Karnkawin Patharateeranart, Fadhel Guermazi, Selen Bayraktaroğlu, Rita Nassanga, Pavlo Korol, Batool Essa Al Balooshi, Sobhan Vinjamuri, Mouaz Al-Mallah, Jamieson M. Bourque, Renée P. Bullock-Palmer, John Jeffrey Carr, Angela Higgins, Dinesh Kalra, Friederike Keating, Lynne Koweek, Bruno Lima, Fay Lin, Saurabh Malhotra, Enrico Martin, Lawrence Phillips, Mark R. Rabbat, Nishant Shah, Amitoj Singh, Randall Thompson, Veeranna, Todd C. Villines, Eric Williamson, David Winchester, Pamela Woodard, Fernando Mut, Gulnora Rozikhodjaeva, Son Mai Hong, Lê Ngọc Hà, Trang Nguyen, Medjahedi Abdelkader, Karim Chentli, Mohamed Amine Habouchi, Mohamed Lamine Lamali, Skander Rahabi, Djawida Tahmi, Roberto Agüero, Ema Aramayo Gerónimo, Andrea Astesiano, Franco Gabriel Busso, Jorge Camilletti, Cesar Chuquel, Claudia Cortés, Daniel Cragnolino, Fernando Dettori, Laura Dragonetti, Juan Erriest, Fernando Faccio, Adolfo Facello, Rosa Lodoli, Neiva Maciel, Matías Ivan Martinez, Osvaldo Masoli, Edgardo Mastrovito, Maria Medus, Maria Merani, Ana Poma, Angel Sandrin, Agustina Spampinato, Maria Spampinato, Sonia Traverso, Gianna Troillo, Chris Anthony, Mandy Baillie, Tiffany Black, Raef Boktor, Julie A. Bradley, Sidney Butler, Jennifer Calcott, Michael Chan, Virgil Chan, Daniel Chen, Robert Chung, Pradnya Dugal, Tej Dugal, Romaniya Fernando, Sebastian Heintze, Randall Hendriks, Victar Hsieh, Abdul Rahman Ihdayhid, Subodh Joshi, Nadya Kisiel, Joseph Lee, Tony Li, Ruth Lim, Bonnia Liu, Elaine Lui, Kegan Monaghetti, J. Morton, Edward O'Rourke, Patricia O'Sullivan, Kunthi Pathmaraj, Stuart C. Ramsay, P. Ratnakanthan, Connor Saunders, Todd Shephard, Divya Srivastava, Danielle Stewart, N. Sutherland, Andrew Taylor, James Theuerle, Corey Thompson, Steven Unger, L. Valerio, Leon Vasquez, Eva A. Wegner, David Wong, Bethany Wornes, Jess Zhang, Lamiaa Zidan, Dietrich Beitzke, Gernot Böhm, Hermann Buttinger, Gudrun Feuchtner, Kristina Grün, Lukas Hehenwarter, Klaus Hergan, Dirk Heute, Claus Kölblinger, Christian Pirich, Victoria Steinbacher, Christina Tugendsam, Afroza Akhter, Jharna Das, Nusrat Ghafoor, Jasmin Ara Haque, Sadia Hossain, Mohammad Khan, Tapati Mandal, Shaila Sharmin, Nasreen Sultana, Olivier Ghekiere, Pieter Waer, Jules Zhang-Yin, Sejla Biscevic, Alem Durmiš, Mirza Skalonja, Valentina Soldat Stanković, Siniša Stanković, Wilson Alves, Ilo S. Baptista, Victoria Bizzi Schvartzman, Anarosa Costa, Leonardo Da Silva, Thayna Diniz, Sanja Dragosavac, Fernando Fernandes, Cibele Gontijo, Gabriel Grossman, Ronaldo Lima, Fabiano R. Lucchesi, Cláudio Tinoco Mesquita, Lucio Nagamati, Danilo Naves, Jacson Neves, Jacqueline Nishimura Matsumoto, Priscila C Quagliato, Paulo R. 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Zacho, Marek Żelechowski, Jan Rasmussen, Pamela Piña Santana, Patricia Severino, Nelson Amores Arellano, Sherif Abbas Hegazy, Amr Abdallah, Abdelfattah Alia, Mohamed Aboulella, Walid Ahmed, Ehab Attalla, Mohamed Attia, Eman Balky, Nihal M. Batouty, Mohamed Donya, Hassan Ebeid, Rehab Elnagar, Rehab Elsheikh, Ahmed Fareed, Ibrahim Helmy, Ahmed Ibrahim, Ghada Ibrahim, Hamdy Ibrahim, Rana Khafagy, Moustafa Mahmoud, Shaimaa Mohamed, Maram Abdel-Latif Mostafa, Basant Raief Mosaad, Ibraam Ramzy, Dina Hussen Salama, Hala T. Salem, Mohamed Ali Salem, Yousef Seliem, Mahmoud Shaaban, Samar Shehata, Donia M. Sobh, Sara W. Tantawy, Ahmed Tawfik, Amr Yahia, Anne Poksi, Ejigu Abdissa, Azmera Gissila Aboye, Hanna Damtew, Daneil Zewideneh, Lauri Lehmonen, Marie Alibert, Matthieu Bailly, Jean-Paul Bérégi, Clothilde Berger, Virginie Carreira Brandao, Virgile Chevance, Daniel Colombier, Franck Couzon, Pierre Croisille, Djamel Dabli, Béatrice Daoud, F. 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Papadopoulos, Nikoletta Pianou, Ioannis Printzipas, Chrissa Sioka, Michael Spartalis, Thomas G. Vrachliotis, Jorge Malouf Sierra, Márton Kolossváry, Mercédesz Matus, Kanhaiyalal Agrawal, Suresh Balani, Vivek Bhat, Madhavi Chawla, Vandana Dhingra, Pankaj Dougall, Vinisha Gunasekaran, Uday Jadhav, Prakashini Koteshwar, Karuppiah Kumaresan, Vikram Lele, Harsh Mahajan, Gaurav Malhotra, Pranab Mandal, Manisha Mane, Parul Mohan, Murali R Nadig, Vineeta Ojha, Shanmuga Sundaram Palaniswamy, Rahul V. Parghane, Dinesh Patel, Vishalkumar M Patel, Rengarajan Rajagopal, Mudalsha Ravina, Sampath Santhosh, Puneet Sethi, Punit Sharma, Megha Sheth, Natasha Singh, Erwin Affandi Soeriadi, Shrikant Solav, Ashwani Sood, Padma Subramanyam, Ajith Shinto Sunil, T Visakh, Sameer Taywade, Anna M. Varghese, Sreelal Thazhathu Veettil, Ritwik Wakankar, A. 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Cossa, Pietro Costantini, Maria Silvia De Feo, Federica De Litteris, Marina De Risi, Maria De Vita, Piero De Vitis, Alberico Del Torto, Alessandro Depaoli, Carlo Di Donna, Eugenio Di Giorgio, Nunzia Di Meo, Francesco Dondi, Daniela Elia, M. 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Ponce-Barahona, Sandra Rosales Uvera, Ana Rosas, Carine Dommerc, Delgertsetseg Davaa, Lkhagvasuren Zundui, Wafaa Ayouzi, Farida Bentayeb, Lakbir El Hamidi, Amal Guensi, Saroj Chhetry, Baidhyanath Yadav, Joris Van Dijk, Marjolein E Hol, Cécile Jeukens, Remco Knol, Casper Mihl, Mohamed Mouden, Nick Nurmohamed, R Nils Planken, Niek J.H. Prakken, Arthur Scholte, Riemer H.J.A. Slart, Derk O. Verschure, Shaw Hua Kueh, Prudence Lamerton, Salome Lingenfelder, Clare McKenzie, Christopher Occleshaw, Víctor Rosales, Halimat Mohammed, Fatima Muhammad, Irena Mitevska, Aleksandra Peshevska, Ljuben Risteski, Zaklina Servini, Marija Vavlukis, Keti Veljanova, Katarina Nikoletić, Rashid Al Umairi, Khalid Alsaadi, Muhammad Abubakar, Salman Habib, Samreen Iqbal, Lubna Khan Jadoon, Mona Jafri, Awais Hussain Kazim, Jameela Maitlo, Sadiq Hussain Nohario, Musab Riaz, Nayyar Rubab, Mohammad Saadullah, Jannine Arrieta Cordova, Franklin R. Espinoza Mori, Delia M. Guerrero, Richard Ledesma, Christian Llontop, Julio Mamani Tito, Aurelio Mendoza, Rosanna Morales, Luisa Talledo Paredes, Juan Urquiaga, Dominic Z Alcantara, Angelin Apostol, Michele Duldulao-Ogbac, Mary Amie Gelina Dumatol, Jerry Obaldo, Francis Manuel Resma, Paweł Banyś, Anna Blach, Olgierd Chrabański, Beata Chrapko, Jadwiga Fijałkowska, Cezary Kepka, Dorota Kulawiak Galaska, Jacek Kwieciński, Julia Niemierko, Konrad Pieszko, Fernando Abreu, Pedro Almeida, João Augusto, João Carvalho, Ricardo Carvalho, Cátia Costa, Pedro De Araújo Gonçalves, Antonio Ferreira, Nuno Ferreira, Filipa Gerardo, Andreia Marques, Hugo Marques, Amadeu Quelhas Martins, Inês Miranda, Patricia Rodrigues, Mahmoud Raheem Heidous, Ahmed Omer, Subramaniyan Ramanathan, Henry Hee-Seung Bom, Sang‐Geon Cho, Ari Chong, Sangwon Han, Won Jun Kang, Myoung Hyoun Kim, Jang Bae Moon, Jin Chul Paeng, Eun Ju Yoon, Theodora Benedek, Petru Capreanu, Diana Marcela Ene, Mirela Gherghe, Simona Manolé, Claudia Gabriela Moldovanu, Diana Piroiu, Marian Pop, Loredana Elisabeta Popa, A. Zaharie, Rustem Bashirov, Olga Dariy, Daria Filatova, Nina Gagarina, Evgeny Kondratyev, Konstantin Kovalev, Pavel Malyshev, Е. В. Мигунова, А. В. Мочула, Natalia Pinchuk, Konstantin Plotnikov, В. А. Поспелов, Guzaliya Saifullina, И.В. Шурупова, Nick Tarasov, Konstantin V. Zavadovsky, К. Н. Журавлев, Amjad M. Ahmed, Mahmoud Al-Abedi, Maryam Alhashim, Hamdy Elkafory, Moustapha Diallo, Želimir Antonić, Konstantin Biron, Sonja Jankovic, Nikola Komazec, Silvija Lučić, Jasna Mihailović, Miodrag Nisevic, Andrea Peter, Dejan Petrović, Dragan Stojanov, Zijuan Huang, Kelvin Siu Hoong Loke, Milan Helebrandt, Dávid Kocan, Barbara Salobir, Lucija Vlaović, Celeste Burger, Lerwine M. Harry, Gerschwin Malan, Letjie C. Maserumule, T.C.G. Moalosi, Stuart More, Venesen Pillay, Khushica Purbhoo, Anica Venter, Belén Aradas Cabado, Manuel Barreiro Pérez, Ana Bustos, J. Cardona Arboniés, Maria Cinta Cinta Calvo, Jose Chacón Salas, Hug Cuellar-Calabria, Sheila De La Torre Fernández, V.V.A. Fernández, J Fernandez Martinez, Albert Flotats, Raquel García Pérez, María Garitacelaya, Fernando Gimenez Cepero, Maria Paula Hernandez, Cristian Herrera Flores, Raquel Jover-Díaz, Ana Legazcue Goñi, Mercedes López, Javier Lopez Diaz, Juana Lopez Martin, Luis Lumbreras Vega, Maria Del Carmen Mallón, Enrique Moratalla Aranda, Manuel Moreno Caballero, Tomás Mut-Dólera, Jose Manuel Nogueiras Alonso, Nuria Orta Tomas, Bianca Patrut, Candelas Pérez del Villar, Maria Pizzi, Virginia Pubul, Maria Mercedes Rodriguez Romero, Albert Roque, Ruano Pérez R, Miguel Sánchez Torrente, Ana Sevilla, Ester Sola-Martinez, Maria Vidal, David Viladés Medel, Abdelbagi Osman, Christian Andersson, Tomas Andersson, Tomasz Baron, Ida Eriksson, Erika Fagman, Fredrik Karlefors, Mateusz Krasun, Marie Kylhammar, Thomas Lindow, Henrik Löfmark, Renata Madru, Adrian Pistea, Magnus Simonsson, Raquel Themudo, Karin Walde, Eva Zelleroth, Hatem Alkadhi, Cristian Antonescu, Flurina Arquint, Peter Burger, Stefano Caselli, Luca Ceriani, Marco Cuzzocrea, Bart W.I. De Boeck, Jean-François Deux, Christoph Juli, Stjepan Jurisic, Christel Kamani, Nadine Kawel-Boehm, Tatjana Leike, Yu-Ching Liu, Lukas J. Moser, Gaetano Paone, Chiara Pozzessere, John Prior, David Rotzinger, Stefan Siebert, Annina Studer Brungger, Giorgio Treglia, Benard Gombanila, Maythinee Chantadisai, Narumol Chaosuwannakit, Tatiya Emasuwan, Arpakorn Kositwattanarerk, Daris Theerakulpisut, Monravee Tumkosit, Khawla Ben Ahmed, Kaouthar Chatti, K. Chtourou, Emna Daoud, Wiem Feki, Zeineb Mnif, Dardouri Teheni, Umit Akdemir, Burcu Esen Akkaş, Pelin Arican, Nilgun Balkan Aksoy, Muhammet Halil Baltacıoğlu, Seckin Bilgic, Hasan Bozkurt, Murat F. Bozkurt, Gonca Bural, Gamze Çapa Kaya, Tevfik Fikret Çermik, Hakan Demir, Emre Entok, Nurhan Ergül, Mustafa Kemal Erol, Nedim C.M. Gulaldi, Aziz Gültekin, Zekiye Hasbek, Semra İnce, Zehra Pınar Koç, Zehra Özcan, Elif Ozdemir, Semra Özdemir, Burak Eren Özer, Ozlem Ozmen, Tamer Özülker, Ozlem Sahin, Yasemin Şanlı, Özden Savaş Den Hartigh, Haluk Burçak Sayman, Selim Serter, Recep Tokaç, Fevziye Canbaz Tosun, Halil Turgut Turoğlu, Funda Üstun, Burcu Uzun, Ayca Yildiz Ekici, Oleksandr Halchenko, Maryna Satyr, Saif-El-Dean Tawfic Abdel-Rahman, Saeed Alseiari, Dalia Mohame Ahmed, Samer Alabed, R. Alcock, Parthiban Arumugam, Peter Ball, Giulia Benedetti, Pushan Bharadwaj, Thomas Biggans, James Birchall, David Brown, Jun Y. Cheong, Neil Craig, Ceri Davies, Luigi D'Errico, Katherine Dixon, Rachel England, Alexia Farrugia, Gavin Freeman, Daniel Furness, Marta Gennaro, Chris Gingles, Prasad Guntur Ramkumar, John Aaron Henry, Chieh-Yin Huang, Ian W. Hufton, Richard Jones, Mohammad Ali Khan, Osher Ngo Yung Lee, Robert Leigh, Krithika Loganath, Matthew J. Memmott, Leon Paixão Menezes, Suraj Menon, Andrew Mitchell, Tarun Mittal, Brian Morrissey, Dr Manish Motwani, Vahini V. Naidoo, Michael T Obafemi, Vineet Kumar Pant, Dilip Patel, Jonathan Rodrigues, Anne M. Scott, Julie Speakman, Richard P. Steeds, Deepak Subedi, Imran Sunderji, William Topping, Edwin Van Beek, Alice Veitch, Jonathan Vigne, Yasmin Wahid, Maria Teodora Wetscherek, Brian Abbott, Talal Alnabelsi, Stephen Bloom, Tim Brockway, Yiannis Chatzizisis, Benjamin Y.C. Cheong, Thomas J. Collard, Rongras Damrongwatanasuk, Sorin Danciu, Albert J. DeLuca, Emma Eberwien, Shana Elman, Ricardo Escarcega, Mary K. Fairlamb, Moath Fawarah, Joy Garnass, Neal George, Michael R. Harowicz, Edward Hulten, Amr Idris, Justin T. Jacob, Sihan Ji, Lynne L. Johnson, Mona Kinkhabwala, Elaine Lam, Jay Leb, Steve Leung, David Lindsay, Victor Marinescu, Alan Morrison, Prabhjot S. Nijjar, Yash Patel, Amit Pursnani, Cameron R. Quick, Ali Aria Razmaria, Christine Schiaffo, Heiko Schöder, Arash Seratnahaei, Vasvi Singh, Leandro Slipczuk, M. Barbara Srichai-Parsia, Rishabh Tandon, Marian Vandyck-Acquah, Michele Wanner, Mario Beretta, Rodolfo Ferrando, Cesar Ferreira, Miguel Kapitán, KHANUM V. ABDUKHALIMOVA, Nodir Abidov, F.F. Almuradov, Gulsanam Aytimova, N. M. Djuraeva, Zulfiya Ikramova, Munojat Khayatovna Ismailova, Muzaffarjon Karimov, Yulduz Karimova, Akrom Khikmatov, Nekruz Nazirkhujaev, Feruza Rozikhodjaeva, Bahodir Sharipov, Kamoliddin Yokubov, Luisa Vera · 发表于：JAMA · 年份：2026 · DOI：10.1001/jama.2026.0703 · 被引用次数：7 · 研究领域：Cardiac Imaging and Diagnostics、Radiation Dose and Imaging、Acute Myocardial Infarction Research

Importance: In recent decades, there has been marked worldwide growth in diagnostic testing for coronary artery disease (CAD), with several common imaging modalities exposing patients to ionizing radiation. Objective: To examine worldwide radiation doses for patients undergoing noninvasive CAD diagnostic testing. Design, Setting, and Participants: This worldwide, cross-sectional study was conducted of radiation dose from noninvasive CAD imaging in 2023, using a consecutive sample of all 19 302 adults undergoing noninvasive CAD diagnostic testing at 742 centers in 101 countries during a single week in October to December 2023. Exposures: Participants underwent CAD testing with single-photon emission computed tomography (SPECT) or positron emission tomography (PET) nuclear cardiac imaging, cardiac computed tomography for coronary artery calcium scoring (CACS), or coronary computed tomography angiography (CCTA). Main Outcomes and Measures: The primary outcomes were radiation effective dose to patients and the percentage of centers with median effective dose less than or equal to 9 mSv, as recommended in guidelines. Results: Of 19 302 patients, 8515 (44%) were females and the median (IQR) age was 63 (54-71) years. Effective dose varied considerably across diagnostic modalities, with median (IQR) effective dose of 1.2 (0.7-2.2) mSv for CACS, 2.0 (1.6-2.4) mSv for PET, 6.5 (3.9-8.6) mSv for SPECT, and 7.4 (3.5-15.5) mSv for CCTA. Significantly more centers performing nuclear cardio...