293 Risk assessment for radiation-induced cancer after Interventional Cardiology procedures

Abstract

The increased use of interventional cardiology (IC) procedures, while providing important benefits to patients, also contributes to their radiation exposure. Radiation is a relatively weak carcinogen and demonstrating a radiation-induced cancer risk remains difficult. Only very crude results of lifetime risk assessment of cancer after IC procedures have been presented elsewhere, but the age distribution of population, technical procedures actually applied and target organs are also important to consider. Based on a previous detailled description of clinical features and dosimetric data (absorbed organ doses: lung and bone marrow) of an adult French population undergoing IC procedure, and the latest radiation risk models (BEIR VII), a specific risk assessment for lung cancer and leukaemia mortalities was realized. We considered patients having undergone either a coronary angiography or cumulating coronary angiography and angioplasty, at age 40-75 years, and followed until 85 years. Based on different scenarios of radiation exposure and delivered-doses, the number of deaths from lung cancer or leukaemia due to radiation per 1,000 general population spontaneous lung cancer or leukaemia deaths respectively, was estimated. Preliminary results show that the risk of specific radio-induced cancer in patients undergoing IC procedure exists even if it remains relatively limited. Moreover, depending on patients’ age and type of IC procedure, additional procedures appeared to increase the lifetime risk estimates. This study provides evidence of the potential radio-induced cancer risk in IC. The limitations of such calculations are due to the difficulty to take into account patients’ possible shorter life prognosis than in general population, partly explained by comorbidities and coronary disease. Because of numerical evolution of IC procedures, interventions to promote delivered-doses optimization and “ALARA” requirements may prevent or limit this risk.