Table 1

Typical Effective Doses for Cardiac Procedures

ModalityProtocolTypical Effective Does (mSv)
MDCTCoronary CT angiography:
helical, no tube current modulation
8–30
MDCTCoronary CT angiography:
helical, tube current modulation
6–20
MDCTCoronary CT angiography:
prospectively triggered axial
0.5–7
MDCTCoronary CT angiography:
high-pitch helical
<0.5–3
MDCTCT angiography, pre-TAVR:
coronary (multiphase) and
chest/abdomen/pelvis
5–50
MDCTCalcium score1–5
MDCTAttenuation correction<0.5–2.0
EBCTCalcium Score1
SPECT10 mCi 99mTc sestamibi rest/
30 mCi 99mTc sestamibi stress
11
SPECT15 mCi 99mTc sestamibi rest/
45 mCi 99mTc sestamibi stress
17
SPECT30 mCi 99mTc sestamibi rest/
30 mCi 99mTc sestamibi stress
18
SPECT10 mCi 99mTc sestamibi stress only2.7
SPECT30 mCi 99mTc sestamibi stress only8
SPECT10 mCi 99mTc tetrofosmin rest/
30 mCi 99mTc tetrofosmin stress
9
SPECT15 mCi 99mTc tetrofosmin rest/
45 mCi 99mTc tetrofosmin stress
14
SPECT30 mCi 99mTc tetrofosmin rest/
30 mCi 99mTc tetrofosmin stress
14
SPECT10 mCi 99mTc tetrofosmin stress only2.3
SPECT30 mCi 99mTc tetrofosmin stress only7
SPECT3.5mCi 201Tl15
SPECTDual isotope: 3.5 mCi 201Tl rest/
30 mCi 99mTc sestamibi stress
23
SPECTDual isotope: 3.5 mCi 201Tl rest/
30 mCi 99mTc tetrofosmin stress
22
PET50 mCi 82Rb rest/
50 mCi 82Rb stress
4
PET15 mCi 13N ammonia rest/
15 mCi 13N ammonia stress
2
PET10 mCi 18F FDG7
Planar30 mCi 99mTc-labeled erythrocytes8
FluoroscopyDiagnostic invasive coronary angiography2–20
FluoroscopyPercutaneous coronary intervention5–57
FluoroscopyTAVR, transapical approach12–23
FluoroscopyTAVR, transfemoral approach33–100
FluoroscopyDiagnostic electrophysiological study0.1–3.2
FluoroscopyRadiofrequency ablation of arrhythmia1–25
FluoroscopyPermanent pacemaker implantation0.2–8

Reproduced with permission from Einstein et al. (7).

CT = computed tomography; EBCT = electron-beam computed tomography; FDG = fluorodeoxyglucose; MDCT = multidetector-row computed tomography; PET = positron emission tomography; Rb = rubidium; SPECT = single-photon emission computed tomography; TAVR = transcatheter aortic valve replacement; Tc = technetium; Tl = thallium.

Note: Current and ongoing engineering physical design and image processing software refinements enable dose reductions for all 3 modalities since the data in Table 1 were compiled. These lower doses can be achieved only if radiological equipment is current generation and if operators consciously take advantage of their improved capabilities. As the majority of the currently installed base of equipment is earlier generation, the data in Table 1 reflect most current exposure levels.