Radiation Dose in Long-Term Angiography for Basilar Aneurysm Monitoring

Inquiry about radiation dose in angiography?

I have been undergoing angiography every three years for over ten years due to a "basilar artery aneurysm." The reports indicate that the imaging includes "carotid angiography (bilateral)" and "vertebral artery angiography." I would like to ask the physician how much radiation dose is typically involved in these procedures.
Since I have been under long-term follow-up and my condition is stable, I would like to understand this information better and possibly discuss with my physician the option of reducing the frequency of these examinations.
Thank you, doctor!

Perry, 30~39 year old female. Ask Date: 2023/10/03

Dr. Wang Yifen reply Radiology

Hello, angiography is divided into "digital X-ray angiography," "computed tomography angiography," and "magnetic resonance angiography." According to the American Society of Radiologic Technologists, the radiation dose for a head and neck X-ray angiogram is approximately 5 millisieverts; the radiation dose for a brain and neck CT angiography with perfusion (CTA/CTP) is 16.4 millisieverts; and magnetic resonance angiography (MRA) has no radiation dose.
Each imaging diagnostic tool has its own advantages and disadvantages.
When considering X-ray radiation examinations, the necessity of the examination should be taken into account, as there are no restrictions on the radiation dose or the number of examinations.
Following your doctor's instructions to undergo radiation-related examinations is based on the consideration that the health benefits outweigh the effects of radiation.
If you have concerns, it is advisable to communicate with your physician before proceeding with the examination.
Do not avoid examinations out of fear of radiation, as this may lead to missing the opportunity for disease treatment.
Please take this into consideration, and I wish you safety and health.

Reply Date: 2023/10/03

More Info

Understanding the radiation dose associated with long-term angiography for monitoring a basilar aneurysm is an important concern, especially for patients who undergo these procedures regularly. In your case, having undergone bilateral carotid angiography and vertebral angiography every three years for over a decade, it is understandable that you want to be informed about the radiation exposure involved and whether it may be possible to reduce the frequency of these examinations.

Radiation Dose in Angiography
The radiation dose from angiographic procedures can vary depending on the type of imaging technique used. According to data from the American College of Radiology and the Radiological Society of North America, the estimated radiation doses for common angiographic procedures are as follows:
1. Digital X-ray Angiography: Approximately 5 mSv (millisieverts) for a head and neck angiogram.

2. CT Angiography (CTA): This can be higher, with doses around 16.4 mSv for brain and neck CT angiography.

3. Magnetic Resonance Angiography (MRA): This technique does not involve ionizing radiation, making it a safer alternative for certain patients.

Given that you have been undergoing these procedures every three years, the cumulative radiation exposure over ten years could be significant, especially if you have primarily been receiving CT angiography, which has a higher dose compared to traditional X-ray angiography.

Evaluating the Need for Continued Imaging
The decision to continue with regular imaging should be based on a careful assessment of the risks and benefits. Since your condition has been stable, it is reasonable to discuss with your healthcare provider the possibility of extending the intervals between imaging studies or considering alternative imaging modalities that may involve less radiation, such as MRA or ultrasound, if appropriate.

Importance of Communication with Your Physician
It is crucial to have an open dialogue with your physician regarding your concerns about radiation exposure. They can provide personalized recommendations based on your medical history, the specifics of your aneurysm, and the latest guidelines in radiology. If your physician agrees that the risk of progression of your aneurysm is low, they may suggest a less frequent imaging schedule or alternative monitoring strategies.

Conclusion
In summary, understanding the radiation dose associated with your angiographic procedures is essential for making informed decisions about your healthcare. The radiation doses for the procedures you have undergone can vary, and it is important to weigh the benefits of monitoring against the potential risks of cumulative radiation exposure. Engaging in a thorough discussion with your healthcare provider can help you navigate these considerations and ensure that your monitoring plan aligns with your health needs and preferences. Always remember that the goal is to balance effective monitoring of your condition with minimizing unnecessary radiation exposure.

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