Among patients worldwide with suspected CoronaryArteryDisease, median radiation doses exceeded guideline thresholds (9 mSv) for 21% undergoing nuclear cardiology studies and 44% undergoing CCTA, with dose differences up to 500% across regions.

The findings suggest considerable opportunities to improve cardiac imaging quality and safety through harmonized protocols and technology upgrades.

Question How does radiation dose from cardiac diagnostic testing vary worldwide?

Findings In this cross-sectional study in 101 countries including 19 302 patients, radiation doses varied significantly between imaging tests and among patients receiving the same tests across centers, regions, and country income strata. This was especially pronounced for coronary computed tomography angiography, for which median dose in low-and lower-middle–income countries was more than 280% of that in high-income countries and median dose in Africa was more than 500% of that in Western Europe.

Meaning Current radiation doses for cardiac testing exceeded 9 mSv for 21% of patients undergoing nuclear cardiology studies and for 44% undergoing coronary computed tomography angiography, identifying critical needs for training, standardized protocols, and updated equipment to reduce radiation worldwide.