Medizinische Fakultät - Digitale Hochschulschriften der LMU - Teil 16/19 Archiv

Radiation induced cardiovascular disease is a risk proven by many studies in patients exposed with high-doses from a thoracal radiotherapy. Since the theory of cardiovascular effects caused by low-doses of ionising radiation amongst the A-bomb survivors has been raised, much effort has been taken to get more information and significant results. Currently there is still no clear evidence of a threshold dose or a linear relation for doses below 0,5Gy (energy dose. The aim of this work was to develop a design for a feasability study, based on the German cohort study KORA (’Kooperative Gesundheitsforschung in der Region Augsburg’), for low dose radiation from diagnostic imaging and possibly induced myocardial infarction. To this end a completely new dosimetric system had to be set up to get the organ dose of the heart from different radiological examinations. This was achieved using conversion coefficients, calculated by Monte Carlo (MC) simulations with the mathematical or voxel phantoms from the ’Helmholtz Zentrum’ Munich (HMGU, former ’Gesellschaft für Strahlenforschung’ GSF), and a large benchmarking for the individual parameters depending on the examinations and patients. The next step was to create a sensible questionnaire for a retrospective radiation anamnesis including data for confounding analysis. This questionnaire combined with the retrospective dosimetry was successfully tested in a pilot study. The setup was a case control study based on actual patients suffering from myocardial infarction who were included in the Augsburg KORA-Herzinfarktregister and an age and gender stratified control group recruited from the population-based KORA-cohort having no diagnoses of myocardial infarction.