scholarly journals Organ dose and total effective dose of whole-body CT in multiple myeloma patients

2019 ◽  
Vol 49 (4) ◽  
pp. 549-554 ◽  
Author(s):  
Robert Hemke ◽  
Kai Yang ◽  
Jad Husseini ◽  
Miriam A. Bredella ◽  
F. Joseph Simeone
Keyword(s):  
Multiple Myeloma ◽  
Lumbar Spine ◽  
Effective Dose ◽  
Organ Dose ◽  
Skeletal Survey ◽  
Whole Body ◽  
Organ Doses ◽  
Contrast Enhanced ◽  
Ct Scanners ◽  
Total Effective Dose

Abstract Objective To evaluate organ dose and total effective dose of whole-body low-dose CT (WBLDCT) performed on different CT-scanner models in patients with multiple myeloma (MM) and to compare it to the effective dose of radiographic skeletal survey and representative diagnostic CTs. Material and methods We retrospectively analyzed data from 228 patients (47.4% females, mean age 67.9 ± 10.4 years, mean weight 81.8 ± 22.4 kg) who underwent WBLDCT for the work-up or surveillance of MM. Patients were scanned using one of six multi-detector CT-scanners. Organ doses and total effective doses per scan were calculated using a commercially available dose-management platform (Radimetrics, Bayer Healthcare, Leverkusen, Germany). The median effective dose was compared to radiographic skeletal survey and representative diagnostic CTs. Results The mean effective dose of our WBLDCT-protocol was 4.82 mSv. A significantly higher effective dose was observed in females compared to males (4.95 vs. 4.70 mSv, P = 0.002). Mean organ dose ranged from 3.72 mSv (esophagus) to 13.09 mSv (skeleton). Mean effective dose varied amongst different CT-scanners (range 4.34–8.37 mSv). The median effective dose of WBLDCT was more than twice the dose of a skeletal survey (4.82 vs. 2.04 mSv), 23% higher than a diagnostic contrast-enhanced chest CT (3.9 mSv), 46% lower than a diagnostic contrast-enhanced abdomen/pelvis CT (9.0 mSv), and 45% lower than a lumbar spine CT (8.7 mSv). Conclusions WBLDCT in MM has a higher effective dose than a radiographic skeletal survey, but a lower effective dose than diagnostic CTs of lumbar spine, abdomen and pelvis. This underlines the broad applicability of WBLDCT in the management of MM patients.

LUMBAR SPINE RADIOGRAPHY: LOWER ORGAN DOSE WITH THE USE OF PA PROJECTION

2019 ◽  
Vol 186 (4) ◽  
pp. 507-512
Author(s):  
Erna Alukić ◽  
Nejc Mekiš
Keyword(s):  
Lumbar Spine ◽  
Effective Dose ◽  
Organ Dose ◽  
Field Size ◽  
Organ Doses ◽  
Dose Area Product ◽  
Spine Radiography ◽  
Spine Imaging ◽  
Significant Difference ◽  
Area Product

Abstract The purpose of the research was to determine the effect of the posteroanterior (PA) patient position in lumbar spine imaging on effective dose and the absorbed organ dose. The study was performed on 100 patients that were referred to the lumbar spine radiography that were divided into two equal groups of 50. Body Mass Index, Dose Area Product (DAP), exposure index (EXI), tube time-current (mAs), image field size and the source-patient distance were acquired for each patient. The entrance surface dose (ESD), the effective dose and the absorbed organ doses were calculated. There was no statistically significant difference in the BMI and EXI between the AP and PA projection. The results showed a significant reduction of ESD by 33% and the effective dose by 53% when the PA projection was used. Furthermore, there was a 64% average reduction of the absorbed organ doses to the selected organs.

Whole Body MRI Versus Skeletal Survey in Multple Myeloma.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5106-5106
Author(s):  
Johnny McHugh ◽  
Ciaran Johnston ◽  
Deirdre Duke ◽  
Patrick Thornton ◽  
Steve Eustace ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Lumbar Spine ◽  
Low Cost ◽  
Lesion Detection ◽  
The Body ◽  
Skeletal Survey ◽  
Bone Involvement ◽  
Whole Body ◽  
X Rays ◽  
Whole Body Mri

Abstract BACKGROUND: Bone involvement in myeloma is conventionally assessed by radiographic skeletal survey (plain x-rays of spine, skull, chest, pelvis and long bones). However this may not pick up bony involvement in all patients who may then present with serious complications of myeloma bone disease such as spinal cord compression. Whole body MRI may be better than skeletal survey at evaluating myeloma bone involvement. AIMS: To compare the evaluation of myeloma bone involvement by conventional radiographic skeletal survey (RSS) with whole body magnetic resonance imaging (MRI). METHODS: 35 patients with multiple myeloma (median age 68 yrs, range 46–81) underwent conventional RSS and whole body MRI. 19 of the patients had newly diagnosed multiple myeloma and 16 had relapsed multiple myeloma. The extent of myeloma bone involvement was evaluated in both RSS and MRI as follows: the body was divided up into ten areas: skull, cervical spine, ribs, thoracic spine, lumbar spine, pelvis, right arm, left arm, right leg, left leg. In each area the extent of myeloma bone involvement was scored in both RSS and MRI as follows: 0 = normal; 1 = one focus of abnormality; 2 = more than one focus of abnormality; 3 = diffuse disease. The scores for each of the ten areas were combined to give an overall score out of thirty for both RSS and MRI. RESULTS: 30 of the 35 patients (85.7%) had evidence of bone involvement on MRI. This compares with 22 out of the 35 (62.9%) on RSS. The mean score for the extent of myeloma bone involvement on MRI was significantly higher than that for RSS (MRI mean score: 15.5 out of 30 (median 17, range 0–30); RSS mean score: 5.5 out of 30 (median 3, range 0 to 24); p<0.001). MRI was superior to RSS in all ten areas evaluated both in terms of lesion detection and extent of disease. The greatest difference between MRI and RSS was seen in the cervical, thoracic and lumbar spine, while the smallest difference was seen in the ribs and skull. Eight of the patients had no bone involvement detectable on RSS but did have bone involvement on MRI and this resulted in upstaging on Durie-Salmon staging in four patients. SUMMARY/CONCLUSIONS: RSS has limited sensitivity and a significant ionising patient dose. It is a cumbersome procedure taking up to 30 minutes. Whole body MRI gives improved sensitivity and appreciation of anatomic location of disease. It is non-ionising and can be rapidly acquired at low cost. We conclude that whole body MRI is superior to conventional RSS in both the identification and evaluation of extent of bone involvement in multiple myeloma.

P-146: A prospective study of conventional skeletal survey versus Whole-body CT for osteolytic lesions in Multiple Myeloma

2021 ◽  
Vol 21 ◽  
pp. S115
Author(s):  
Michael Gundesen ◽  
Jon Thor Asmussen ◽  
Einar Haukås ◽  
Michael Schubert ◽  
Niels Abildgaard ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Prospective Study ◽  
Skeletal Survey ◽  
Whole Body ◽  
Osteolytic Lesions ◽  
Whole Body Ct ◽  
A Prospective Study ◽  
Body Ct

Radiation Dose to Patients and Personnel during Fluoroscopy at Percutaneous Renal Stone Extraction

1989 ◽  
Vol 30 (2) ◽  
pp. 201-206 ◽  
Author(s):  
K. Geterud ◽  
A. Larsson ◽  
S. Mattsson
Keyword(s):  
Radiation Dose ◽  
Effective Dose ◽  
Renal Stone ◽  
Absorbed Dose ◽  
Effective Dose Equivalent ◽  
Dose Equivalent ◽  
Organ Doses ◽  
The Mean ◽  
Total Effective Dose Equivalent ◽  
Total Effective Dose

The radiation dose to patients and personnel was estimated during 11 percutaneous renal stone extractions. For the patients the energy imparted, the mean absorbed dose to various organs, and the effective dose equivalent were estimated. For different personnel categories some organ doses and the effective dose equivalent were also estimated. Large differences in the radiation dose between patients were observed. The mean effective dose equivalent to the patient was 4.2 (range 0.6–8.3) mSv, and the energy imparted 285 (range 50–500) mJ. These figures are comparable to those reported for routine colon examination and urography. For the personnel there were also large differences between individuals and categories. The highest radiation dose was received by the radiologist. It was estimated that a radiologist who performs 150 percutaneous renal stone extractions per year will receive a yearly contribution to his/her effective dose equivalent of 2.4 mSv. Even when the contribution from other diagnostic and interventional radiologic procedures is added, the total effective dose equivalent hardly exceeds 5 mSv or 1/10 of the present dose limit for persons engaged in radiologic work. For the hands of the radiologist there is a risk of doses closer to the present limit for single organs or tissues of 500 mSv/year.

Clinical implication of PET/CT and skeletal bone survey in evaluation of multiple myeloma and related monoclonal disorders.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e18574-e18574
Author(s):  
Muhammad Jawad Popalzai ◽  
Homam Alkaied ◽  
Maryah Mansoor ◽  
Arnold Brenner ◽  
Qun Dai
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cell ◽  
Skeletal Survey ◽  
Whole Body ◽  
Bone Lesions ◽  
Positive Finding ◽  
Pet Ct ◽  
Plasma Cell Disorders ◽  
Smoldering Myeloma

e18574 Background: Whole body skeletal x-ray is considered a gold standard for detecting bone lesions in patients with plasma cell disorders. PET/CT has been increasingly used but its role is yet to be defined. We conducted this study to compare the role of these two imaging modalities in evaluation of plasma cell disorders. Methods: This is single institution, retrospective study to evaluate the role of skeletal survey and PET/CT in patients with multiple myeloma, smoldering myeloma and MGUS. Patients’ records, imaging reports and subsequent management plan were reviewed and compared. Results: A total of 16 patients were reviewed. Among them, 11 patients had multiple myeloma, 2 had smoldering myeloma, and 3 had MGUS. 7/11 patients with multiple myeloma had concordant findings on skeletal survey and PET. 3 of these patients had negative skeletal surveys but had positive finding on PET/CT. PET/CT also identified plasmacytomas in 2 patients. In 2 patients with smoldering myeloma, both skeletal survey and PET/CT were negative. 2/3 patients with MGUS had lytic lesions on skeletal surveys which were not revealed by subsequent PET/CT’s. Both patients were observed without treatment and at 2 years follow up did not show disease progression. Conclusions: Our retrospective analysis showed that skeletal survey is still important for base-line evaluation of bone lesions in multiple myeloma and related monoclonal disorders. PET/CT is more sensitive for detection of bone lesions and can also detect extraosseous lesions such as plasmacytomas. Using tumor metabolic activity, PET/CT may improve diagnostic accuracy and is complementary to conventional skeletal survey. [Table: see text]

Multiple Myeloma Lesion Detection With Whole Body CT Versus Radiographic Skeletal Survey

2013 ◽  
Vol 31 (3) ◽  
pp. 206-211 ◽  
Author(s):  
Kelechi Princewill ◽  
Sampson Kyere ◽  
Omer Awan ◽  
Michael Mulligan
Keyword(s):  
Multiple Myeloma ◽  
Lesion Detection ◽  
Skeletal Survey ◽  
Whole Body ◽  
Whole Body Ct ◽  
Body Ct

scholarly journals Pre-treatment staging of multiple myeloma patients: comparison of whole-body diffusion weighted imaging with whole-body T1-weighted contrast-enhanced imaging

2015 ◽  
Vol 56 (6) ◽  
pp. 733-738 ◽  
Author(s):  
Ettore Squillaci ◽  
Francesca Bolacchi ◽  
Simone Altobelli ◽  
Luca Franceschini ◽  
Alberto Bergamini ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Diffusion Weighted Imaging ◽  
Whole Body ◽  
Diffusion Weighted ◽  
Contrast Enhanced ◽  
Pre Treatment ◽  
Enhanced Imaging

scholarly journals Influence of Different Arm Positions in the Localizer Radiograph(s) on Patient Dose during Exposure-Controlled CT Examinations of the Neck to Pelvis

Tomography ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. 313-322
Author(s):  
Tony M. Svahn ◽  
Lovre Peric ◽  
Jennifer C. Ast
Keyword(s):  
Computed Tomography ◽  
Monte Carlo ◽  
Effective Dose ◽  
Patient Dose ◽  
Whole Body ◽  
Ct Scanner ◽  
Effective Doses ◽  
The Impact ◽  
Total Effective Dose

Our aim was to examine the impact of different arm positions during imaging of the localizer radiograph(s) on effective dose for exposure-controlled computed tomography (CT) (Siemens/Canon) scans of the neck to pelvis. An anthropomorphic whole-body phantom was scanned from the neck to pelvis with the arms positioned in three different ways during the acquisition of the localizer radiograph: (i) above the head, (ii) alongside the trunk, and (iii) along the trunk with the hands placed on the abdomen. In accordance with clinical routines, the arms were not included in the subsequent helical scans. Effective doses were computed to a standard-sized patient (male/female) using a dedicated system-specific Monte Carlo-based software. Effective doses for the Canon CT scanner for the different alternatives (male/female) were (a) 5.3/6.62 mSv, (b) 5.62/7.15 mSv and (c) 5.92/7.44 mSv. For the Siemens CT scanner, effective doses were (a) 4.47/5.59 mSv, (b) 5.4/6.69 mSv and (c) 5.7/6.99 mSv. Arms placed above the head during localizer radiograph imaging in the current CT procedures substantially reduced the total effective dose to the patient.

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