Scoliosis imaging: An analysis of radiation risk in the CT scan projection radiograph and a comparison with projection radiography and EOS

Objective: Physicians who often request for computed tomography (CT) scan examinations are expected to have sound knowledge of radiation exposure (risks) to patients in line with the basic radiation protection principles according to the International Commission on Radiological Protection (ICRP), the Protection of Persons Undergoing Medical Exposure or Treatment (POPUMET), and the Ionizing Radiation (Medical Exposure) Regulations (IR(ME)R). The aim is to assess the level of requesting physicians’ knowledge of ionizing radiation from CT scan examinations in two Nigerian tertiary hospitals. Materials and Methods: An 18-item-based questionnaire was distributed to 141 practicing medical doctors, excluding radiologists with work experience from 0 to >16 years in two major teaching hospitals in Nigeria with a return rate of 69%, using a voluntary sampling technique. Results: The results showed that 25% of the respondents identified CT thorax, abdomen, and pelvis examination as having the highest radiation risk, while 22% said that it was a conventional chest X-ray. Furthermore, 14% concluded that CT head had the highest risk while 9% gave their answer to be conventional abdominal X-ray. In addition, 17% inferred that magnetic resonance imaging had the highest radiation risk while 11% had no idea. Furthermore, 25.5% of the respondents have had training on ionizing radiation from CT scan examinations while 74.5% had no training. Majority (90%) of the respondents were not aware of the ICRP guidelines for requesting investigations with very little (<3%) or no knowledge (0%) on the POPUMET and the IR(ME)R respectively. Conclusion: There is low level of knowledge of ionizing radiation from CT scan examinations among requesting physicians in the study locations.

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FAST and abnormal urinalysis: the effective screening tools in pediatric abdominal trauma

Journal of Emergency Practice and Trauma ◽

10.15171/jept.2018.05 ◽

2018 ◽

Vol 5 (1) ◽

pp. 14-18

Author(s):

Majid Zamani ◽

Farhad Heydari ◽

Mehrdad Esmailian

Keyword(s):

Diagnostic Accuracy ◽

Ct Scan ◽

Abdominal Trauma ◽

Predictive Value ◽

Radiation Risk ◽

Diagnostic Value ◽

Screening Tools ◽

Accuracy Evaluation ◽

Abdominal Ultrasonography ◽

Predictive Values

Objective: The present study examines the diagnostic accuracy of abdominal ultrasonography and urinalysis test in children with blunt abdominal trauma, compared with CT scan. The aim of this study was to compare the diagnostic value of ultrasound and urinalysis test with CT scan as a golden standard diagnostic method in predicting abdominal peritoneal injury in these patients. Methods: This prospective study, based on diagnostic accuracy evaluation, was performed on children with blunt abdominal traumas less than 12 years of age who were referred to the emergency department from 2017-2018 and for whom abdominal ultrasonography, urinalysis and abdominal CT scans were requested. Demographic data, mechanism of trauma, the results of urine tests, ultrasound and CT scan of the abdomen were recorded. Sensitivity, specificity, positive and negative predictive values were used to measure the diagnostic power of the tests. Results: In this study, 100 children with multiple traumas were included. The mean age of these patients was 5.75 ± 3 years with a range of 1-12 years. In terms of sexual distribution, 69 (69%) were boys and 31 (31%) were girls. According to the results, ultrasound with an abnormal urinalysis test had sensitivity of 85.7%, specificity of 91.9%, positive predictive value of 63.2% and negative predictive value of 97.5%. The accuracy was 91%. Conclusion: According to the results of this study, the combination of ultrasonography and urinalysis resulted in a significant increase in diagnostic value (P <0.001). Pediatric patients with a negative ultrasonography and urinalysis test should be observed rather than subjected to the radiation risk of CT

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Patients’ perception of radiation safety of radiological investigations in urology

Journal of Clinical Urology ◽

10.1177/2051415820964979 ◽

2020 ◽

pp. 205141582096497

Author(s):

Prakrit R Kumar ◽

Stuart Irving

Keyword(s):

Ct Scan ◽

Radiation Exposure ◽

Risk Score ◽

Rank Order ◽

Radiation Risk ◽

University Teaching ◽

Risk Scores ◽

Level Of Evidence ◽

X Ray ◽

Perception Of Safety

Background: This study analyses patients’ knowledge of common radiological investigations. Methods: At a university teaching hospital, 100 patients attending urological clinics, who had had a plain X-ray of the kidney, ureter and bladder, magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound scan (USS), completed a 14-item Likert scale questionnaire assessing patients’ perception of safety (both qualitatively and quantitatively) and the hazards of radiological investigations. Results: Using a radiation risk score, patients perceived the following investigations to be in rank order of increasing radiation risk: USS (0.84), MRI (1.4), CT (1.5) and plain X-ray (1.6). On the same scale (0–5), only 17% of patients correctly attributed a risk score of 3 or 4 for a CT scan, and 49% were able to identify a plain X-ray’s risk score correctly as 1 or 2. In addition, more patients identified CT (34%) as having a lower risk of 0 than an X-ray (24%). The mean (1.35 vs. 1.60), median (1 vs. 1) and mode (0 vs. 1) for the CT risk scores are less than those for a plain X-ray, demonstrating that patients perceived CT scans to be safer. Further, the majority of patients understood USS to have no radiation exposure (56%) but thought that MRI posed a radiation risk (62%). Patients were unable to quantify radiation exposure correctly: USS (37% correctly attributed – 0 mSv), MRI (22% – 0 mSv), X-ray (47% – 1 mSv) and CT scan (28% – 10 mSv). Conclusion: This demonstration of suboptimal patient awareness of radiation exposure of common radiological investigations highlights the need to educate patients in order to improve patient autonomy and possibly reduce the demand for unnecessary radiological investigations such as CT. Level of evidence: Level 2.

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Pulmonary atelectasis during paediatric anaesthesia: CT scan evaluation and effect of positive endexpiratory pressure (PEEP)

Pediatric Anesthesia ◽

10.1046/j.1460-9584.1999.00340.x ◽

1999 ◽

Vol 9 (3) ◽

pp. 225-228 ◽

Cited By ~ 6

Author(s):

G Serafini ◽

G Cornara ◽

F Cavalloro ◽

A Mori ◽

R Dore ◽

...

Keyword(s):

Ct Scan ◽

Paediatric Anaesthesia ◽

Pulmonary Atelectasis ◽

Positive Endexpiratory Pressure

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1596: Lymph Node Staging in Prostate Cancer by the use of 11C-CHOLIN-PET/CT Scan Imaging

The Journal of Urology ◽

10.1016/s0022-5347(18)35718-5 ◽

2005 ◽

Vol 173 (4S) ◽

pp. 432-432

Author(s):

Georg C. Bartsch ◽

Norbert Blumstein ◽

Ludwig J. Rinnab ◽

Richard E. Hautmann ◽

Peter M. Messer ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Ct Scan ◽

Lymph Node Staging ◽

Pet Ct ◽

Pet Ct Scan

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Synchronous celiac axis and superior mesenteric artery embolism

VASA ◽

10.1024/0301-1526/a000154 ◽

2011 ◽

Vol 40 (6) ◽

pp. 495-498 ◽

Cited By ~ 1

Author(s):

Rajkovic ◽

Zelic ◽

Papes ◽

Cizmek ◽

Arslani

Keyword(s):

Atrial Fibrillation ◽

Small Intestine ◽

Abdominal Pain ◽

Ct Scan ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Abdominal Cavity ◽

Celiac Axis ◽

Contrast Administration ◽

Artery Embolism

We present a case of combined celiac axis and superior mesenteric artery embolism in a 70-year-old patient that was examined in emergency department for atrial fibrillation and diffuse abdominal pain. Standard abdominal x-ray showed air in the portal vein. CT scan with contrast showed air in the lumen of the stomach and small intestine, bowel distension with wall thickening, and a free gallstone in the abdominal cavity. Massive embolism of both celiac axis and superior mesenteric artery was seen after contrast administration. On laparotomy, complete necrosis of the liver, spleen, stomach and small intestine was found. Gallbladder was gangrenous and perforated, and the gallstone had migrated into the abdominal cavity. We found free air that crackled on palpation of the veins of the gastric surface. The patients condition was incurable and she died of multiple organ failure a few hours after surgery. Acute visceral thromboembolism should always be excluded first if a combination of atrial fibrillation and abdominal pain exists. Determining the serum levels of d-dimers and lactate, combined with CT scan with contrast administration can, in most cases, confirm the diagnosis and lead to faster surgical intervention. It is crucial to act early on clinical suspicion and not to wait for the development of hard evidence.

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Successful Endovascular Repair of a Leaking Abdominal Aortic Aneurysm under Local Anesthesia

Swiss Surgery ◽

10.1024/1023-9332.7.2.86 ◽

2001 ◽

Vol 7 (2) ◽

pp. 86-89 ◽

Cited By ~ 17

Author(s):

Lachat ◽

Pfammatter ◽

Bernard ◽

Jaggy ◽

Vogt ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Ct Scan ◽

Local Anesthesia ◽

Endovascular Repair ◽

Anesthetic Management ◽

High Risk Patient ◽

Invasive Technique ◽

Chronic Obstructive ◽

Abdominal Aortic

Local anesthesia is a safe and less invasive anesthetic management for the endovascular approach to elective aortic aneurysm. We have successfully extended the indication of local anesthesia to a high-risk patient with leaking aneurysm and stable hemodynamics. Patient and methods: A 86 year old patient with renal insufficiency due to longstanding hypertension, coronary artery and chronic obstructive lung disease was transferred to our hospital with a leaking abdominal aortic aneurysm. Stable hemodynamics allowed to perform a fast CT scan, that confirmed the feasibility of endovascular repair. A bifurcated endograft (24mm x 12mm x 153mm) was implanted under local anesthesia. Results: The procedure was completed within 85 minutes without problems. The complete sealing of the aneurysm was confirmed by CT scan on the third postoperative day. Twenty months later, the patient is doing well and radiological control confirmed complete exclusion of the aneurysm. Discussion: The endoluminal treatment is a minimally invasive technique. It's feasibility can be rapidly assessed by CT scan. The transfemoral implantation can be performed under local anesthesia provided that hemodynamics are stable. This anesthetic management seems to be particularly advantageous for leaking abdominal aortic aneurysm since it doesn't change the hemodynamic situation in contrast to general anesthesia. Hemodynamic instability, abdominal distension or tenderness may indicate intraperitoneal rupture and conversion to open graft repair should be performed without delay.

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