How much is the effective dose from medical imaging in pediatric patients in the neurosurgery department?

2021 ◽  
Author(s):  
B. Zeinali-Rafsanjani ◽  
S. Haseli ◽  
R. Jalli ◽  
M. Saeedi-Moghadam
Keyword(s):  
Medical Imaging ◽  
Ionizing Radiation ◽  
Ct Scan ◽  
Effective Dose ◽  
Pediatric Patients ◽  
Ct Scans ◽  
Imaging Data ◽  
Plain Radiographs ◽  
Brain Ct ◽  
Abdomen Ct

Medical imaging with ionizing radiation in pediatric patients is rising, and their radiation sensitivity is 2–3 times more than adults. The objective of this study was to estimate the total effective dose (ED) of all medical imaging by CT scan and plain radiography in patients in pediatric neurosurgery department. Patients with at least one brain CT scan and recorded dose length product (DLP) were included. Patients’ imaging data were collected from the picture-archiving-and-communicating system (PACS) using their national code to find all their medical imaging. Total ED (mSv) from CT scans and plain radiographs were calculated. A total of 300 patients were included, of which 129 were females and 171 males with a mean age of 5.45 ± 4.34 years. Mean DLPs of brain, abdomen, and chest CT were 329.16, 393.06, 284.46 mGy.cm. The most frequent CT scans in these children were brain CT scans with ED range of 0.09 to 47.09 mSv. Total ED due to all CT scans and plain radiographs were in the range of 0.38 to 63.41 mSv. Although the mean DLP of each brain, chest, and abdomen CT of patients was in the range of DRLs reported by previous studies, the patients with numerous CT scans received more radiation doses than mean ED (6.21 mSv between all age groups). The most frequent CT scan was the brain, and the most frequent plain radiographs were chest and lower extremities. It can be concluded that reducing the number of CT scans or plain radiographs by appropriate physical exams or replacing them with modalities that do not use ionizing radiation can reduce ED.

scholarly journals The Necessity of Follow-Up Brain Computed-Tomography Scans: Is It the Pathology Itself Or Our Fear that We Should Overcome?

2017 ◽  
Vol 5 (6) ◽  
pp. 740-743
Author(s):  
Ahmet Öğrenci ◽  
Orkun Koban ◽  
Murat Ekşi ◽  
Onur Yaman ◽  
Sedat Dalbayrak
Keyword(s):  
Ct Scan ◽  
Pediatric Patients ◽  
Obstructive Hydrocephalus ◽  
Hospital Setting ◽  
Ct Scans ◽  
Time Interval ◽  
Clinical Approach ◽  
Abnormal Finding ◽  
Brain Ct

AIM: This study aimed to make a retrospective analysis of pediatric patients with head traumas that were admitted to one hospital setting and to make an analysis of the patients for whom follow-up CT scans were obtained.METHODS: Pediatric head trauma cases were retrospectively retrieved from the hospital’s electronic database. Patients’ charts, CT scans and surgical notes were evaluated by one of the authors. Repeat CT scans for operated patients were excluded from the total number of repeat CT scans.RESULTS: One thousand one hundred and thirty-eight pediatric patients were admitted to the clinic due to head traumas. Brain CT scan was requested in 863 patients (76%) in the cohort. Follow-up brain CT scans were obtained in 102 patients. Additional abnormal finding requiring surgical intervention was observed in only one patient (isolated 4th ventricle hematoma) on the control CTs (1% of repeat CT scans), who developed obstructive hydrocephalus. None of the patients with no more than 1 cm epidural hematoma in its widest dimension and repeat CT scans obtained 1.5 hours after the trauma necessitated surgery.CONCLUSION: Follow-up CT scans changed clinical approach in only one patient in the present series. When ordering CT scan in the follow-up of pediatric traumas, benefits and harms should be weighted based upon time interval from trauma onset to initial CT scan and underlying pathology.

scholarly journals Optimization of pediatric CT scans in a developing country

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fotso Eddy Kamdem ◽  
Samba Odette Ngano ◽  
Clemence Alla Takam ◽  
Alain Jervé Fotue ◽  
Serge Abogo ◽  
...  
Keyword(s):  
Developing Countries ◽  
Ionizing Radiation ◽  
Ct Scan ◽  
Developing Country ◽  
Head Trauma ◽  
Pediatric Patients ◽  
Ct Scans ◽  
Pediatric Ct ◽  
The Common ◽  
New Machine

Abstract Background The purpose of this study was to assess scan parameters and to propose strategies to optimize the examinations of children (from 0 to 15 years old) on adult scanners in developing countries. Methods A study was done in 2015 and 2018 on 312 pediatric patients to verify improved practices. The study of 2015 ended with proposed strategies. Dose and scan parameters were available for prospective dose analysis. These strategies were implemented in a study of 2018. Results Amount the CT examinations study in this paper, the common was head trauma (90 %). For every pediatric CT scan in 2015, a kV of 120 was used in the various hospitals. The mAs ranged from 57.75 to 283.33, slice thicknesses from 1.25 to 2.5 mm and pitch from 0.525 to 1.375 mm. In the study of 2018, implementing the strategy defined in the methodology and proposed in 2015: CTDIVol decreased by 21.27 % for children < 1 year, 31.97 % for children 1–4 years, 17 % for children 5–9 years. DLP also decreased by 25.14 %, 36.29 % and 19.85 % for children < 1 year, 1–4 years and 5–9 years respectively. Children were exposed to ionizing radiation on machines designed for adults, but now the doses received by children are reduced. Conclusions The reduction of doses during the pediatric CT examination is possible with the introduction of new optimization protocols or the acquisition of a new machine with a pediatric protocol.

Radiation exposure during the treatment of spinal deformities

2021 ◽  
pp. 1-7
Author(s):  
Jwalant S. Mehta ◽  
Kirsten Hodgson ◽  
Lu Yiping ◽  
James Swee Beng Kho ◽  
Ravindra Thimmaiah ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Ionizing Radiation ◽  
Effective Dose ◽  
Spinal Deformity ◽  
Background Radiation ◽  
Ct Scans ◽  
Intraoperative Fluoroscopy ◽  
The Difference ◽  
Risk Of Cancer ◽  
Surgical Group

Aims To benchmark the radiation dose to patients during the course of treatment for a spinal deformity. Methods Our radiation dose database identified 25,745 exposures of 6,017 children (under 18 years of age) and adults treated for a spinal deformity between 1 January 2008 and 31 December 2016. Patients were divided into surgical (974 patients) and non-surgical (5,043 patients) cohorts. We documented the number and doses of ionizing radiation imaging events (radiographs, CT scans, or intraoperative fluoroscopy) for each patient. All the doses for plain radiographs, CT scans, and intraoperative fluoroscopy were combined into a single effective dose by a medical physicist (milliSivert (mSv)). Results There were more ionizing radiation-based imaging events and higher radiation dose exposures in the surgical group than in the non-surgical group (p < 0.001). The difference in effective dose for children between the surgical and non-surgical groups was statistically significant, the surgical group being significantly higher (p < 0.001). This led to a higher estimated risk of cancer induction for the surgical group (1:222 surgical vs 1:1,418 non-surgical). However, the dose difference for adults was not statistically different between the surgical and non-surgical groups. In all cases the effective dose received by all cohorts was significantly higher than that from exposure to natural background radiation. Conclusion The treatment of spinal deformity is radiation-heavy. The dose exposure is several times higher when surgical treatment is undertaken. Clinicians should be aware of this and review their practices in order to reduce the radiation dose where possible.

scholarly journals Patient Knowledge Regarding Radiation Exposure from Orthopaedic Foot and Ankle Imaging

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0015
Author(s):  
Daniel Bohl ◽  
Blaine Manning ◽  
George Holmes ◽  
Simon Lee ◽  
Johnny Lin ◽  
...  
Keyword(s):  
Ionizing Radiation ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Cone Beam Ct ◽  
Plain Film ◽  
Ct Scans ◽  
Cone Beam ◽  
X Rays ◽  
Foot And Ankle ◽  
X Ray

Category: Other Introduction/Purpose: Foot and ankle surgeons routinely prescribe diagnostic imaging that exposes patients to potentially harmful ionizing radiation. The purpose of this study is to characterize patients’ knowledge regarding radiation exposure associated with common forms of foot and ankle imaging. Methods: A survey was administered to all new patients prior to their first foot and ankle clinic appointments. Patients were asked to compare the amount of harmful radiation associated with chest x-rays to that associated with various types of foot and ankle imaging. Results were tabulated and compared to actual values of radiation exposure from the published literature. Results: A total of 890 patients were invited to participate, of whom 791 (88.9%) completed the survey. The majority of patients believed that a foot x-ray, an ankle x-ray, a “low dose” CT scan of the foot and ankle (alluding to cone-beam CT), and a traditional CT scan of the foot and ankle all contain similar amounts of harmful ionizing radiation to a chest x-ray (Table 1). This is in contrast to the published literature, which suggests that foot x-rays, ankle x-rays, cone beam CT scans of the foot and ankle, and traditional CT scans of the foot and ankle expose patients to 0.006, 0.006, 0.127, and 0.833 chest x-rays worth of radiation. Conclusion: The results of the present study suggest that patients greatly over-estimate the amount of harmful ionizing radiation associated with plain film and cone-beam CT scans of the foot and ankle. Interestingly, their estimates of radiation associated with traditional CT scans of the foot and ankle were relatively accurate. Results suggest that patients may benefit from increased counseling by surgeons regarding the relatively low risk of radiation exposure associated with plain film and cone-beam CT imaging of the foot and ankle.

scholarly journals Validity of mild TBI risk score to predict intracranial hemorrhage in cases of mild traumatic brain injury in Thailand

2020 ◽  
Vol 5 (1) ◽  
pp. e000453
Author(s):  
Kasamon Aramvanitch ◽  
Chaiyaporn Yuksen ◽  
Chetsadakon Jenpanitpong ◽  
Promphet Nuanprom ◽  
Yuranan Phootothum ◽  
...  
Keyword(s):  
High Risk ◽  
Ct Scan ◽  
Intracranial Hemorrhage ◽  
Risk Score ◽  
Risk Group ◽  
Ct Scans ◽  
Moderate Risk ◽  
Mild Tbi ◽  
Brain Ct ◽  
Brain Ct Scan

BackgroundPatients with mild traumatic brain injury (TBI) will receive a brain CT scan based on risk of injury. A previous study established a scoring system for patients with mild TBI that assigned <3 points for the low-risk group, 3–6 points for the moderate-risk group, and ≥6 points for the high-risk group. The purpose of this study was to evaluate the external validity of mild TBI risk scores for predicting intracranial hemorrhage in patients with mild TBI who had been transferred to receive a brain CT scan at the 10 nationwide CT scan–capable facilities in Thailand.MethodsThe study was a retrospective cross-sectional review of patients with mild TBI who received a brain CT scan in 10 nationwide hospitals of Thailand. Risk factors were observed and points calculated for predicting mild TBI scores based on patient records. Injured patients were divided into two groups: CT scans indicating normal and abnormal brain images. After this, the accuracy of mild TBI score for predicting the presence of intracranial hemorrhage was investigated.ResultsThe study included a total of 999 patients, comprising 461 (46.15%) patients with abnormal brain CT scans indicating intracranial hemorrhage and 538 (53.85%) indicating no intracranial hemorrhage. In the low-risk group (mild TBI risk score <3), moderate-risk group (mild TBI risk score 3–6), and high-risk group (mild TBI risk score >6), the likelihood ratio positive of brain CT scans were 0.41, 3.53, and 77.3, respectively.DiscussionMild TBI risk score may assist healthcare providers to select patients with mild TBI for brain CT scan referral, particularly in hospitals without CT scan facilities. In such cases, based on the proposed scoring system, immediate transfer of moderate-risk and high-risk patients with mild TBI to a CT scan–capable facility is necessary.

Comparison of extra-articular radiographic parameters of distal radius fractures on plain radiographs and CT scans

2021 ◽  
pp. 175319342110210
Author(s):  
Simon B. Kramer ◽  
Caroline A. Selles ◽  
Daniel Bakker ◽  
Niels W. L. Schep
Keyword(s):  
Ct Scan ◽  
Intraclass Correlation ◽  
Plain Radiograph ◽  
Ulnar Variance ◽  
Ct Scans ◽  
Distal Radial Fractures ◽  
Plain Radiographs ◽  
Radial Inclination ◽  
Radiographic Parameters ◽  
Radiograph Measurements

The aim of this study was to compare extra-articular radiographic parameters of distal radial fractures measured on plain radiographs and CT scans. Two researchers independently measured four extra-articular radiographic parameters (dorsal tilt, carpal alignment, radial inclination and ulnar variance) on both radiographs and CT scans in 85 patients. Inter-observer reliability for both techniques was assessed, along with the agreement between CT scans and radiographs using the intraclass correlation coefficient and Bland–Altman plots. The results showed that dorsal tilt, carpal alignment, radial inclination and ulnar variance can be measured reliably on both radiographs and CT scans. At a patient level, carpal alignment, radial inclination and ulnar variance CT scan measurements are an acceptable alternative to plain radiograph measurements in the vast majority of patients. In contrast, dorsal tilt CT scan measurements are not comparable with radiographs in 40% of the cases. Therefore, caution should be taken in measuring dorsal tilt on CT scans.

scholarly journals Study protocol for investigating the performance of an automated blood test measuring GFAP and UCH-L1 in a prospective observational cohort of patients with mild traumatic brain injury: European BRAINI study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043635
Author(s):  
Marion Richard ◽  
Alfonso Lagares ◽  
Victor Bondanese ◽  
Javier de la Cruz ◽  
Odile Mejan ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Ct Scan ◽  
Mild Traumatic Brain Injury ◽  
Brain Lesions ◽  
Ct Scans ◽  
Secondary Outcome ◽  
Serum Concentrations ◽  
Brain Ct ◽  
Automated Assay

IntroductionMild traumatic brain injury (mTBI) is a common cause of clinical consultation in the emergency department. Patients with mTBI may undergo brain CT scans based on clinical criteria. However, the proportion of patients with brain lesions on CT is very low. Two serum biomarkers, glial fibrillar acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), have been shown to discriminate patients regarding the presence or absence of brain lesions on initial CT scan when assessed within the first 12 hours after TBI. However, the current technique for measuring serum concentrations of GFAP and UCH-L1 is manual and time consuming, which may hinder its use in routine clinical practice. This study assesses the diagnostic accuracy of an automated assay for the measurement of serum GFAP and UCH-L1 in a cohort of patients with mTBI who received a CT scan as the standard of care.Methods and analysisThis is a prospective multicentre observational study of 1760 patients with mTBI recruited in France and Spain across 16 participating sites. Adult patients with an initial Glasgow Coma Scale score of 13–15 and a brain CT scan underwent blood sampling within 12 hours after TBI. The primary outcome measure is the diagnostic performance of an automated assay measuring serum concentrations of GFAP and UCH-L1 for discriminating between patients with positive and negative findings on brain CT-scans. Secondary outcome measures include the performance of these two biomarkers in predicting the neurological status and quality of life at 1 week and 3 months after the trauma.Ethics and disseminationEthics approval was obtained by the Institutional Review Board of Sud-Ouest Outre Mer III in France (Re#2019-A01525-52) and Hospital 12 de Octubre in Spain (Re#19/322). The results will be presented at scientific meetings and published in peer-reviewed publications.Trial registration numberClinicalTrials.gov: NCT04032509.

scholarly journals Rapidly progressive brain atrophy in septic ICU patients: a retrospective descriptive study using semiautomatic CT volumetry

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Ryuta Nakae ◽  
Tetsuro Sekine ◽  
Takashi Tagami ◽  
Yasuo Murai ◽  
Eigo Kodani ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Ct Scan ◽  
Brain Atrophy ◽  
Brain Volume ◽  
Length Of Hospital Stay ◽  
Ct Scans ◽  
Icu Patients ◽  
Brain Ct ◽  
Disturbance Of Consciousness ◽  
The Brain

Abstract Background Sepsis is often associated with multiple organ failure; however, changes in brain volume with sepsis are not well understood. We assessed brain atrophy in the acute phase of sepsis using brain computed tomography (CT) scans, and their findings’ relationship to risk factors and outcomes. Methods Patients with sepsis admitted to an intensive care unit (ICU) and who underwent at least two head CT scans during hospitalization were included (n = 48). The first brain CT scan was routinely performed on admission, and the second and further brain CT scans were obtained whenever prolonged disturbance of consciousness or abnormal neurological findings were observed. Brain volume was estimated using an automatic segmentation method and any changes in brain volume between the two scans were recorded. Patients with a brain volume change < 0% from the first CT scan to the second CT scan were defined as the “brain atrophy group (n = 42)”, and those with ≥ 0% were defined as the “no brain atrophy group (n = 6).” Use and duration of mechanical ventilation, length of ICU stay, length of hospital stay, and mortality were compared between the groups. Results Analysis of all 42 cases in the brain atrophy group showed a significant decrease in brain volume (first CT scan: 1.041 ± 0.123 L vs. second CT scan: 1.002 ± 0.121 L, t (41) = 9.436, p < 0.001). The mean percentage change in brain volume between CT scans in the brain atrophy group was –3.7% over a median of 31 days, which is equivalent to a brain volume of 38.5 cm3. The proportion of cases on mechanical ventilation (95.2% vs. 66.7%; p = 0.02) and median time on mechanical ventilation (28 [IQR 15–57] days vs. 15 [IQR 0–25] days, p = 0.04) were significantly higher in the brain atrophy group than in the no brain atrophy group. Conclusions Many ICU patients with severe sepsis who developed prolonged mental status changes and neurological sequelae showed signs of brain atrophy. Patients with rapidly progressive brain atrophy were more likely to have required mechanical ventilation.

scholarly journals Assessment of the Awareness of Radiology Residents About Ionizing Radiations and Their Risks of Educational Hospitals, Kermanshah, Iran

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Sogand Abbasi Azizi ◽  
Mohammad-Rasoul Tohidnia ◽  
Mohsen Zhaleh
Keyword(s):  
Ionizing Radiation ◽  
Ct Scan ◽  
Effective Dose ◽  
Biological Effects ◽  
Abdominal Ct ◽  
Cross Sectional ◽  
X Ray ◽  
Abdominal Ct Scan ◽  
Chest X Ray ◽  
Radiology Residents

Background: Although many radiological examinations are requested daily to aid clinical diagnosis by the referring physician, it should be kept in mind that ionizing radiation has adverse biological effects on the life of living organisms, which may vary in individuals depending on the dose and duration of exposure. Therefore, radiologists and their assistants should have comprehensive information about ionizing radiation. Methods: In this descriptive cross-sectional study, all the radiology residents (41) were included in the study. The questionnaire consisted of two parts, the first part including of demographic information and part 2 includes 21 questions about the effective dose created by a chest X-ray, the approximate effective dose from various imaging examines, as well as the awareness of the risks of brain, abdominal CT scans. Results: The results showed that out of 41 residents, 56.1% were male. Based on these results, 19.5% were aware of the approximate effective dose received by a patient on PA chest X-ray. Also, knowledge of some X-ray absorptiometry parameters based on chest X-ray in PA position are: 12.2% abdominal CT scan, 17.1% and 2.4% brain and chest CT scan respectively. In this study the radiology resident’s awareness about dangers of ionizing radiation and the likelihood of cancer were evaluated in 31% and 48.8% of brain and abdominal CT scan, respectively. Conclusions: According to the findings, awareness of radiology residents in Kermanshah university of medical sciences is at an inappropriate level. Therefore, training is needed to raise the awareness of radiology residents by conducting several workshops.

Radiographic and CT Evaluation of Tibiofibular Syndesmotic Diastasis: A Cadaver Study

1997 ◽  
Vol 18 (11) ◽  
pp. 693-698 ◽  
Author(s):  
Nabil A. Ebraheim ◽  
Jike Lu ◽  
Hua Yang ◽  
Anis O. Mekhail ◽  
Richard A. Yeasting
Keyword(s):  
Ct Scan ◽  
Ct Scanning ◽  
Cadaver Study ◽  
Lower Limbs ◽  
Ankle Injuries ◽  
Ct Scans ◽  
Tibiofibular Syndesmosis ◽  
Postoperative Evaluation ◽  
Plain Radiographs ◽  
Ct Evaluation

Twelve cadaver lower limbs were used for radiographic and CT assessment of the tibiofibular syndesmosis. Plastic spacers were placed in the distal tibiofibular intervals of each specimen in successive 1-mm increments until diastasis could be appreciated on the plain radiographs. All 2- and 3-mm diastases could be noted and clearly identified on CT scans, while the 1-, 2-mm, and half of the 3-mm syndesmotic diastases could not be appreciated with routine radiographs. CT scanning is more sensitive than radiography for detecting the minor degrees of syndesmotic injuries. Therefore, a CT scan can be performed in cases of syndesmotic instability after ankle injuries and for preoperative or postoperative evaluation of the integrity of the distal tibiofibular syndesmosis in cases of doubtful condition of the syndesmosis.

Sign in / Sign up

Export Citation Format

Share Document