scholarly journals A Preliminary Study of Personalized Head CT Scan in Pediatric Patients

Dose-Response ◽  
2021 ◽  
Vol 19 (1) ◽  
pp. 155932582098566
Author(s):  
Bian Bingyang ◽  
Wang Gang ◽  
Shao Zhiqing ◽  
Nan Li ◽  
BoXu Zhou ◽  
...  

Objectives: In the present study, we introduced a practical approach to quantify organ-specific radiation doses and investigated whether low-dose head circumference (HC)-based protocols for non-enhanced head computed tomography (CT) could reduce organs-specific radiation dose in pediatric patients while maintaining high image quality. Methods: A total of 83 pediatric patients were prospectively recruited. Without limits to the HC, 15 patients were selected as a convention group (CON group) and underwent non-enhanced head CT scan with standard-dose protocols (tube current-time products of 250mAs). Low-dose group (LD group), including remaining 68 pediatrics were divided into 3 subgroups based on the HC: 54.1-57.0 cm for LD200mAs group (HC-based protocols of 200mAs), 51.1-54.0 cm for LD150mAs group (HC-based protocols of 150mAs), 48.1-51.0 cm for LD100mAs group (HC-based protocols of 100mAs). Subjective and objective image quality was evaluated and measured by 2 experienced radiologists. Radimetrics was used to calculate organs-specific radiation dose, including the brain, eye lenses, and salivary glands. Results: In CON250mAs group, radiation doses in the brain and salivary glands were conversely correlated with HC, and pediatric patients with smaller HC received higher organs-specific radiation dose. Reducing tube current-time product from 250 to 100mAs could significantly reduce the organ-specific radiation dose. The subjective image quality score ≥ 3.0 is acceptable for diagnosis purposes. The signal to noise ratio (SNR) and the contrast to noise ratio (CNR) of bilateral thalamus and centrum semiovale in 3 LD subgroups were not statistically different compared with the CON group. Conclusion: Our research indicated that low-dose HC-based protocols of non-enhanced head CT scan can evidently reduce the organ-specific radiation doses, while maintaining high image quality. HC can serve as a vital tool to guide personalized low-dose head CT scan for pediatric patients.

Dose-Response ◽  
2020 ◽  
Vol 19 (1) ◽  
pp. 155932582090977
Author(s):  
Dan Wu ◽  
Gang Wang ◽  
Bingyang Bian ◽  
Zhuohang Liu ◽  
Dan Li

Objectives: For patients with intracranial hemorrhage (ICH), routine follow-up computed tomography (CT) scans are typically required to monitor the progression of intracranial pathology. Remarkable levels of radiation exposure are accumulated during repeated CT scan. However, the effects and associated risks have still remained elusive. This study presented an effective approach to quantify organ-specific radiation dose of repeated CT scans of head for patients with ICH. We also indicated whether a low-dose CT scan may reduce radiation exposure and keep the image quality highly acceptable for diagnosis. Methods: Herein, 72 patients with a history of ICH were recruited. The patients were divided into 4 groups and underwent CT scan of head with different tube current–time products (250, 200, 150, and 100 mAs). Two experienced radiologists visually rated scores of quality of images according to objective image noise, sharpness, diagnostic acceptability, and artifacts due to physiological noise on the same workstation. Organ-/tissue-specific radiation doses were analyzed using Radimetrics. Results: In conventional CT scan group, signal to noise ratio (SNR) and contrast to noise ratio (CNR) of ICH images were significantly higher than those in normal brain structures. Reducing the tube current–time product may decrease the image quality. However, the predilection sites for ICH could be clearly identified. The SNR and CNR in the predilection sites for ICH were notably higher than other areas. The brain, eye lenses, and salivary glands received the highest radiation dose. Reducing tube current–time product from 250 to 100 mA can significantly reduce the radiation dose. Discussion: We demonstrated that low-dose CT scan of head can still provide reasonable images for diagnosing ICH. The radiation dose can be reduced to ∼45% of the conventional CT scan group.


2019 ◽  
Author(s):  
BingYang Bian ◽  
BoXu Zhou ◽  
Gang Wang ◽  
QingChen Zhou ◽  
ShuJia Xu ◽  
...  

Abstract Background: Same head CT examination protocol was employed for pediatric patients who’s skull sizes are different , this could be excessive radiation doses because they usually have smaller head circumference. In our study, we investigate if mAs according to head circumference(HC) reduce radiation doses of sensitive organs including brain, eye lens and salivary glands, but could keep the image quality. Methods: 83 pediatric patients were prospectively selected. Without limiting the head circumference, 15 pediatrics were selected as conventional group by random number method and received routine head CT examination protocol (250mAs). Low-dose group including remaining 68 patients were divided into 3 subgroups based on HC: 54.1-57.0cm for group A(200mAs), 51.1-54.0cm for group B(150mAs), 48.1-51.0cm for group C(100mAs). The Image quality was assessed by subjective and objective image score. Radimetrics was used to calculate radiation doses of sensitive- organs. Results: In the conventional group, pediatric patients with smaller head circumference receive higher radiation doses of sensitive-organs. Radiation doses of brain and salivary glands were negatively correlated with HC. The radiation dose of sensitive-organs in 3 low-dose subgroups were significantly lower than conventional group. The subjective image quality scores in group A and B was no statistical different than conventional group. The SNR of thalamus and centrum ovale in low-dose subgroups were no statistical differences compared with conventional group. Conclusions: Our research indicates that personalized brain CT examination in pediatrics can reduce the radiation doses of sensitive-organs but keep image quality. HC can serve as an effective index to guide personalized head CT scan.


2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Richard G. Kavanagh ◽  
John O’Grady ◽  
Brian W. Carey ◽  
Patrick D. McLaughlin ◽  
Siobhan B. O’Neill ◽  
...  

Magnetic resonance imaging (MRI) is the mainstay method for the radiological imaging of the small bowel in patients with inflammatory bowel disease without the use of ionizing radiation. There are circumstances where imaging using ionizing radiation is required, particularly in the acute setting. This usually takes the form of computed tomography (CT). There has been a significant increase in the utilization of computed tomography (CT) for patients with Crohn’s disease as patients are frequently diagnosed at a relatively young age and require repeated imaging. Between seven and eleven percent of patients with IBD are exposed to high cumulative effective radiation doses (CEDs) (>35–75 mSv), mostly patients with Crohn’s disease (Newnham E 2007, Levi Z 2009, Hou JK 2014, Estay C 2015). This is primarily due to the more widespread and repeated use of CT, which accounts for 77% of radiation dose exposure amongst patients with Crohn’s disease (Desmond et al., 2008). Reports of the projected cancer risks from the increasing CT use (Berrington et al., 2007) have led to increased patient awareness regarding the potential health risks from ionizing radiation (Coakley et al., 2011). Our responsibilities as physicians caring for these patients include education regarding radiation risk and, when an investigation that utilizes ionizing radiation is required, to keep radiation doses as low as reasonably achievable: the “ALARA” principle. Recent advances in CT technology have facilitated substantial radiation dose reductions in many clinical settings, and several studies have demonstrated significantly decreased radiation doses in Crohn’s disease patients while maintaining diagnostic image quality. However, there is a balance to be struck between reducing radiation exposure and maintaining satisfactory image quality; if radiation dose is reduced excessively, the resulting CT images can be of poor quality and may be nondiagnostic. In this paper, we summarize the available evidence related to imaging of Crohn’s disease, radiation exposure, and risk, and we report recent advances in low-dose CT technology that have particular relevance.


Author(s):  
A. Mokhtar ◽  
Z. A. Aabdelbary ◽  
A. Sarhan ◽  
H. M. Gad ◽  
M. T. Ahmed

Abstract Background To study radiation dose, image quality and low-contrast cylinder detectability from multislice CT (MSCT) abdomen by using low tube voltage using the American College of Radiology (ACR) phantom. The ACR phantom (low-contrast module) was scanned with 64 MSCT scanner (Brilliance, Philips Medical System, Eindhoven, Netherlands) with 80 and 120 KVP, utilizing different tube current time product (mAs) range from 50 to 380 mAs. The image noise (SD), signal to noise ratio, contrast-to-noise ratio (CNR), and scores of low contrast detectability were assessed for every image respectively. Results From images analyses, the noise essentially increased with the use of low tube voltage. The CNR was 0.94 ± 0.27 at 120 KVP, and CNR was 0.43 ± 0.22 at 80 KVP. However, with the same dose, there were no differences of statistical significance in scores of low-contrast detectability between 120 KVP at 300mAs and 80 KVP at (200–380) mAs (p > 0.05). At 300 mAs, the CTDIvol obtained at 80 KVP was about 29% of that at 120 KVP. The CTDIvol obtained at 80 KVP were decreased from 5% at 50 mAs, to 37% at 380 mAs. Conclusions There is a possibility to decrease exposure of radiation virtually by reducing KVP from 120 to 80 KVP in examination of abdominal CT when the high tube current is used, though increasing image noise at low tube voltage.


2017 ◽  
Vol 59 (6) ◽  
pp. 740-747
Author(s):  
Marie-Louise Aurumskjöld ◽  
Marcus Söderberg ◽  
Fredrik Stålhammar ◽  
Kristina Vult von Steyern ◽  
Anders Tingberg ◽  
...  

Background In pediatric patients, computed tomography (CT) is important in the medical chain of diagnosing and monitoring various diseases. Because children are more radiosensitive than adults, they require minimal radiation exposure. One way to achieve this goal is to implement new technical solutions, like iterative reconstruction. Purpose To evaluate the potential of a new, iterative, model-based method for reconstructing (IMR) pediatric abdominal CT at a low radiation dose and determine whether it maintains or improves image quality, compared to the current reconstruction method. Material and Methods Forty pediatric patients underwent abdominal CT. Twenty patients were examined with the standard dose settings and 20 patients were examined with a 32% lower radiation dose. Images from the standard examination were reconstructed with a hybrid iterative reconstruction method (iDose4), and images from the low-dose examinations were reconstructed with both iDose4 and IMR. Image quality was evaluated subjectively by three observers, according to modified EU image quality criteria, and evaluated objectively based on the noise observed in liver images. Results Visual grading characteristics analyses showed no difference in image quality between the standard dose examination reconstructed with iDose4 and the low dose examination reconstructed with IMR. IMR showed lower image noise in the liver compared to iDose4 images. Inter- and intra-observer variance was low: the intraclass coefficient was 0.66 (95% confidence interval = 0.60–0.71) for the three observers. Conclusion IMR provided image quality equivalent or superior to the standard iDose4 method for evaluating pediatric abdominal CT, even with a 32% dose reduction.


Author(s):  
Nico Sollmann ◽  
Kai Mei ◽  
Isabelle Riederer ◽  
Monika Probst ◽  
Maximilian T. Löffler ◽  
...  

Abstract Objectives To investigate potential radiation dose reduction for multi-detector computed tomography (MDCT) exams of the spine by using sparse sampling and virtually lowered tube currents combined with statistical iterative reconstruction (SIR). Methods MDCT data of 26 patients (68.9 ± 11.7 years, 42.3% males) were retrospectively simulated as if the scans were acquired at 50%, 10%, 5%, and 3% of the original X-ray tube current or number of projections, using SIR for image reconstructions. Two readers performed qualitative image evaluation considering overall image quality, artifacts, and contrast and determined the number and type of degenerative changes. Scoring was compared between readers and virtual low-dose and sparse-sampled MDCT, respectively. Results Image quality and contrast decreased with virtual lowering of tube current and sparse sampling, but all degenerative changes were correctly detected in MDCT with 50% of tube current as well as MDCT with 50% of projections. Sparse-sampled MDCT with only 10% of initial projections still enabled correct identification of all degenerative changes, in contrast to MDCT with virtual tube current reduction by 90% where non-calcified disc herniations were frequently missed (R1: 23.1%, R2: 21.2% non-diagnosed herniations). The average volumetric CT dose index (CTDIvol) was 1.4 mGy for MDCT with 10% of initial projections, compared with 13.8 mGy for standard-dose imaging. Conclusions MDCT with 50% of original tube current or projections using SIR still allowed for accurate diagnosis of degenerative changes. Sparse sampling may be more promising for further radiation dose reductions since no degenerative changes were missed with 10% of initial projections. Key Points • Most common degenerative changes of the spine can be diagnosed in multi-detector CT with 50% of tube current or number of projections. • Sparse-sampled multi-detector CT with only 10% of initial projections still enables correct identification of degenerative changes, in contrast to imaging with 10% of original tube current. • Sparse sampling may be a promising option for distinct lowering of radiation dose, reducing the CTDIvolfrom 13.8 to 1.4 mGy in the study cohort.


1998 ◽  
Vol 39 (5) ◽  
pp. 514-519 ◽  
Author(s):  
H. Seifert ◽  
H.-J. Jesberger ◽  
G. Schneider ◽  
L. Rein ◽  
G. Blass ◽  
...  

Purpose: to determine the minimum acceptable radiation dose for an adequate image quality in thorax a.p. radiographs of neonates using mobile X-ray equipment Material and Methods: the influence of additional filtration (1.0 mm Al+0.1 mm Cu) on image quality and radiation dose was determined for the speed class 400 screen-film system (SFS) and digital luminescence radiography (DLR) by making radiographs of a test phantom. Conventional and digital thorax a.p. radiographs of a rabbit were produced using various tube current-time products. the quality of the rabbit radiographs was judged by eight radiologists applying image quality criteria according to the German guidelines and the recommendations of the European Community Results: the added filter resulted in a dose reduction of 39% at 66 kV. DLR gave a further dose reduction of 25% in comparison to the speed class 400 SFS while maintaining adequate image quality, i. e. the radiographs were clinically acceptable with regard to quality criteria Conclusion: the radiation dose resulting from thorax a.p. radiographs of neonates can be reduced by approximately 50% with the use of additional filtration and DLR


2021 ◽  
Vol 22 (1) ◽  
pp. 5-19
Author(s):  
Piyaporn Apisarnthanarak ◽  
Anawat Sriwaleephun ◽  
Sastrawut Thammakittiphan ◽  
Wimonrat Lornimitdee ◽  
Atchariya Klinhom ◽  
...  

OBJECTIVE: To compare the image quality and the radiation dose between fixed tube current (FTC) low dose abdominal CT currently performed at our hospital and new automatic tube current modulation (ATCM) low dose abdominal CT. MATERIALS AND METHODS: We prospectively performed ATCM low dose abdominal CT in 88 participants who had prior FTC low dose CT for comparison. Four experienced abdominal radiologists independently and blindly assessed the quality of FTC and ATCM low dose CT images by using a 5-point-scale satisfaction score (1 = unacceptable, 2 = poor, 3 = average, 4 = good, and 5 = excellent image quality). Each reader selected the preferred image set between FTC and ATCM low dose techniques for each participant. The image noise of the liver and the aorta in both techniques was measured. The volume CT dose index (CTDIvol) of both techniques was compared. RESULTS: The mean satisfaction scores (SD) for FTC and ATCM low dose CT were 4.38 (0.66) and 4.38 (0.64), respectively with the ranges of 3 to 5 in both techniques, which were all acceptable for CT interpretation. The preferred image set between FTC and ATCM low dose techniques of each participant randomly selected by each reader were varied, depending on the readers’ opinions. The mean image noise of the aorta on FTC and ATCM low dose CT accounted for 34.75 and 36.46, respectively, while the mean image noise of the liver was 28.86 and 29.81, respectively. The mean CTDIvol (SD) of FTC and ATCM low dose CT were 8.42 (0.32) and 8.12 (0.43) mGy, respectively.   CONCLUSION: FTC and ATCM low dose abdominal CT provided comparable acceptable image quality and showed no clinical significance in radiation dose optimization.


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