scholarly journals Differences in radiation dose for computed tomography of the brain among pediatric patients at the emergency departments: an observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xi Min Tan ◽  
Mohammad Taufik Bin Mohamed Shah ◽  
Shu-Ling Chong ◽  
Yong-Kwang Gene Ong ◽  
Peck Har Ang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Effective Dose ◽  
Emergency Departments ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Radiological Protection ◽  
Radiation Doses ◽  
Reference Levels ◽  
Ct Brain ◽  
Risk Of Cancer

Abstract Background Computed tomography (CT) is associated with a risk of cancer development. Strategies to reduce radiation doses vary between centers. We compared radiation doses of CT brain studies between pediatric and general emergency departments (EDs), and determine the proportion studies performed within the reference levels recommended by the International Commission on Radiological Protection (ICRP). Methods A retrospective review was carried out in a healthcare network consisting of one pediatric ED and three general hospital EDs. Pediatric patients less than 16 years old with CT brain studies performed between 1 January 2015 and 31 December 2018 were included. Information on demographic, diagnosis, volume-averaged computed-tomography dose index and dose length product (DLP) were collected. Effective dose was then calculated from DLP using conversion factors, termed k-coefficients which were derived using a 16 cm head CT dose phantom. Results Four hundred and seventy-nine CT brain studies were performed – 379 (79.1%) at the pediatric ED. Seizure (149, 31.1%), head injury (147, 30.7%) and altered mental status (44, 9.2%) were the top three ED diagnoses. The median effective dose estimates were higher in general than pediatric EDs, particularly for those aged > 3 to ≤6 years old [1.57 mSv (IQR 1.42–1.79) versus 1.93 mSv (IQR 1.51–2.28), p = 0.047], > 6 to ≤10 years old [1.43 mSv (IQR 1.27–1.67) versus 1.94 mSv (IQR 1.61–2.59), p = 0.002) and > 10 years old (1.68 mSv (IQR 1.32–1.72) versus 2.03 mSv (IQR 1.58–2.88), p < 0.001). Overall, 233 (48.6%) and 13 (2.7%) studies were within the reference levels recommended by ICRP 60 and 103 respectively. Conclusions Radiation doses for CT brain studies were significantly higher at general EDs and less than half of the studies were within the reference levels recommended by ICRP. The development of diagnostic reference levels (DRLs) as a benchmark and clinical justification for performing CT studies can help reduce the radiation risks in the pediatric population.

Establishing local diagnostic reference levels for adult computed tomography in Morocco

2022 ◽  
Author(s):  
M. El Mansouri ◽  
M. Talbi ◽  
A. Choukri ◽  
O. Nhila ◽  
M. Aabid
Keyword(s):  
Computed Tomography ◽  
Adult Patients ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Length Product ◽  
Head Ct ◽  
Ct Examination ◽  
Japanese Studies ◽  
The Uk

In Morocco, the radiation doses received by adult patients are increasing due to the number of CT examinations performed and the larger number of computed tomography (CT) scanners installed. The aim of this study was to evaluate the radiation doses received by patients for the most common adult CT examinations in order to establish local diagnostic reference levels (DRLs). Data from 1016 adult patients were collected during 3 months from four Moroccan hospitals. Dose length product (DLP) and volumetric computed tomography dose index (CTDIvol) were evaluated by determining the 75th percentile as diagnostic reference levels for the most common examinations including head, chest and abdomen. The DRL for each examination was compared with other studies. The established DRLs in Morocco in terms of CTDIvol were 57.4, 12.3 and 10.9 for CT examinations of the head, chest, abdomen, respectively. For DLP, they were 1020, 632 and 714, respectively. These established DRLs for CTDIvol were almost similar to the UK DRLs at all examinations, higher than the Egyptian DRLs and lower than the Japanese DRLs at the head CT examination, lower than the DRLs from Egypt and Japan at the CT abdomen examination. In terms of DLP, the DRLs were higher than those of the British studies, lower than those of the Egyptian and Japanese studies at the head CT examination were higher at chest CT and lower at abdominal CT than those of all selected studies. The higher level of established DRLs in our study demonstrates the requirement of an optimization process while keeping a good image quality for a reliable diagnosis.

Comparison of Radiation Dose in CT Examinations At PIMS with European Commission Reference Doses

2021 ◽  
Vol 17 (3) ◽  
pp. 216-221
Author(s):  
Fawad Yasin ◽  
Anum Rasheed ◽  
Muhammad Nauman Malik ◽  
Farheen Raza ◽  
Ramish Riaz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
European Commission ◽  
Large Scale ◽  
Radiology Department ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Length Product ◽  
Ct Dose

OBJECTIVE - The purpose of this study was to assess the radiation dose levels from common computed tomography (CT) examinations performed in Radiology Department of Pakistan Institute of Medical Sciences (PIMS), and evaluate these according to diagnostic reference levels (DRLs) proposed by European Commission (EC) guidelines, and thus contributing towards the establishment of local and national DRLs. To the best of our knowledge, this is the first study of its kind to explore radiation doses from CT examinations in Pakistan. STUDY DESIGN - This was a quantitative study conducted at PIMS, Islamabad, spanning a duration of eight weeks. Scan parameters and dose profile data of 1506 adults undergoing examinations of head, neck, chest and abdomen-pelvis regions, comprising of single- and multi-phase, contrast-enhanced and unenhanced studies. Dose indicators utilized by EC guidelines for DRLs include volume CT dose index (CTDIvol) and Dose Length Product (DLP) for single slice and complete examination radiation doses, respectively. METHOD - Values of CTDIvol, DLP and scan lengths were extracted from the CT operators console. Other control variables included gender, contrast enhancement and phasicity of study. IBM SPSS package was used to obtain descriptive statistics such as mean and quartiles. RESULTS - DRLs calculated as 75th percentile of CTDIvol, DLP for various anatomical regions are by and far comparable to European DRLs. CONCLUSION – This study describes institutional diagnostic reference levels for common CT exams in Islamabad and provides benchmark values for future reference. Our DRL values are mostly comparable to European and international DRLs. Similar, albeit large scale, surveys are recommended for establishment of local and national DRLs, eventually contributing towards development of regional DRLs. KEYWORDS: CTDIvol, DLP, Diagnostic Reference Levels, Computed Tomography, Radiation Monitoring, Scan length

scholarly journals International variation in radiation dose for computed tomography examinations: prospective cohort study

BMJ ◽  
2019 ◽  
pp. k4931 ◽  
Author(s):  
Rebecca Smith-Bindman ◽  
Yifei Wang ◽  
Philip Chu ◽  
Robert Chung ◽  
Andrew J Einstein ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cohort Study ◽  
Effective Dose ◽  
Patient Characteristics ◽  
High Dose ◽  
Radiation Doses ◽  
Head Ct ◽  
Technical Parameters ◽  
Abdomen Ct ◽  
Type Of Institution

Abstract Objective To determine patient, institution, and machine characteristics that contribute to variation in radiation doses used for computed tomography (CT). Design Prospective cohort study. Setting Data were assembled and analyzed from the University of California San Francisco CT International Dose Registry. Participants Standardized data from over 2.0 million CT examinations of adults who underwent CT between November 2015 and August 2017 from 151 institutions, across seven countries (Switzerland, Netherlands, Germany, United Kingdom, United States, Israel, and Japan). Main outcome measures Mean effective doses and proportions of high dose examinations for abdomen, chest, combined chest and abdomen, and head CT were determined by patient characteristics (sex, age, and size), type of institution (trauma center, care provision 24 hours per day and seven days per week, academic, private), institutional practice volume, machine factors (manufacturer, model), country, and how scanners were used, before and after adjustment for patient characteristics, using hierarchical linear and logistic regression. High dose examinations were defined as CT scans with doses above the 75th percentile defined during a baseline period. Results The mean effective dose and proportion of high dose examinations varied substantially across institutions. The doses varied modestly (10-30%) by type of institution and machine characteristics after adjusting for patient characteristics. By contrast, even after adjusting for patient characteristics, wide variations in radiation doses across countries persisted, with a fourfold range in mean effective dose for abdomen CT examinations (7.0-25.7 mSv) and a 17-fold range in proportion of high dose examinations (4-69%). Similar variation across countries was observed for chest (mean effective dose 1.7-6.4 mSv, proportion of high dose examinations 1-26%) and combined chest and abdomen CT (10.0-37.9 mSv, 2-78%). Doses for head CT varied less (1.4-1.9 mSv, 8-27%). In multivariable models, the dose variation across countries was primarily attributable to institutional decisions regarding technical parameters (that is, how the scanners were used). Conclusions CT protocols and radiation doses vary greatly across countries and are primarily attributable to local choices regarding technical parameters, rather than patient, institution, or machine characteristics. These findings suggest that the optimization of doses to a consistent standard should be possible. Study registration Clinicaltrials.gov NCT03000751 .

ADULT CT EXAMINATIONS IN ALGERIA: TOWARDS UPDATING NATIONAL DIAGNOSTIC REFERENCE LEVELS

2020 ◽  
Vol 190 (4) ◽  
pp. 364-371
Author(s):  
Nadia Khelassi-Toutaoui ◽  
Ahmed Merad ◽  
Virginia Tsapaki ◽  
Fouzia Meddad ◽  
Zakia Sakhri-Brahimi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Length Product ◽  
Institutional Evaluation ◽  
Starting Point ◽  
First Results ◽  
Ct Radiation ◽  
Computed Tomography Dose Index

Abstract A pilot study has concerned the most frequent computed tomography examinations (CT). This represents the first results based on actual survey for diagnostic reference levels (DRLs) establishment in Algeria. A total number of 2540 patients underwent this survey that has included the recording of CT parameters, computed tomography dose index (CTDIvol) and dose-length product of the head, thorax, abdomen, abdomen–pelvis (AP), lumbar spine (LS) and thorax–abdomen–pelvis (TAP) performed on standard patients. The proposed DRLs are 71 mGy/1282 mGy.cm for head, 16 mGy/555 mGy.cm for thorax, 18 mGy/671 mGy.cm for abdomen, 21 mGy/950 mGy.cm for AP, 36 mGy/957 mGy.cm for LS and 18 mGy/994 mGy.cm for TAP. The rounded 75th percentile seems to be higher in some examinations compared to the literature. Our findings confirm the need to optimise our practice. These results provide a starting point for institutional evaluation of CT radiation doses.

scholarly journals Assessment of Organ and Effective Doses Received by Paediatric Patients Undergoing Computed Tomography Examinations in Three Hospitals in Brazzaville, Congo Republic: An Urgent Necessity for Regulatory Control

2021 ◽  
pp. 527-550
Author(s):  
J. Bazoma ◽  
G. B. Dallou ◽  
P. Ondo Meye ◽  
C. Bouka Biona ◽  
Saïdou ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Effective Dose ◽  
Absorbed Dose ◽  
Regulatory Control ◽  
Ct Scans ◽  
Radiological Protection ◽  
Age Group ◽  
Organ Doses ◽  
Paediatric Patients ◽  
Effective Doses

The present study aimed at estimating organ and effective doses from computed tomography (CT) scans of paediatric patients in three hospitals in Brazzaville, Congo Republic. A total of 136 data on paediatric patients, from 0.25 (3 months) to 15 years old, who underwent head, chest, abdomen – pelvis (AP) and chest – abdomen – pelvis (CAP) CT scans was considered. The approach followed in the present study to compute organ doses was to use pre-calculated volume CT dose index (CTDIvol) – and 100 milliampere-second (mAs) – normalized organ doses determined by Monte Carlo (MC) simulation. Effective dose were then derived using the international commission on radiological protection (ICRP) publications 60 and 103 formalism. For comparison purposes, effective dose were also computed using dose-length product (DLP) – to – effective dose conversion factors. A relatively high variation in organ and effective doses was observed in each age group due to the dependence of patient dose on the practice of technicians who perform the CT scan within the same facility or from one facility to another, patient size and lack of adequate training of technicians. In the particular case of head scan, the brain and the eye lens were delivered maximum absorbed doses of 991.81 mGy and 1176.51 mGy, respectively (age group 10-15 y). The maximum absorbed dose determined for the red bone marrow was 246.08 mGy (age group 1-5 y). This is of concern as leukaemia and brain tumours are the most common childhood cancers and as the ICRP recommended absorbed dose threshold for induction of cataract is largely exceeded. Effective doses derived from MC calculations and ICRP publications 60 and 103 tissues weighting factors showed a 0.40-17.61 % difference while the difference between effective doses derived by the use of k- factors and those obtained by MC calculations ranges from 0.06 to 224.87 %. The study has shown that urgent steps should be taken in order to significantly reduce doses to paediatric patients to levels observed in countries where dose reduction techniques are successfully applied.

EFFECTIVE DOSE VARIATION IN PEDIATRIC COMPUTED TOMOGRAPHY: DOSE REFERENCE LEVELS IN GREECE

2009 ◽  
Vol 97 (6) ◽  
pp. 595-603 ◽  
Author(s):  
E Yakoumakis ◽  
M Karlatira ◽  
G Gialousis ◽  
A Dimitriadis ◽  
T Makri ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Effective Dose ◽  
Reference Levels ◽  
Dose Variation

scholarly journals Digital orthodontic radiographic set versus cone-beam computed tomography: an evaluation of the effective dose

2016 ◽  
Vol 21 (4) ◽  
pp. 66-72 ◽  
Author(s):  
Lillian Atsumi Simabuguro Chinem ◽  
Beatriz de Souza Vilella ◽  
Cláudia Lúcia de Pinho Maurício ◽  
Lucia Viviana Canevaro ◽  
Luiz Fernando Deluiz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
New York ◽  
Effective Dose ◽  
Cone Beam Computed Tomography ◽  
Cone Beam ◽  
Radiological Protection ◽  
Anthropomorphic Phantom ◽  
Thermoluminescent Dosimeters ◽  
Optimization Principle ◽  
Effective Doses

ABSTRACT Objective: The aim of this study was to compare the equivalent and effective doses of different digital radiographic methods (panoramic, lateral cephalometric and periapical) with cone-beam computed tomography (CBCT). Methods: Precalibrated thermoluminescent dosimeters were placed at 24 locations in an anthropomorphic phantom (Alderson Rando Phantom, Alderson Research Laboratories, New York, NY, USA), representing a medium sized adult. The following devices were tested: Heliodent Plus (Sirona Dental Systems, Bernsheim, Germany), Orthophos XG 5 (Sirona Dental Systems, Bernsheim, Germany) and i-CAT (Imaging Sciences International, Hatfield, PA, USA). The equivalent doses and effective doses were calculated considering the recommendations of the International Commission of Radiological Protection (ICRP) issued in 1990 and 2007. Results: Although the effective dose of the radiographic set corresponded to 17.5% (ICRP 1990) and 47.2% (ICRP 2007) of the CBCT dose, the equivalent doses of skin, bone surface and muscle obtained by the radiographic set were higher when compared to CBCT. However, in some areas, the radiation produced by the orthodontic set was higher due to the complete periapical examination. Conclusion: Considering the optimization principle of radiation protection, i-CAT tomography should be used only in specific and justified circumstances. Additionally, following the ALARA principle, single periapical radiographies covering restricted areas are more suitable than the complete periapical examination.

Effective dose from inhaled radon and its progeny

2012 ◽  
Vol 41 (3-4) ◽  
pp. 378-388 ◽  
Author(s):  
J.D. Harrison ◽  
J.W. Marsh
Keyword(s):  
Effective Dose ◽  
Reference Conditions ◽  
International Commission ◽  
Radiological Protection ◽  
Dose Calculations ◽  
Reference Levels ◽  
Weighting Factors ◽  
Preliminary Results ◽  
Recent Statement ◽  
Dose Coefficients

Currently, the International Commission on Radiological Protection (ICRP) uses the dose conversion convention to calculate effective dose per unit exposure to radon and its progeny. In a recent statement, ICRP indicated the intention that, in future, the same approach will be applied to intakes of radon and its progeny as is applied to all other radionuclides, calculating effective dose using reference biokinetic and dosimetric models, and radiation and tissue weighting factors. Effective dose coefficients will be given for reference conditions of exposure. In this paper, preliminary results of dose calculations for Rn-222 progeny are presented and compared with values obtained using the dose conversion convention. Implications for the setting of reference levels are also discussed.

EVALUATION OF IRRADIATION DOSES DELIVERED TO PATIENTS IN COMPUTED TOMOGRAPHY EXAMINATIONS IN 10 RADIOLOGY DEPARTMENTS IN DOUALA-CAMEROON

2020 ◽  
Vol 191 (3) ◽  
pp. 288-295
Author(s):  
Celestin Mpeke Mokubangele ◽  
Alexandre Ngwa Ebongue ◽  
Francisse Ouogue ◽  
Daniel Bongue ◽  
Boniface Moifo
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Pediatric Population ◽  
Adult Population ◽  
Daily Practice ◽  
Ct Scans ◽  
Radiological Protection ◽  
Dose Length Product ◽  
Need To Evaluate ◽  
Adults And Children

Abstract Computed tomography (CT) scan is currently the most irradiating radio diagnostic procedure for the patients. The effective dose delivered by a CT-scan exploration corresponds to 1–20 years of natural irradiation of an individual. Hence, there is need to evaluate this medical exposure, in order to provide indicators and propose guidelines for its daily practice. The purpose of this work was to assess patient exposure levels due to CT-scan exams and propose a local diagnostic reference levels for the most common CT examinations performed in the radiology units of Douala/Cameroon. Data from 1775 CT scans, amongst which 10 different types of common CT examinations on adults and children, were collected, of which 1378 were adult CT scans and 397 were pediatric CT scans. The dose-length product (DLP) values in the adult population for head, abdomen–pelvic and lumber spine CT scans were high as compared to the Institute for Radiological Protection and Nuclear Safety recommendations and previous local DRL with an increase of 36, 15 and 23%, respectively. A general decrease of the DLP for CT-scans examinations in the pediatric population was observed.

SIZE-SPECIFIC DOSE ESTIMATES FOR PEDIATRIC NON-CONTRAST HEAD CT SCANS: A RETROSPECTIVE PATIENT STUDY IN TUNJA, COLOMBIA

2021 ◽  
Author(s):  
W Jaramillo-Garzón ◽  
M A Caballero ◽  
D F Alvarez-Aldana
Keyword(s):  
Computed Tomography ◽  
Pediatric Patients ◽  
Optimization Process ◽  
Ct Scans ◽  
Reference Levels ◽  
Dose Length Product ◽  
Patient Study ◽  
Head Ct ◽  
Pediatric Ct ◽  
Dose Estimate

Abstract This investigation is aimed to study the feasibility of size-specific dose estimate (SSDE) to patient dosimetry in pediatric head CT scans and to establish typical values in a hospital in Tunja, Colombia. The volumetric computed tomography index (CTDIvol) and the dose-length product of 468 pediatric patients from newborn to 15-year-olds, who underwent non-contrast head CT scans, were collected retrospectively. For 186 cases only, SSDE was estimated using patient attenuated-based size metrics and CTDIvol,16-to-SSDE conversion factors reported in AAPM report 293. Results showed that SSDE is an accurate metric that can be used to establish typical dose values from pediatric head CT scans. Median SSDE values of 33.5, 31.6, 36.2 and 57.9 mGy were established as typical dose values for the 0–&lt;3 months, 3 months–&lt;1 y, 1–&lt;6 y and ≥6 y, respectively, to further assist the optimization process at the hospital. Further studies with more robust data of patients and hospitals should be conducted to establish local and national dose reference levels from pediatric CT scans in Colombia.

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