Analysis and results from a UK national dose audit of paediatric CT examinations

2021 ◽  
Author(s):  
Mark Worrall ◽  
Mike Holubinka ◽  
Glafkos Havariyoun ◽  
Kirsten Hodgson ◽  
Sue Edyvean ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Patient Dose ◽  
Radiological Protection ◽  
Tube Current ◽  
National Patient ◽  
Ct Head ◽  
The Uk ◽  
First Time ◽  
Pro Forma ◽  
Selection Of

Objectives: To present the results following a UK national patient dose audit of paediatric CT examinations, to propose updated UK national diagnostic reference levels (DRLs) and to analyse current practice to see if any recommendations can be made to assist with optimisation. Methods: A UK national dose audit was undertaken in 2019 focussing on paediatric CT examinations of the head, chest, abdomen/pelvis and cervical spine using the methods proposed by the International Commission on Radiological Protection. The audit pro-forma contained mandatory fields, of which the post-examination dosimetry (CTDIvol and DLP) and the patient weight (for body examinations) were the most important. Results: Analysis of the data submitted indicates that it is appropriate to propose national DRLs for CT head examinations in the 0- < 1, 1- < 5, 5- < 10 and 10- < 15 year age ranges. This extends the number of age categories of national DRLs from those at present and revises the existing values downwards. For CT chest examinations, it is appropriate to propose national DRLs for the first time in the UK for the 5- < 15, 15- < 30, 30- < 50 and 50- < 80 kg weight ranges. There were insufficient data received to propose national DRLs for abdomen/pelvis or cervical spine examinations. Recommendations towards optimisation focus on the use of tube current (mA) modulation, iterative reconstruction and the selection of examination tube voltage (kVp). Conclusions: Updated UK national DRLs are proposed for paediatric CT examinations of the head and chest. Advances in knowledge: A national patient dose audit of paediatric CT examinations has led to the proposal of updated national DRLs.

scholarly journals Fourth review of the UK national patient dose database

2012 ◽  
Vol 85 (1018) ◽  
pp. e957-e958 ◽  
Author(s):  
D Hart ◽  
P C Shrimpton
Keyword(s):  
Patient Dose ◽  
National Patient ◽  
The Uk

scholarly journals Doses from cervical spine computed tomography (CT) examinations in the UK

2018 ◽  
Vol 91 (1085) ◽  
pp. 20170834 ◽  
Author(s):  
John R Holroyd ◽  
Sue Edyvean
Keyword(s):  
Cervical Spine ◽  
Mean Value ◽  
Patient Dose ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Ct Dose ◽  
Spine Ct ◽  
Ct Dose Index ◽  
The Uk ◽  
Dose Index

Objective: To review doses to patients undergoing cervical spine CT examinations in the UK. Methods: A data collection form was developed and distributed to medical physicists and radiographers via e-mail distribution lists. The form requested details of CT scanners, exposure protocols and patient dose index information. Results: Data were received for 73 scanners. It was seen that 97% of scanners used automatic exposure control, and 60% of scanners used an iterative reconstruction technique for cervical spine examinations. The majority of scans were taken at 120 kV. The average patient dose indicators in terms of CT dose index (CTDIvol) ranged from 3.5 to 39.7 mGy (mean value 16.7 mGy), and for the DLP, ranged from 87 to 1030 mGy cm (mean value 379 mGy cm) as quoted for the standard 32 cm phantom. Conclusion: The rounded third quartile value of the mean dose distributions from this study were a CT dose index (CTDIvol) of 20 mGy and a dose–length product of 440 mGy cm as quoted for a 32 cm body phantom. These are significantly higher than those in the 2011 Public Health England CT dose survey when adjusted for phantom size. It is suggested that the existing national diagnostic reference levels for cervical spine CT should be amended, both with the new values and also to quote according to the 32 cm phantom. Advances in knowledge: Proposed new national diagnostic reference levels are presented for cervical spine CT examinations.

ESTIMATES OF PATIENT DOSES AND KERMA-AREA PRODUCT MONITORING IN DIGITAL RADIOGRAPHY

2020 ◽  
Vol 190 (1) ◽  
pp. 22-30
Author(s):  
Chanchal Kaushik ◽  
Inderjeet Singh Sandhu ◽  
A K Srivastava
Keyword(s):  
Cervical Spine ◽  
Lumbar Spine ◽  
Radiological Protection ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Energy Agency ◽  
Pka Values ◽  
The Third ◽  
Area Product ◽  
The Uk

Abstract The application of the kerma-area product (PKA) meter is increased rapidly in dosimetry. This study presents measurements of PKA in adherence to the International Atomic Energy Agency protocol for 300 adult patients in digital radiographic procedures. Effective doses (ED) were calculated from PKA measurements and conversion coefficients (E-103/PKA) obtained from the International Commission on radiological protection 103. In skull posteroanterior (PA), skull lateral (LAT), cervical spine anteroposterior (AP), cervical spine LAT, chest PA, abdomen AP, lumbar spine AP, pelvis AP and lumbar spine LAT, the third-quartile PKA values were found to be 0.2, 0.28, 0.33, 0.19, 0.26, 0.95, 0.93, 0.96 and 3.15 Gycm2, and estimated mean EDs were 0.005, 0.008, 0.056, 0.021, 0.037, 0.146, 0.165, 0.097 and 0.258 mSv, respectively. The third-quartile PKA values were suggested as local diagnostic reference levels (LDRLs). Results were compared with the diagnostic reference levels (DRLs) of the UK, the European Commission, previously published LDRLs in Greece and China by Metaxas et al. and Zhang and Chu, respectively. The PKA (third-quartile) value for cervical spine AP was 120% higher than UK 2010 DRLs, lumbar spine LAT was 123% higher than LDRLs given by Metaxas et al. and chest PA was 160% higher than UK 2010 DRLs and 225% higher than Metaxas et al. provided LDRLs. The PKA results were lower than the UK, and two studies in Greece by Metaxas et al. except for chest PA, cervical spine AP and lumbar spine LAT showed the need for further optimization. The LDRLs reported in this study may further contribute to establishing future national DRLs.

The UK National Patient Dose Database: now and in the future

2003 ◽  
Vol 76 (906) ◽  
pp. 361-365 ◽  
Author(s):  
D Hart ◽  
B F Wall
Keyword(s):  
Patient Dose ◽  
The Future ◽  
National Patient ◽  
The Uk

Radiation Minimisation and Outcome Maximisation in Cardiac Computed Tomograpy

2010 ◽  
Vol 6 (1) ◽  
pp. 15
Author(s):  
James P Earls ◽  
Jonathon A Leipsic ◽  
◽  
Keyword(s):  
Radiation Dose ◽  
Dose Reduction ◽  
New Technologies ◽  
Cardiac Computed Tomography ◽  
Substantial Reduction ◽  
Radiation Doses ◽  
Tube Current ◽  
Prospective Triggering ◽  
Effective Radiation ◽  
Selection Of

Recent reports have raised general awareness that cardiac computed tomography (CT) has the potential for relatively high effective radiation doses. While the actual amount of risk this poses to the patient is controversial, the increasing concern has led to a great deal of research on new CT techniques capable of imaging the heart at substantially lower radiation doses than was available only a few years ago. Methods of dose reduction include optimised selection of user-defined parameters, such as tube current and voltage, as well as use of new technologies, such as prospective triggering and iterative reconstruction. These techniques have each been shown to lead to substantial reduction in radiation dose without loss of diagnostic accuracy. This article will review the most frequently used and widely available methods for radiation dose reduction in cardiac CT and give practical advice on their use and limitations.

Competition of Verb Aspects and Its Resolution as a Creative Act (Based on the Material of Aspects Variants in the Texts by F. M. Dostoevsky)

2020 ◽  
Vol 81 (2) ◽  
pp. 56-63
Author(s):  
S. A. Karpukhin
Keyword(s):  
Traditional Method ◽  
Contextual Analysis ◽  
Verb Aspect ◽  
Component Theory ◽  
Two Component ◽  
Artistic Interpretation ◽  
New Perspective ◽  
First Time ◽  
Selection Of ◽  
Aspectual Meaning

The article considers the competition of verbal aspects from a new perspective. Instead of employing the traditional method of demonstrating this phenomenon — an empirical replacement of the aspect of a verb in a phrase with the opposite — the author examines Dostoevsky’s choice between the variants found in different manuscripts of the same text. For the first time, based on a two-component theory of the semantic invariant of a verb type, the aspectual meaning of the selection of a verb aspect is revealed and, as a result of contextual analysis, an artistic interpretation of the selected type is proposed.

Peculiarities of the juvenile period of the native Chechen genotypes of willow leaf pear (Pyrus salicifolia Pall.)

2020 ◽  
Vol 62 ◽  
pp. 32-38
Author(s):  
E. A. Dolmatov ◽  
R. B. Borzayev ◽  
A. N. Shaipov
Keyword(s):  
Chestnut Soil ◽  
Crop Breeding ◽  
Juvenile Period ◽  
Period 2 ◽  
Russian Research Institute ◽  
The Common ◽  
One Year ◽  
First Time ◽  
Selection Of ◽  
Creative Cooperation

The results of the study of the duration of the juvenile period of indigenous Chechen willow leaf pear genotypes (Pyrus salicifolia Pall.) are given in connection with the acceleration of the breeding process and the use of selected forms in pear breeding for high precocity. The studies were carried out in 2016-2019 at OOO “Orchards of Chechnya” in accordance with the Agreement on creative cooperation with the Russian Research Institute of Fruit Crop Breeding. The work was carried out in accordance with generally accepted programs and methods. The objects of the study were one-year and two-year-old pear seedlings obtained from sowing seeds of selected dwarf and low-growing local Chechen forms of willow pear (P. salicifolia Pall.), laying fruit buds on annual growths and seedlings of Caucasian pear (P. caucasica Fed.), 20 500 pcs. of each specie. The aim of the research was to study the potential of precocity of willow pear seedlings and to reveal of selected forms with the greatest degree of this trait. Stratified seeds were sown in the sowing department of the OOO “Orchards of Chechnya” production nursery in April, 2017. The seedlings were grown according to the common technology in dryland conditions on the plot with chestnut soil. The first fl owering of plants was noted in the spring, 2019. As a result of the research, for the first time on a large number of the experimental material it was found that in the off spring of the indigenous Chechen willow leaf pear genotypes, the selection of a little more than 2% of seedlings with a very short juvenile period (2 years) was possible. They are of great interest in accelerating the breeding process and in the selection of new pear varieties with high precocity. 20 willow leaf pear genotypes were selected for the further use in breeding for high precocity and as sources of the trait of short juvenile period.

A Court of Specialists

2020 ◽  
Author(s):  
Chris Hanretty
Keyword(s):  
Family Law ◽  
Public Law ◽  
Tax Law ◽  
Decision Making Process ◽  
Main Argument ◽  
Political Differences ◽  
Uk Supreme Court ◽  
The Uk ◽  
Initial Selection ◽  
Selection Of

This book explains how judges on the UK Supreme Court behave. It looks at different stages in the court's decision-making process—from the initial selection of cases, to the choice of judges to sit on panels, to the final outcome. The main argument of the book is that judges' behavior is strongly affected by their specialism in different areas of law. Cases in tax law (or family law, or public law) are more likely to be heard by specialists in that area, and those specialists are more likely to write the court's decision—or disagree with the decision when there is dissent. Legal factors like specialization in areas of law explains more of the court's work than do political differences between judges.

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