scholarly journals Application of 70kVp in abdominal CT angiography to reduce both radiation and contrast dosage and improve patient comfort for children

2020 ◽  
Author(s):  
Jihang Sun ◽  
Haoyan Li ◽  
Lixin Yang ◽  
Jianying Li ◽  
Zuofu Zhou ◽  
...  

Abstract Objective To evaluate the application of 70kVp in pediatric abdominal CT angiography (CTA) to reduce radiation and contrast dose and improve patient comfort. Methods Forty-six children needing abdominal CTA were enrolled in the study group using low-dose scanning protocol with 70kVp and 0.7-1.1ml/kg contrast dose, and reconstructed with 50%ASIR-V. They were compared with another 46 children (control group) with matching body weight who underwent conventional CT scans with 100kVp, 1.2-1.8ml/kg contrast dose and reconstructed using 50%ASIR. The image quality of large vessels was evaluated using a 5-point scale, and the number of superior mesenteric artery branches identifiable by CAD was recorded. The CT value and standard deviation of descending aorta (Ao) was measured, and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) calculated. Radiation dose, contrast dose, the maximum injection pressure, correlation between flow rate and injection pressure were compared between the two groups. Results The score for displaying large vessels by 70kVp images was 3.91±0.28, and up to 3 superior mesenteric artery branches could be identified, all of which met the diagnostic requirements. The CT value of Ao was 390.87±86.79HU in the study group, higher than 343.93±49.94HU in the control group, while no difference in SNR and CNR between the two groups; the radiation dose, contrast dosage and injection pressure of the study group were 1.23±0.39mGy, 12.67±7.27ml and 43.83±17.16psi respectively, significantly lower than the 1.95±0.37mGy, 22.67±7.39ml, and 77.59±19.68psi of the control group. The correlation coefficients between flow rate and injection pressure were 0.82 and 0.86 in 70kVp group and 100kVp group. Conclusion 70kVp scanning meets the diagnostic requirements in pediatric abdominal CTA while providing significant radiation dose, contrast dose and injection pressure reduction.

Author(s):  
Jihang Sun ◽  
Haoyan Li ◽  
Lixin Yang ◽  
Zuofu Zhou ◽  
Michelle Li ◽  
...  

BACKGROUND: Low-tube voltage scanning improves CT attenuation value of contrast medium (CM). Thus, we hypothesized that 70 kVp in pediatric abdominal CT angiography (CTA) could be used to reduce both radiation and CM dose and improve patient comfort at the same time. OBJECTIVE: To evaluate the feasibility of using 70 kVp in pediatric abdominal CTA to reduce radiation dose and CM dose and improve patient care for children. MATERIALS AND METHODS: Forty-six children needing abdominal CTA were enrolled in the study group using low-dose scanning protocol with 70 kVp and 0.7–1.1 ml/kg contrast dose, and reconstructed with 50%ASIR-V. They were compared with other 46 children in control group with matching body weight and underwent conventional CT scans with 100 kVp, 1.2–1.8 ml/kg contrast dose and reconstructed using 50%ASIR. Image quality of large vessels was evaluated using a 5-point scale. CT value and standard deviation of descending aorta (Ao) was measured, and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Radiation dose, contrast dose, the maximum injection pressure between the two groups were also compared. RESULTS: Score for displaying large vessels by 70 kVp images was 3.91±0.28, lower than that (4.17±0.38) of the control group (p <  0.05), but fully met the diagnostic requirements. CT value of Ao was 390.87±86.79HU in study group, which is higher than 343.93±49.94HU in control group, while there was no difference in SNR and CNR between two groups; the radiation dose, contrast dosage and injection pressure of the study group were 1.23±0.39mGy, 12.67±7.27 ml and 43.83±17.16psi, respectively, which are significantly lower than the 1.95±0.37mGy, 22.67±7.39 ml, and 77.59±19.68psi of control group. CONCLUSION: Use of 70 kVp in pediatric abdominal CTA provides diagnostic quality images while significantly reduce radiation and contrast dose, as well as injection pressure to improve patient comfort for children.


2021 ◽  
pp. 028418512198995
Author(s):  
Erdal Tekin ◽  
Kutsi Tuncer ◽  
Ibrahim Ozlu ◽  
Recep Sade ◽  
Rustem Berhan Pirimoglu ◽  
...  

Background The use and frequency of computed tomography (CT) are increasing day by day in emergency departments (ED). This increases the amount of radiation exposed. Purpose To evaluate the image quality obtained by ultra-low-dose CT (ULDCT) in patients with suspected wrist fractures in the ED and to investigate whether it is an alternative to standard-dose CT (SDCT). Material and Methods This is a study prospectively examining 336 patients who consulted the ED for wrist trauma. After exclusion criteria were applied, the patients were divided into the study and control groups. Then, SDCT (120 kVp and 100 mAs) and ULDCT (80 kVp and 5 mAs) wrist protocols were applied simultaneously. The images obtained were evaluated for image quality and fracture independently by a radiologist and an emergency medical specialist using a 5-point scale. Results The effective radiation dose calculated for the control group scans was 41.1 ± 2.1 µSv, whereas the effective radiation dose calculated for the study group scans was 0.5 ± 0.0 µSv. The effective radiation dose of the study group was significantly lower than that of the control group ( P < 0.01). The CT images in the study group showed no significant differences in the mean image quality score between observer 1 and observer 2 (3.4 and 4.3, respectively; P = 0.58). Both observers could detect all fractures using the ULDCT images. Conclusion ULDCT provides high-quality images in wrist traumas while reducing the radiation dose by approximately 98% compared to SDCT without any changes in diagnostic accuracy.


Author(s):  
Peoli Mukutawat ◽  
Vivek Kaushal ◽  
Rakesh Dhankhar ◽  
Rajeev Atri ◽  
Anil Kumar Dhull ◽  
...  

Introduction: Head and neck cancers include malignant neoplasms that develop in the oral cavity, nasal cavity, paranasal sinuses, pharynx, larynx and salivary glands. Out of the newly diagnosed patients of head and neck carcinoma in India, most of the patients present in locally advanced stage. Because of extensive local disease and associated co-morbidities and compromised KPS, palliative radiation therapy is preferred treatment for these patients. Material and methods: The study was conducted on 60 previously untreated, histo-pathologically proven patients of locally advanced head and neck cancer who were randomized in two equal groups by draw of lots. Study group received radiation dose of 30 Gy/ 10 fractions / 2 weeks followed by repeat dose of 30 Gy/ 10 fractions / 2 weeks (Total dose 60 Gy in 20 fractions delivered with a gap of 4 weeks). Control group received radiation dose of 20 Gy/ 5 fractions/ 5 days followed by repeat dose of 20 Gy/ 5 fractions/ 5 days followed by repeat dose of 20 Gy/ 5 fractions/ 5 days (Total dose 60 Gy in 3 sessions with a gap of 3 weeks each). Objectives were to compare efficacy of above schedules based on symptomatic relief and overall tumor response and to compare the toxicities of the above schedules. Results and Conclusion: To expedite the treatment time in tertiary care centres, control group (20 Gy / 5 fractions / 1 week; 3 weekly X 3) was better than the study group (30 Gy / 10 fractions / 2 weeks; 4 weekly X 2) as it had comparable local control and toxicity (acute mucosal reactions being slightly higher in the study group) with the added advantage of only 15 total fractions (machine days) in control group rather than 20 total fractions (machine days) in study group. This reduced the patient visits to the hospital by one week (i.e. 5 fractions) with comparable local control and toxicity.


2019 ◽  
Author(s):  
Jihang Sun ◽  
Lixin Yang ◽  
Zuofu Zhou ◽  
Dan Zhang ◽  
Wei Han ◽  
...  

Abstract Background The adverse effect of low-dose CT on image quality may be mitigated using iterative reconstructions. The purpose of this study was to evaluate the performance of the full model-based iterative reconstruction (MBIR) and adaptive statistical reconstruction (ASIR) algorithms in low radiation dose and low contrast dose abdominal contrast-enhanced CT (CECT) in children. Methods A total of 59 children (32 males and 27 females) undergoing low radiation dose (100kVp) and low contrast dose (270 mgI/ml) abdominal CECT were enrolled. The median age was 4.0 years (ranging from 0.3 to 13 years). The raw data were reconstructed with MBIR, ASIR and filtered back projection (FBP) algorithms into 6 groups (MBIR, 100%ASIR, 80%ASIR, 60%ASIR, 40%ASIR and FBP). The CT numbers, standard deviations, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of liver, pancreas, kidney and abdominal aorta were measured. Two radiologists independently evaluated the subjective image quality including the overall image noise and structure display ability on a 4-point scale with 3 being clinically acceptable. The measurements among the reconstruction groups were compared using one-way ANOVA. Results The overall image noise score and display ability were 4.00±0.00 and 4.00±0.00 with MBIR, and 3.27±0.33 and 3.25±0.43 with ASIR100%, respectively, which met the diagnostic requirement; other reconstructions couldn’t meet the diagnostic requirements. Compared with FBP images, the noise of MBIR images was reduced by 62.86%-65.73% for the respective organs (F=48.15-80.47, P<0.05), and CNR increased by 151.38%-170.69% (F=22.94-38.02, P<0.05). Conclusions MBIR or ASIR100% improves the image quality of low radiation dose and contrast dose abdominal CT in children to meet the diagnostic requirements, and MBIR has the best performance.


2013 ◽  
Vol 200 (2) ◽  
pp. 383-388 ◽  
Author(s):  
Tobias Fält ◽  
Marcus Söderberg ◽  
Lisa Hörberg ◽  
Ingela Carlgren ◽  
Peter Leander

2015 ◽  
Vol 18 (4) ◽  
pp. 171 ◽  
Author(s):  
Tolga Demir ◽  
Mehmet Umit Ergenoglu ◽  
Hale Bolgi Demir ◽  
Nursen Tanrikulu ◽  
Mazlum Sahin ◽  
...  

<strong>Background</strong>: This study was undertaken to determine whether methylprednisolone could improve myocardial protection by altering the cytokine profile toward an anti-inflammatory course in patients undergoing elective coronary artery bypass grafting (CABG) surgery with cardiopulmonary bypass (CPB).<br /><strong>Methods</strong>: Forty patients who were scheduled for elective CABG surgery were randomized into two groups: the study group (n = 20), who received 1 g of methylprednisolone intravenously before CPB, and the control group (n = 20), who underwent a standard CABG surgery without any additional medication. Blood samples were withdrawn prior to surgery (T1) and then 4 hours (T2), 24 hours (T3), and 36 hours (T4) after CPB. Plasma levels of interleukin (IL)-6, IL-10, creatine kinase isoenzyme MB (CK-MB), cardiac troponin-t (cTnT), and blood glucose as well as neutrophil counts were measured at each sampling time. <br /><strong>Results</strong>: A comparison of patients between both groups revealed significantly high levels of IL-6 in the control group at T2, T3, and T4 with respect to T1 (T2: P &lt; .001; T3: <br />P &lt; .001; T4: P &lt; .001). IL-10 levels were significantly higher in the study group at T2 compared with the control group <br />(P = .007). CK-MB levels were significantly lower in the study group than in the control group at T4 (P = .001). The increase of cTnT was higher in the control group at T3 and T4 compared with the study group (T3: P = .002; T4: P = .001).<br /><strong>Conclusions</strong>: This study demonstrates that methylprednisolone is effective for ensuring better myocardial protection during cardiac surgery by suppressing the inflammatory response via decreasing the levels of IL-6 and by increasing anti-inflammatory activity through IL-10.<br /><br />


Author(s):  
Tupitsyn V.V. ◽  
Bataev Kh.M. ◽  
Men’shikova A.N. ◽  
Godina Z.N.

Relevance. Information about the cardiovascular diseases risk factors (CVD RF) for in men with chronic lung inflam-matory pathology (CLID) is contradictory and requires clarification. Aim. To evaluate the peculiarities of CVD RF in men under 60 years of age with CLID in myocardial infarction (MI) to improve prevention. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with CLID - 142 patients; II - control, without it - 424 patients. A comparative analysis of the frequency of observation of the main and additional cardiovascular risk fac-tors in groups was performed. Results. In patients of the study group, more often than in the control group we observed: hereditary burden of is-chemic heart disease (40.8 and 31.6%, respectively; p = 0.0461) and arterial hypertension (54.2 and 44.6%; p = 0.0461), frequent colds (24.6 and 12.0%; p = 0.0003), a history of extrasystoles (19.7 and 12.7%; p = 0.04); chronic foci of infections of internal organs (75.4 and 29.5%; p˂0.0001), non-ulcer lesions of the digestive system (26.1 and 14.6%; p = 0.007), smoking (95.1 and 66.3%; p˂0.0001), MI in winter (40.8 and 25.9%; p = 0.006). Less commonly were observed: oral cavity infections (9.2 and 23.6%; p˂0.0001); hypodynamia (74.5 and 82.5%; p = 0.0358), over-weight (44.4 and 55.2%; p = 0.0136), a subjective relationship between the worsening of the course of coronary heart disease and the season of the year (43.7 and 55.2%; p = 0.0173) and MI - in the autumn (14.1 and 21.9%; p = 0.006) period. Conclusions. The structure of CVD RF in men under 60 years of age with CLID with MI is characterized by the pre-dominance of smoking, non-ulcer pathology of the digestive system, frequent pro-student diseases, meteorological dependence, a history of cardiac arrhythmias and foci of internal organ infections. It is advisable to use the listed factors when planning preventive measures in such patients.


2018 ◽  
Vol 20 (2) ◽  
pp. 123-132
Author(s):  
Dae-hyun Park ◽  
Young-Kyoon Kim ◽  
Jong-Ho Ahn ◽  
Kwang-Hyun Chang ◽  
Yoon-Chul Nam ◽  
...  

2014 ◽  
pp. 206-215
Author(s):  
Huu Tham Nguyen ◽  
Thi Tan Nguyen

Objectives: To investigate clinical characteristics of patients with sciatica in Traditional Medicine Hospital in Thua Thien Hue province; To evaluate the effectiveness of the catgut-embedding method combining with herbal medicine on the treatment of sciatica by wind-cold-damp arthralgia. Subjects and Methods: Patients diagnosed with sciatica by wind-cold-damp arthralgia in-patient treatment in Traditional Medicine Hospital in Thua Thien Hue province. Methods: Clinical and controlled trials, a survey of 72 patients, which were divided into 2 groups: The study group: 36 patients: receiving treatment by catgut-embedding and herbal medicine; The control group: 36 patients: only use herbal medicine. 28-day treatment period. Patients were assessed at admission (T0), after 14 days (T14), after 28 days of treatment (T28). Results: After 28 days of treatment: no severity both 2 groups. The study group fell to 8.3% moderate pain, mostly mild pain (91.7%); the control group was 44.4% moderate pain, mild 55.6%.The catgut-embedding method does not cause any side effects. Key words: catgut-embedding method, sciatica by wind-cold-damp arthralgia


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