Strategy to reduce radiation exposure in postoperative spinal computed tomography scans

Background: When diagnosing and treating spinal disorders, spine surgeons commonly utilize computed tomography (CT) scans preoperatively, intraoperatively, and postoperatively. Methods: This article reviews the literature regarding the potentially harmful effects of X-rays, specifically from CT scans. Results: The risk for damaging DNA and developing cancer increases with increasing scan length (e.g., increasing amount of radiation received). Conclusion: When assessing postoperative status, CT scans should be directed only through the area of specific interest to limit the total dose of radiation received by the patient.

Download Full-text

Comparison of Sinus X-rays with Computed Tomography Scans in Acute Sinusitis

Academic Emergency Medicine ◽

10.1111/j.1553-2712.1994.tb02437.x ◽

2008 ◽

Vol 1 (3) ◽

pp. 235-239 ◽

Cited By ~ 38

Author(s):

Thomas F. Burke ◽

Andrew T. Guertler ◽

James H. Timmons

Keyword(s):

Computed Tomography ◽

Acute Sinusitis ◽

X Rays ◽

Computed Tomography Scans

Download Full-text

A Comparison of Intra-Observer and Inter-Observer Reliability of Plain Radiographs, Standard Computed Tomography Scans and Mobile Computed Tomography Scans in the Assessment of Distal Radius Fractures: A Cadaveric Study

Journal of Health Science and Medical Research ◽

10.31584/jhsmr.202078 ◽

2019 ◽

pp. 53

Author(s):

Sitthiphong Suwannaphisit ◽

Saowapar Yoykaew ◽

Chitchaya Suwanraksa ◽

Varah Yuenyongviwat ◽

Porames Suwanno ◽

...

Keyword(s):

Computed Tomography ◽

Distal Radius ◽

Distal Radius Fractures ◽

Observer Agreement ◽

Ct Scans ◽

Radius Fractures ◽

Plain Radiographs ◽

Observer Reliability ◽

Computed Tomography Scans ◽

Mobile Ct

Objective: Diagnosis of a distal end radius fracture relies on various imaging studies. However, the relative usefulness of these studies is still a matter of some controversy. The aim of this study was to compare the intra-observer and inter-observer reliability of plain radiographs, standard computed tomography (CT) scans and mobile CT scans in the assessment of distal radius fractures as categorized by the Fernandez classification method. The secondary objective was to compare the dosages of radiation between the different imaging modalities. Material and Methods: Sixteen fresh cadaveric wrist bones were used in this experimental study. The desired fractures were created in the bones to mimic Fernandez types I-V fractures and plain radiographs were taken in 4 views. Standard CT and mobile CT scans were also taken with the fractured bones in the same four positions. Interobserver reliability was assessed using Kappa statistics to determine the diagnostic consistency among the nine observers. Inter-observer agreement was assessed based on the Fernandez classification system diagnoses. Results: Overall, the inter-observer agreement was substantial for the Fernandez classifications (Kappa range 0.636 0.727) in all types of imaging. For intra-observer agreement, the analysis found higher agreement for both standard CT scans and mobile CT scans. The standard CT images imparted a higher average dose of radiation than both the mobile CT scans and the plain radiographs.Conclusion: The mobile CT scan can provide an alternative imaging method for precise diagnosis of distal end radius fractures, with the additional benefits of mobility and lower radiation exposure.

Download Full-text

Is This Contrast? Is This Blood? An Agreement Study on Post-thrombectomy Computed Tomography Scans

Frontiers in Neurology ◽

10.3389/fneur.2020.593098 ◽

2020 ◽

Vol 11 ◽

Author(s):

Ronda Lun ◽

Gregory B. Walker ◽

Adrien Guenego ◽

Mohammed Kassab ◽

Eduardo Portela ◽

...

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Hemorrhagic Transformation ◽

Ct Scans ◽

Computed Tomography Scans ◽

Kappa Value ◽

Level Of Training ◽

Global Agreement ◽

Contrast Ct ◽

Agreement Study

Background: Hemorrhagic transformation after acute ischemic stroke is a dreaded and severe complication of thrombolysis and thrombectomy. However, its detection on post-thrombectomy conventional non-contrast computed tomography (CT) scan can be complicated by the frequent (and sometimes concomitant) presence of contrast, resulting in changes in management.Aims: Our objective was to assess the inter- and intra-rater reliability for the detection of blood and/or contrast on day-1 post-thrombectomy CT scans.Methods: A total of 18 raters across 3 different specialties independently examined 30 post-thrombectomy CT scans selected from the Aspiration vs. STEnt-Retriever (ASTER) trial. They were asked to judge the presence of blood and contrast. Thirty days later, the same 18 raters again independently judged the 30 scans, in randomized order. Agreement was measured with Fleiss' and Cohen's K statistics.Results: Overall agreement on blood and/ or contrast presence was only fair, k = 0.291 (95% CI = 0.273–0.309). There were 0 scans with consensus among the 18 readers on the presence of blood and/or contrast. However, intra-rater global agreement across all 18 physicians was relatively high, with a median kappa value of 0.675. This intra-rater consistency was seen across all specialties, regardless of level of training.Conclusion: Physician judgment for the presence of blood and/or contrast on day-1 post-thrombectomy non-contrast CT scan shows limited inter-observer reliability. Advanced imaging modalities may then be warranted for challenging clinical cases.

Download Full-text

Computer-assisted hip resurfacing surgery using the Acrobot® Navigation System

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1243/09544119jeim283 ◽

2007 ◽

Vol 221 (7) ◽

pp. 773-785 ◽

Cited By ~ 29

Author(s):

A R W Barrett ◽

B L Davies ◽

M P S F Gomes ◽

S J Harris ◽

J Henckel ◽

...

Keyword(s):

Computed Tomography ◽

Navigation System ◽

Clinical Results ◽

Hip Resurfacing ◽

Conventional Technique ◽

Ct Scans ◽

Computer Assisted ◽

Present System ◽

X Rays ◽

Laboratory Development

The authors have previously reported on the laboratory development of the Acrobot® Navigation System for accurate computer-assisted hip resurfacing surgery. This paper describes the findings of using the system in the clinical setting and including the improvements that have been made to expedite the procedure. The aim of the present system is to allow accurate planning of the procedure and precise placement of the prosthesis in accordance with the plan, with a zero intraoperative time penalty in comparison to the standard non-navigated technique. At present the navigation system is undergoing final clinical evaluation prior to a clinical study designed to demonstrate the accuracy of outcome compared with the conventional technique. While full results are not yet available, this paper describes the techniques that will be used to evaluate accuracy by comparing pre-operative computed tomography (CT)-based plans with post-operative CT scans. Example qualitative clinical results are included based on visual comparison of the plan with post-operative X-rays.

Download Full-text

Cuboid stress fracture. A case report

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-83-3-153 ◽

1993 ◽

Vol 83 (3) ◽

pp. 153-155 ◽

Cited By ~ 16

Author(s):

JB Chen

Keyword(s):

Computed Tomography ◽

Case Report ◽

Stress Fracture ◽

Healing Process ◽

X Rays ◽

Computed Tomography Scan ◽

X Ray ◽

Computed Tomography Scans ◽

Bone Changes ◽

Tomography Scan

Because a stress fracture is rare and easily missed on an x-ray, it might go undetected. If a patient presents with an activity related injury to the midfoot and x-rays are negative, a computed tomography scan can be helpful in diagnosing a cuboid stress fracture. Also, computed tomography scans graphically show the fracture location and size, in addition to tracking progressive bone changes during the healing process.

Download Full-text

Minimising medically unwarranted computed tomography scans

Annals of the ICRP ◽

10.1016/j.icrp.2012.06.004 ◽

2012 ◽

Vol 41 (3-4) ◽

pp. 161-169 ◽

Cited By ~ 16

Author(s):

D.J. Brenner

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Decision Rules ◽

Clinical Decision ◽

Ct Scans ◽

Slowing Down ◽

Powerful Approach ◽

Computed Tomography Scans ◽

Risk Balance ◽

Major Factors

As computed tomography (CT) is such a superb diagnostic tool and individual CT risks are small, whenever a CT scan is clinically warranted, the CT benefit/risk balance is by far in the patient's favour. However, if a CT scan is not clinically warranted, this balance shifts dramatically. It is likely that at least 25% of CT scans fall into this latter category, in that they could either be replaced with alternative imaging modalities or could be avoided entirely. Use of clinical decision rules for CT usage represents a powerful approach for slowing down the increase in CT usage, because they have the potential to overcome some of the major factors that result in some CT scans being undertaken when they may not be clinically helpful.

Download Full-text

Radiation in Dental Practice: Awareness, Protection and Recommendations

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1289 ◽

2013 ◽

Vol 14 (1) ◽

pp. 143-148 ◽

Cited By ~ 6

Author(s):

BN Praveen ◽

AR Shubhasini ◽

R Bhanushree ◽

PS Sumsum ◽

CN Sushma

Keyword(s):

Ionizing Radiation ◽

Radiation Protection ◽

Dental Practice ◽

X Rays ◽

Protection Measures ◽

Reduce Radiation Exposure ◽

Set Up ◽

Effects Of Radiation ◽

Harmful Effects ◽

Radiation Exposure To Patients

ABSTRACT Radiation is the transmission of energy through space and matter. There are several forms of radiation, including ionizing and nonionizing. X-rays are the ionizing radiation used extensively in medical and dental practice. Even though they provide useful information and aid in diagnosis, they also have the potential to cause harmful effects. In dentistry, it is mainly used for diagnostic purposes and in a dental set-up usually the practicing dentist exposes, processes and interprets the radiograph. Even though such exposure is less, it is critical to reduce the exposure to the dental personnel and patients in order to prevent the harmful effects of radiation. Several radiation protection measures have been advocated to ameliorate these effects. A survey conducted in the Bengaluru among practicing dentists revealed that radiation protection awareness was very low and the necessary measures taken to reduce the exposure were not adequate. The aim of the article is to review important parameters that must be taken into consideration in the clinical set-up to reduce radiation exposure to patients and dental personnel. How to cite this article Praveen BN, Shubhasini AR, Bhanushree R, Sumsum PS, Sushma CN. Radiation in Dental Practice: Awareness, Protection and Recommendations. J Contemp Dent Pract 2013;14(1):143-148.

Download Full-text

Migration of a Swallowed Blunt Foreign Body to the Neck

Case Reports in Otolaryngology ◽

10.1155/2014/646785 ◽

2014 ◽

Vol 2014 ◽

pp. 1-2

Author(s):

Kerem Ozturk ◽

Goksel Turhal ◽

Sercan Gode ◽

Atilla Yavuzer

Keyword(s):

Computed Tomography ◽

Foreign Body ◽

Primary Closure ◽

Foreign Bodies ◽

Barium Swallow ◽

X Rays ◽

Upper Aerodigestive Tract ◽

Computed Tomography Scans ◽

History Of ◽

The Right

Ingestion of foreign bodies is a common problem in the otolaryngology practice. Reports of extraluminal migration of the foreign bodies from the upper aerodigestive tract are rare. Penetration and extraluminal migration of ingested foreign bodies may cause severe vascular and suppurative complications, even death. We report a 4-year-old girl who presented with a mass and partial extrusion of a foreign body in the neck. She had a history of ingesting the plastic top piece of a knitting needle approximately 1 year ago. She had been asymptomatic until the present time. The examination revealed a red, blunt, rectangular plastic foreign body half embedded in the skin of the right neck. Esophagography with barium swallow, cervical X-rays, and computed tomography scans were obtained. The foreign body was easily removed under general anesthesia. Primary closure and direct laryngoscopy was also performed. The patient recovered very well without any complications.

Download Full-text