scholarly journals Diagnostic Reference Level of Radiation Dose and Image Quality among Paediatric CT Examinations in A Tertiary Hospital in Malaysia

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 591
Author(s):  
Nor Azura Muhammad ◽  
Muhammad Khalis Abdul Karim ◽  
Hasyma Abu Hassan ◽  
Mazliana Ahmad Kamarudin ◽  
Jeannie Hsiu Ding Wong ◽  
...  
Keyword(s):  
Image Quality ◽  
Age Groups ◽  
Reference Level ◽  
P Value ◽  
Age Group ◽  
Dose Length Product ◽  
Diagnostic Quality ◽  
Noise Index ◽  
Ct Dose ◽  
Ct Brain

Pediatrics are more vulnerable to radiation and are prone to dose compared to adults, requiring more attention to computed tomography (CT) optimization. Hence, diagnostic reference levels (DRLs) have been implemented as part of optimization process in order to monitor CT dose and diagnostic quality. The noise index has recently been endorsed to be included as a part of CT optimization in the DRLs report. In this study, we have therefore set local DRLs for pediatric CT examination with a noise index as an indicator of image quality. One thousand one hundred and ninety-two (1192) paediatric patients undergoing CT brain, CT thorax and CT chest-abdomen-pelvis (CAP) examinations were analyzed retrospectively and categorized into four age groups; group 1 (0–1 year), group 2 (1–5 years), group 3 (5–10 years) and group 4 (10–15 years). For each group, data such as the volume-weighted CT dose index (CTDIvol), dose-length product (DLP) and the effective dose (E) were calculated and DRLs for each age group set at 50th percentile were determined. Both CT dose and image noise values between age groups have differed significantly with p-value < 0.05. The highest CTDIvol and DLP values in all age groups with the lowest noise index value reported in the 10–15 age group were found in CT brain examination. In conclusion, there was a significant variation in doses and noise intensity among children of different ages, and the need to change specific parameters to fit the clinical requirement.

Pediatric Regional Drl Assessment in Common Ct Examinations For Medical Exposure Optimization in Tehran, Iran

2020 ◽  
Author(s):  
Atefeh Tahmasebzadeh ◽  
Reza Paydar ◽  
Mojtaba Soltani kermanshahi ◽  
Asghar Maziar ◽  
Mehdi Rezaei ◽  
...  
Keyword(s):  
Age Groups ◽  
Reference Level ◽  
P Value ◽  
International Studies ◽  
Dose Length Product ◽  
Tube Current ◽  
European Values ◽  
Medical Exposure ◽  
Scan Length ◽  
Ct Volume

Abstract The main purpose of this pilot study was to assess the regional diagnostic reference level (RDRL) of computed tomography (CT) examinations to optimise medical exposure in five pediatric medical imaging centers in Tehran, Iran where the most frequent CT examinations were investigated. For each patient, CT volume dose indexes (CTDIvol) and dose length product (DLP) in each group were recorded and their third quartile was calculated and set as RDRL. Pediatrics were divided into four age groups (&lt;1; 1–5; 5–10 and 10–15 years). Then, the third quartile values for head, chest and abdomen-pelvic CTs were, respectively, calculated for each group in terms of CTDIvol: 21.3, 24.4, 24.2 and 36.3 mGy; 2.9, 3.2, 3.7 and 5.7 mGy; 3.7, 5.7, 6.3 and 6.8 mGy; and in terms of DLP: 322.2, 390.1, 424.9 and 694.1 mGy.cm; 53.1, 115.2, 145.3 and 167.6 mGy.cm and 128.7, 317.7, 460.2 and 813.8 mGy.cm. Finally, RDRLs were compared with other countries and preceding data in Iran. As a result, CTDIVOL values were lower than other national and international studies except for chest and abdomen-pelvic values obtained in Europe. Moreover, this matter applied to DLP so that other formerly reported values were higher than the present study but European values for chest and abdomen-pelvic scans and also Tehran studies conducted in 2012. Variation of scan parameters (tube voltage (kVp), tube current (mAs) and scan length), CTDIvol and DLP of different procedures among different age groups were statistically significant (P-value &lt; 0.05). The variations in dose between CT departments as well as between identical scanners suggest a large potential for optimization of examinations relative to which this study provides helpful data.

scholarly journals Trends of Stomach Cancer in Central Serbia

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 665
Author(s):  
Miodrag M. Stojanovic ◽  
Natasa K. Rancic ◽  
Marija R. Andjelkovic Apostolovic ◽  
Aleksandra M. Ignjatovic ◽  
Mirko V. Ilic
Keyword(s):  
Stomach Cancer ◽  
Preventive Measures ◽  
Age Groups ◽  
Optimal Number ◽  
P Value ◽  
Age Group ◽  
Joinpoint Regression ◽  
Mortality Trends ◽  
Incidence Trend ◽  
Incidence And Mortality

Somach cancer is the third most common cause of cancer-related deaths worldwide. The objective of the paper was to analyze the incidence and mortality trends of stomach cancer in Central Serbia in the period between 1999–2017. Materials and Methods: trends and annual percentage change (APC) of the incidence and mortality rate with corresponding 95% confidence intervals (CI) were calculated by joinpoint regression analyses. The optimal number of Joinpoints was identified using the Monte Carlo permutation method. The trend was considered to be significantly increasing (positive change) or decreasing (negative change) when the p-value was below 0.05 (p < 0.05). Results: the total number of new cases was 16,914 (10,873 males and 6041 females) and the total number of mortality cases was 14,790 (9348 in and 5442 in females). Almost one third (30.8%) of new cases were registered in the 60–69-year age group, and new cases were significantly more frequent in males than in females (30.8% vs. 29.02%, p < 0.001). Joinpoint regression analysis showed a significant decrease of incidence trend in females during the 2000–2015 period with APC of −2.13% (95% CI: −3.8 to −0.5, p < 0.001). An insignificant decrease in incidence trend was in males with APC of −0.72% (95% CI: −2.3 to 0.9, p = 0.30). According to the joinpoint analysis, a significant decrease of mortality trends both in males during 2000–2015 with APC of −2.21% (95% CI: −1.6 to −7.5, p ≤ 0.001 and in females, during the same period, with APC of −1.75% (95% CI: −2.9 to −0.6, p < 0.001) was registered. From 2015 to 2017, a significant increase of mortality was registered with APC of 44.5% (95% CI: from 24.2 to −68.1, p ≤ 0.001) in females and in males with APC of 53.15% (95% CI: 13.5 to −106.6, p ≤ 0.001). Conclusion: a significant decrease of stomach cancer incidence trend in females and insignificant decrease of incidence trend in males were determined in Central Serbia. Based on presented results, the mortality trend decreased significantly both in males and in females during 2000–2015, and from 2015 to 2017 we recorded a significant increase in mortality in both sexes. We found significantly more new cases in women than in men in the age group of 40–49, and the mortality of stomach cancer was significantly more frequent among females compared to males in the age groups 30–39, as well as in the 50–59 age group. There is a need for improving recording and registration of new cases of stomach cancer, especially in females. Urgent primary and secondary preventive measures are needed—introducing stomach cancer screening and early detection of premalignant changes. Urgent primary and secondary preventive measures are needed.

scholarly journals Healthy aging profile in octogenarians in Brazil

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Ana Cristina Viana Campos ◽  
Efigênia Ferreira e Ferreira ◽  
Andréa Maria Duarte Vargas ◽  
Lúcia Hisako Takase Gonçalves
Keyword(s):  
Older Adults ◽  
Decision Tree ◽  
Healthy Aging ◽  
Age Groups ◽  
Population Based ◽  
P Value ◽  
Age Group ◽  
Monthly Income ◽  
Tree Model ◽  
Socioeconomic Characteristics

ABSTRACT Objective: to identify the healthy aging profile in octogenarians in Brazil. Method: this population-based epidemiological study was conducted using household interviews of 335 octogenarians in a Brazilian municipality. The decision-tree model was used to assess the healthy aging profile in relation to the socioeconomic characteristics evaluated at baseline. All of the tests used a p-value < 0.05. Results: the majority of the 335 participating older adults were women (62.1%), were aged between 80 and 84 years (50.4%), were widowed (53.4%), were illiterate (59.1%), had a monthly income of less than one minimum wage (59.1%), were retired (85.7%), lived with their spouse (63.8%), did not have a caregiver (60.3%), had two or more children (82.7%), and had two or more grandchildren (78.8%). The results indicate three age groups with a healthier aging profile: older adults aged 80 to 84 years (55.6%), older adults aged 85 years and older who are married (64.9%), and older adults aged 85 and older who do not have a partner or a caregiver (54.2%). Conclusion: the healthy aging profile of octogenarians can be explained by age group, marital status, and the presence of a caregiver.

scholarly journals Risk Factors Associated with Ischemic Heart Diseases in Different Age Groups Patients of Tertiary Care Hospitals of Peshawar

2015 ◽  
Vol 1 (2) ◽  
pp. 3-9
Author(s):  
Riaz Gul ◽  
Sumaira Naz
Keyword(s):  
Risk Factors ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Age Groups ◽  
Ischemic Heart ◽  
P Value ◽  
Age Group ◽  
Ischemic Heart Diseases ◽  
Sedentary Life ◽  
Tertiary Care Hospitals

Objectives:To determine different risk factors associated with ischemic heart diseases in different age group patients of tertiary care hospitals of Peshawar.Methodology:A cross sectional study conducted on 350 patients of different age groups presented with ischemic heart diseases in tertiary care hospitals of Peshawar. Study was conducted for duration of 3 months from December 2013 to February 2014. Non probability convenient sampling technique was used. Sample size was calculated using standard sample size calculator. Semi structured questionnaire was used as data collection tool. Patient’s record and investigations were used as adding tools. Standard definition was made for ischemic heart disease. Different modifiable and non-modifiable factors were assessed and were analyzed using SPSS version 16.Results:This study contains 350 patients in which female patients were 133(38%) and male were 217(62%).The mean age was 57.23±11.36 years. The age of the patients ranges from 22 to 80 years. The frequencies of risk factors were stress (73.1%) followed by hypertension (65.7%), sedentary life style (59.4%), family history (57.1%), smoking (50.6%), over weight and obese (39.1%), below normal HDL (30.3%), high LDL (29.1%), hypertriglyceridemia (28%), hypercholesterolemia (23.7%). 64.3% patients were presenting with acute IHD and 35.7% were with chronic IHD. Stress, HTN, DM and sedentary life style were found to be significantly associated with male gender (p- value <0.05). Age was divided into two groups, <45 years and >45 years. Stress, HTN, DM and hypercholesterolemia had a significant association with >45 years of age group. (P-value <0.05).Conclusion:Stress, HTN, DM, sedentary life styles were the major risk factors. And they were found to be more in male gender and in equal to more than 45 years of age group.

Comparison of the image quality and radiation dose of different scanning modes in head-neck CT angiography

2021 ◽  
pp. 20200428
Author(s):  
Tianle Zhang ◽  
Xue Geng ◽  
Dongxue Li ◽  
Yize Xu ◽  
Yongxia Zhao
Keyword(s):  
Body Mass Index ◽  
Image Quality ◽  
Ct Angiography ◽  
The Other ◽  
Signal To Noise ◽  
Dose Length Product ◽  
Gemstone Spectral Imaging ◽  
Ct Dose ◽  
Group B ◽  
Head Neck

Objectives: To analyze and compare the radiation dose and image quality of different CT scanning modes on head-neck CT angiography. Methods: A total of 180 patients were divided into Group A and Group B. The groups were further subdivided according to different scanning modes: subgroups A1, A2, A3, B1, B2, and B3. Subgroups A1 and B1 used conventional CT protocol, subgroups A2 and B2 used the kV-Assist scan mode, and subgroups A3 and B3 used the dual-energy gemstone spectral imaging protocol. The CT dose index and dose–length product were recorded. The objective image quality and subjective image evaluation was conducted by two independent radiologists. Results: The signal-to-noise ratios, contrast-to-noise ratios, and subjective scores of subgroups A3 and B3 were higher than the other subgroups. In subgroups B1 and B2, the subjective scores of 9 patients and 12 patients were lower than 3, respectively. The subjective scores of subgroups B1 and B2 were lower than the other subgroups. There was no statistically significant difference in signal-to-noise ratios, contrast-to-noise ratios, and subjective scores between subgroups A1 and A2. The effective dose of subgroup A2 was 41.7 and 36.4% lower than that in subgroups A1 and A3, respectively (p < 0.05). In Group B, there were no statistically significant differences in CT dose indexvol, dose–length product, and ED among the subgroups (p > 0.05). Conclusion: In the head-neck CT angiography, the kV-Assist scan mode is recommended for patients with body mass index between 18.5 and 34.9 kg m−2; gemstone spectral imaging scanning mode is recommended for patients with body mass index ≥34.9 kg m−2.

scholarly journals DISTRIBUTION OF MYCOPLASMA SPP. AND UREAPLASMA SPP. AMONG PREGNANT WOMEN

2021 ◽  
Vol 27 (1) ◽  
pp. 3630-3633
Author(s):  
Anton G. Petrov ◽  
◽  
Vladislav M. Nankov ◽  
Rositsa V. Petrova ◽  
Irena I. Gencheva ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Age Groups ◽  
University Hospital ◽  
Statistical Dependence ◽  
P Value ◽  
Age Group ◽  
Fetal Infection ◽  
Biological Methods ◽  
Ureaplasma Spp ◽  
Mycoplasma Spp

The purpose of the present study is to determine the prevalence of genital mycoplasmas (M. genitalium, M. hominis, U. parvum, U. urealyticum) in pregnant women by molecular biological methods. Material/Methods: A prospective epidemiological study of 107 pregnant women hospitalized in the Clinic of Obstetrics and Gynecology, University Hospital-Pleven, Bulgaria, was conducted. Vaginal secretion samples were taken from all 107 pregnant women. A Polymerase chain reaction (PCR) assay was used to detect the genomic DNA of the bacteria in pregnant women. Results: The highest is the relative share of women in the age group from 20 to 35 years - 66 (64.68%), followed by women under 20 years - 27 (25.23%) and women over 35 years - 14 (13.08%). Detection of bacterial DNA was found in 85 (79.44%) of the cases, with present Ureaplasma spp. Colonization in 42 women (39.25%). Although no statistical dependence was found on open bacteria and age groups (p-value = 0.4688), it is noteworthy that the prevalence of Mycoplasma spp. and Ureaplasma spp. as a whole in the age group from 20 to 35 years, which has the highest birth rate, is more than twice higher than the group of up to 20 years and more than five times higher compared to the group over 35 years. Conclusions: Studies on the incidence of Mycoplasma spp. and Ureaplasma spp. in pregnant women is important for controlling the pregnancy, predicting the risk of developing maternal-fetal infection and discussing the options for timely treatment.

scholarly journals Establishment of diagnostic reference levels arising from common CT examinations in Semnan County, Iran

2019 ◽  
Vol 25 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Daryoush Khoramian ◽  
Soroush Sistani ◽  
Peyman Hejazi
Keyword(s):  
Cervical Spine ◽  
The Other ◽  
Reference Level ◽  
Ct Scanner ◽  
Dose Length Product ◽  
Ct Dose ◽  
Patient Doses ◽  
Ct Dose Index ◽  
Ct Scanners ◽  
Dose Levels

Abstract Objective: The literature has approved that the use of the concept of diagnostic reference level (DRL) as a part of an optimization process could help to reduce patient doses in diagnostic radiology comprising the Computed Tomography (CT) examinations. There are four public/governmental CT centers in the province (Semnan, Iran) and, to our knowledge, after about 12 years since the launch of the first CT scanner in the province there is no dosimetry information on those CT scanners. The aim of this study was to evaluate CT dose indices with the aim of the establishment of the DRL for head, chest, cervical spine, and abdomen-pelvis examinations. Methods: Scan parameters of 381 patients were collected during two months from 4 CT scanners. The CT dose index (CTDI) was measured using a calibrated ionization chamber on two cylindrical poly methyl methacrylate (PMMA) phantoms. For each sequences, weighted CTDI (CTDIw), volumetric CTDI (CTDIv) and dose length product (DLP) were calculated. The 75th percentile was proposed as the criterion for DRL values. Results: Proposed DRL (CTDIw, CTDIv, DLP) for the head, chest, cervical spine, and abdomen-pelvis were (46.1 mGy, 46.1 mGy, 723 mGy × cm), (13.8 mGy, 12.0 mGy, 377 mGy × cm), (40.0 mGy, 40.0 mGy, 572 mGy × cm) and (14.9 mGy, 12.1 mGy, 524 mGy × cm), respectively. Conclusion: Comparison with the others results from the other countries indicates that the head, chest and abdomen-pelvis scans in our region are lower or in the range of the other studies investigated in terms of dose. In the case of cervical spine scanning it’s necessary to review and regulate scan protocols to reach acceptable dose levels.

scholarly journals Correlation Between Blood Glucose and Estradiol Levels in Women in Reproductive Age

2020 ◽  
Vol 52 (3) ◽  
pp. 139-143
Author(s):  
David Lionardi ◽  
Chrismis Novalinda Ginting ◽  
Linda Chiuman
Keyword(s):  
Blood Sugar ◽  
Blood Sugar Level ◽  
Hormone Level ◽  
Age Groups ◽  
Reproductive Age ◽  
P Value ◽  
Age Group ◽  
Type 2 Dm ◽  
Two Age Groups

Type 2 Diabetes mellitus (Type 2 DM) is a metabolic disorder characterized by an increase in blood sugar caused by decreased insulin secretion by pancreatic beta cells and/or impaired insulin function (insulin resistance). This study aimed to determine the specific levels of estradiol hormone in reproductive age women with diabetes mellitus in different age groups. This was an analytical study in September at Royal Prima Hospital, North Sumatra, Indonesia. Twenty women participated in this study after informed consent and were divided into two age groups: 40–45 years old and 46–50 years old. Blood samples were collected after 10-12 hours of fasting to assess blood sugar and estradiol hormone levels. Data were then analyzed using the dependent t-test dependent and compared. No significant difference in blood sugar level was found between the two age groups (p-value=0.113, p-value> 0.05) that there were no significant differences in blood sugar levels between the two age groups. The estradiol hormone level in the age group 40-45 years was lower than in the age group 46–50 years, and the difference was significant (p-value =0.000, p-value<0.05). No significant correlation was seen between type 2 DM and estradiol hormone level in this study. In conclusion, age is not the main contributing factor for the increase and decrease in blood sugar level, and type 2 DM does not correlate with estradiol hormone.

Thoracic-abdominal imaging with a novel dual-layer spectral detector CT: intra-individual comparison of image quality and radiation dose with 128-row single-energy acquisition

2018 ◽  
Vol 59 (12) ◽  
pp. 1458-1465 ◽  
Author(s):  
Stefan Haneder ◽  
Florian Siedek ◽  
Jonas Doerner ◽  
Gregor Pahn ◽  
Nils Grosse Hokamp ◽  
...  
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Ct Images ◽  
Ct Image ◽  
Dose Length Product ◽  
Portal Venous Phase ◽  
Ct Dose ◽  
Automatic Tube Current Modulation ◽  
Lower Radiation Dose

Background A novel, multi-energy, dual-layer spectral detector computed tomography (SDCT) is commercially available now with the vendor’s claim that it yields the same or better quality of polychromatic, conventional CT images like modern single-energy CT scanners without any radiation dose penalty. Purpose To intra-individually compare the quality of conventional polychromatic CT images acquired with a dual-layer spectral detector (SDCT) and the latest generation 128-row single-energy-detector (CT128) from the same manufacturer. Material and Methods Fifty patients underwent portal-venous phase, thoracic-abdominal CT scans with the SDCT and prior CT128 imaging. The SDCT scanning protocol was adapted to yield a similar estimated dose length product (DLP) as the CT128. Patient dose optimization by automatic tube current modulation and CT image reconstruction with a state-of-the-art iterative algorithm were identical on both scanners. CT image contrast-to-noise ratio (CNR) was compared between the SDCT and CT128 in different anatomic structures. Image quality and noise were assessed independently by two readers with 5-point-Likert-scales. Volume CT dose index (CTDIvol), and DLP were recorded and normalized to 68 cm acquisition length (DLP68). Results The SDCT yielded higher mean CNR values of 30.0% ± 2.0% (26.4–32.5%) in all anatomic structures ( P < 0.001) and excellent scores for qualitative parameters surpassing the CT128 (all P < 0.0001) with substantial inter-rater agreement (κ ≥ 0.801). Despite adapted scan protocols the SDCT yielded lower values for CTDIvol (–10.1 ± 12.8%), DLP (−13.1 ± 13.9%), and DLP68 (–15.3 ± 16.9%) than the CT128 (all P < 0.0001). Conclusion The SDCT scanner yielded better CT image quality compared to the CT128 and lower radiation dose parameters.

Clinical features and outcome of T-cell acute lymphoblastic leukemia in patients older than 9 years: A single center experience of 110 patients from AIIMS, New Delhi, India.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7081-7081
Author(s):  
Sunu Lazar Cyriac ◽  
Bivas Biswas ◽  
Sameer Bakhshi ◽  
Atul Sharma ◽  
Ritu Gupta ◽  
...  
Keyword(s):  
T Cell ◽  
Lymphoblastic Leukemia ◽  
Tumor Lysis Syndrome ◽  
Age Groups ◽  
Maintenance Phase ◽  
Total Leucocyte Count ◽  
P Value ◽  
Age Group ◽  
Single Center ◽  
Single Center Experience

7081 Background: It is known that T cell acute lymphoblastic leukemias (ALL) have poorer outcomes than their B cell counterparts. Data on T-ALL in the age group of >9 years from India is minimal. Methods: This is a single institutional analysis of patients of above 9 years who were treated from January 2000 to December 2010. All patients who completed at least 4 weeks of induction therapy were analysed for various outcomes. Results: T-ALL formed 30% of all ALL in this age group. Of the 110 newly registered patients of T-ALL, the median age was 17 years (Range 10-50 years) with an M:F ratio of 5.9:1. Of this 62%, 30% and 18% patients belonged to 10-18, 19-30 and > 31 years age group respectively. Eighteen (19%) and 2 (2%) and 33 (30%) had CSF, testicular and other extramedullary sites involvement respectively. Twenty eight per cent had a total leucocyte count (TLC) of above 100x109/L. Patients available for survival analysis were 104(94.5%). Complete remission (CR)rate was 68.2% and induction mortality was 14.4%. At a median follow up of 56.4 months 5 year leukemia free survival was 52.3% (median not attained). Twenty seven (38%) patients relapsed (median relapse time of 15.2 months, range 0.7 to 47.3 months), 55% during maintenance phase. The 5 year overall survival (OS) was 46.9% (median OS of 35.4 months). The 5 year OS of 10-18, 19-30 and > 31 years age groups were 42.8%, 71% and 16.6% respectively (p value not significant). Not attaining CR in 1st induction, spontaneous tumor lysis syndrome and peripheral blood blast count of > 80% were significant poor prognostic factors for survival. Conclusions: This is one of the largest study of T-ALL outcomes in patients above 9 years from a single center from India. Attainment of CR in 1st induction was the most important risk factor for survival. 5 year OS was 47%.

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