scholarly journals RADIATION DOSE TO THE EYE AND POTENTIAL OCCURRENCE RADIATION- INDUCED CATARACT FOLLOWING COMPUTED TOMOGRAPHY (CT) HEAD EXAMINATION

2021 ◽  
Vol 21 (2) ◽  
pp. 1-7
Author(s):  
Muhammad Ikhmal Naim Mohd Hilal ◽  
Rekha Ganesan ◽  
Norhashimah Mohd Norsuddin ◽  
Mohd Izuan Ibrahim ◽  
Said Mohd Shaffiq Said. Rahmat ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Absorbed Dose ◽  
Pitch Factor ◽  
Exclusion Criteria ◽  
Head Ct ◽  
Tube Potential ◽  
Tube Current ◽  
Ct Head ◽  
Radiation Induced ◽  
Ct Brain

The eye is a radiosensitive organ that lies within the scan range during Computed Tomography (CT) of the head. The utilization of the head CT is increasing with growing concern about the chances of development of cataract which induces by ionising radiation. This research aimed to calculate eye absorbed dose and to study the potential occurrence of radiation induces cataracts between CT Brain and CT Temporal. A total of 399 set data were obtained retrospectively according to inclusion and exclusion criteria. 364 patients underwent CT Brain while 35 patients’ data obtained for CT Temporal. The scanning parameters such as tube current, tube potential, pitch factor, beamwidth, filter, revolution time, and filter were recorded. Eye absorbed dose was significantly different (p<0.05) between CT brain (49.07±10.08mGy) and CT temporal (25.72 ± 6.12mGy). None of the analysed data exceeded the eye threshold dose recommended by ICRP 2012. However, as expected, the cumulative eye absorbed dose was increased as the frequencies of the scan increase. The highest number of repeated scans is five times with cumulative dose was recorded as 278.27mGy. In conclusion, the eye absorbed dose is higher in CT Brain compared to CT Temporal and has potential for induction of cataract in the future especially with the patient that undergoes repeated CT examination.

scholarly journals Pattern of Emergent Head Computed Tomography Findings in a Tertiary Care Hospital during off Working Hours: Retrospective Analysis

2019 ◽  
Vol 10 (02) ◽  
pp. 207-211
Author(s):  
Rajneesh K. Patel ◽  
Amit Kumar Choubey ◽  
Brijesh K. Soni ◽  
Rajeev Sivasankar ◽  
Vikash Chauhan
Keyword(s):  
Computed Tomography ◽  
Health Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Working Hours ◽  
Care Hospital ◽  
Head Ct ◽  
Total Head ◽  
Ct Head ◽  
Head Computed Tomography

ABSTRACT Introduction: Emergency head computed tomography (CT) is rising exponentially during off working hours due to evidence-based medicine, patient’s expectation and desires, easy availability and apprehension of medico-legal cases, thereby raising health-care cost. There is huge gap in demand and supply of radiologist, especially during off working hours. There is need to know the pattern of emergency head findings. Materials and Methods: A retrospective analysis of all emergent noncontrast CT head during off working hours in the Department of Radiodiagnosis of a Tertiary Care Hospital, Mumbai, India, which were performed from June 2017 to May 2018. CT findings of 308 patients were analyzed. Results: About 63.6% of total head CT showed no significant abnormality. The most common abnormality was intracranial hemorrhage which was just 9.1% followed by acute infarct which was 6.2%. Extradural hemorrhage, subdural hemorrhage, and subarachnoid hemorrhage was only 1% each of total head CT findings. No significant abnormality was detected in 74.65%, 70.21%, 89.13%, 31.37%, 100%, and 69.09% in cases of head injury, seizure, giddiness/dizziness/syncope, cerebrovascular accident, transient ischemic attack, and altered sensorium, respectively. Conclusion: Pattern analysis of emergent head CT reveals that most of the emergent CT head shows no significant abnormality. There is a need for stringent guidelines for emergent head CT, training of emergency physician as well as CT technician for common findings to bridge the radiologist demand-supply gap for providing effective health care in peripheral hospitals.

scholarly journals P015: Implementing the Canadian CT Head Rule in a community emergency department

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S83-S83
Author(s):  
G. Bock ◽  
R. Setrak ◽  
S. Freeman
Keyword(s):  
Emergency Department ◽  
Demographic Data ◽  
Ct Scans ◽  
P Value ◽  
Relative Reduction ◽  
Exclusion Criteria ◽  
Head Ct ◽  
Preliminary Results ◽  
Ct Head ◽  
Significant Injury

Introduction: The Canadian CT Head Rule (‘the rule’) is widely used across the country and its use is specifically recommended by Choosing Wisely Canada. Studies in Canadian hospitals have shown appropriate declines in CT scans when decision tools have been made readily available and useable at the point of care. Research into the implementation of the Canadian CT Head Rule in particular has shown that barriers to its use include an inability to accurately recall each criteria and forgetting to attempt to apply the rule altogether. In an attempt to provide our clinicians with effective access to the rule, we modified CT requisitions and order procedures to facilitate the use of the rule for every head CT in our emergency department (ED). Methods: A quality improvement (QI) approach was used to pilot, implement, and evaluate the modified CT requisition at our hospital. Several Plan-Do-Study-Act cycles involving stakeholders in the hospital resulted in iterative changes to the requisition leading to the implemented version. The new requisition required physicians to indicate which rules or exclusion criteria were met and this was made mandatory for all head CTs ordered. Demographic data was collected on all patients presenting to the ED on age, gender, CTAS level, disposition, and length of stay. Data on which exclusion criteria were appropriate, the rules met leading to CT scans, whether each requisition was used appropriately, and whether there was a significant injury found was collected for each patient receiving a head CT after implementation. Results: In our primary outcome (% of ED visits receiving a head CT), preliminary results have demonstrated a relative reduction in head CT ordering of 10.9%. Our study at completion is powered to detect a ~10% relative change in ordering behaviour, and a Chi square of the data to date yields a P-value of 0.0147. There are no significant differences in visit volume or any of the demographics collected to date. Final results including analysis are anticipated in March, 2016. Conclusion: Preliminary results on this simple, no-cost intervention are very promising. The reduction in head CTs ordered suggests that with mandated access to an easy-to-use, well validated decision tool, ED physicians have been able to confidently defer scans that have a very low risk of having any significant injury present, reducing cost, radiation exposure, and perhaps time in department.

scholarly journals Effect of Lowering Tube Potential and Increase Iodine Concentration of Contrast Medium on Radiation Dose and Image Quality in Computed Tomography Pulmonary Angiography Procedure: A Phantom Study

2021 ◽  
Vol 47 (3) ◽  
pp. 1211-1224
Author(s):  
Justin E Ngaile ◽  
Peter K Msaki ◽  
Evarist M Kahuluda ◽  
Furaha M Chuma ◽  
Jerome M Mwimanzi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Radiation Dose ◽  
Contrast Medium ◽  
Iodine Concentration ◽  
Pulmonary Angiography ◽  
Computed Tomography Pulmonary Angiography ◽  
Iodinated Contrast ◽  
Tube Potential ◽  
Tube Current

The aim of the study was to examine the effect of lowering tube potential and increase iodine concentration on image quality and radiation dose in computed tomography pulmonary angiography procedure. The pulmonary arteries were simulated by three syringes. The syringes were filled with 1:10 diluted solutions of 300 mg, 350 mg and 370 mg of iodine per millilitre concentration in three water-filled phantoms simulating thin, intermediate and thick patients. The phantoms were scanned at 80 kVp, 110 kVp and 130 kVp and 0.6 second rotation time using a 16 slice computed tomography (CT) scanner. The tube current was either fixed at 80, 100, 200, 250 and 300 mA or automatically adjusted with quality reference tube current-time product (mAsQR). In comparison with 130 kVp, images acquired at 80 kVp and 110 kVp, respectively, showed 76.2% to 99% and 19% to 26% enhancement in CT attenuation of iodinated contrast material. A volume CT dose index (CTDIvol) reduction by 35.3% was attained in small phantom with the use of 80 kVp, while in the medium phantom, a CTDIvol reduction by 29.9% was attained with the use of 110 kVp instead of 130 kVp. In light of the above, lowering tube potential and increase iodinated CM could substantially reduce the dose to small-sized adults and children. Keywords: Angiography; Computed tomography; Low tube potential; Iodinated contrast medium; Radiation dose

How often does computed tomography (CT) of the brain demonstrate a cause for psychosis? A 7-year retrospective study at a tertiary metropolitan hospital

2018 ◽  
Vol 27 (2) ◽  
pp. 183-186 ◽  
Author(s):  
Guy Harris ◽  
Hao Xiang ◽  
Irene Tan ◽  
Varundeep Randhawa
Keyword(s):  
Computed Tomography ◽  
Diagnostic Yield ◽  
Diagnostic Value ◽  
Exclusion Criteria ◽  
Demyelinating Disorder ◽  
Brain Anomaly ◽  
Metropolitan Hospital ◽  
Significant Pathology ◽  
Ct Brain ◽  
The Brain

Objectives: The aim of the study was to determine the diagnostic yield of computed tomography (CT) of the brain for the investigation of psychosis. Methods: CT brain requests describing psychosis over a 7-year period at a 500-bed major metropolitan hospital were identified retrospectively. Patients were excluded if they were aged greater than 50 years or if the CT request described focal neurological findings on examination, trauma/falls or known brain tumour, demyelinating disorder, encephalopathy, seizure disorder, congenital brain anomaly, stroke or traumatic brain injury. Results: A total of 805 patients meeting the inclusion and exclusion criteria were identified, representing the largest published study on this topic. Only 0.4% of patients (3 out of 805) had a potential cause for psychosis demonstrated on CT. None of these patients had their management altered as a result. An additional 0.6% of patients (5 out of 805) had significant pathology that was deemed unrelated to their psychosis. Conclusions: The diagnostic value of CT in the setting of psychosis was found to be extremely low in patients meeting the inclusion and exclusion criteria. Given the risk of ionising radiation and the expenditure of time and cost, more judicious use of CT is suggested.

Radiation doses and image information in digital pelvimetry with a phosphorous screen

1997 ◽  
Vol 38 (1) ◽  
pp. 181-184 ◽  
Author(s):  
G. Holje ◽  
O. Jarlman ◽  
L. Samuelsson
Keyword(s):  
Radiation Risk ◽  
Absorbed Dose ◽  
High Sensitivity ◽  
Imaging Plate ◽  
Film System ◽  
Entrance Dose ◽  
Tube Potential ◽  
Tube Current ◽  
Dose Measurements ◽  
Current Exposure

Purpose: The aim of the investigation was to determine the patient dose in digital pelvimetry by means of a phosphorous screen as compared to a screen-film combination of very high sensitivity. Material and Methods: Entrance dose measurements and absorbed dose determinations in a series of patient exposures were made. In the first series the exposure reduction was achieved by reducing the mAs (tube current × exposure time) for the lateral and the a.p. views as compared with those used for the screen-film system. In the second series the tube potential, kV, was increased for both projections in order to increase the penetration capacity of the radiation. Results and Conclusion: The imaging plate technique can be used in pelvimetry with a dose reduction (and a corresponding reduction of the radiation risk to the foetus) to less than 50% of that achieved with a screen-film system of the very highest sensitivity.

scholarly journals MP23: The yield of computed tomography of the head in patients presenting with syncope: a systematic review

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S72-S73
Author(s):  
J.A. Viau ◽  
H. Chaudry ◽  
A. Hannigan ◽  
M. Boutet ◽  
M.A. Mukarram ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Diagnostic Yield ◽  
Case Reports ◽  
Meta Analysis ◽  
Observer Agreement ◽  
Acute Management ◽  
Head Ct ◽  
Inpatient Settings ◽  
Ct Head

Introduction: Syncope accounts for 1-3% of Emergency Department (ED) visits. Previous studies have reported overuse of computed tomography (CT) of the head among syncope patients. Professional organizations including Choosing Wisely have recommended against its use in the absence of high-risk features. However, a review of CT head use among syncope patients and its diagnostic yield has not been previously reported. Methods: We conducted a systematic review using EMBASE, Medline, and Cochrane databases from inception to August 2016. We included studies involving adult syncope patients that reported CT head use and its diagnostic yield during acute management by a two-step process: first title/abstract review and then full-text review of selected articles. We excluded case reports, narrative reviews and those involving children. We collected the proportion of patients who had CT head performed, and its diagnostic yield. Outcomes included identification of acute intracranial conditions (hemorrhage, mass or infarct) that require further management. Two reviewers independently abstracted the data and discrepancies were resolved by consensus. We calculated inter-observer reliability for inclusion in the systematic review using kappa values. We performed meta-analysis for diagnostic yield of the CT head. Results: Fifteen studies with 2,802 syncope patients in four sub-groups (proportion of patients among whom CT head was performed and its yield in ED and inpatient settings; studies that reported only the yield among those with CT head performed; and the use and yield among syncope patients ≥65 years old) were included. The inter-observer agreement for inclusion of final articles for meta-analysis was κ=0.925 [95% CI: 0.861-0.990]. Seven ED studies (n=1,261) reported 55.7% patients (95% CI: 32.1-78.0%) had head CT performed with a yield of 4.0% (95% CI: 2.7-5.6%); 5 studies with 1138 hospitalized patients reported that 38.6% (95% CI: 20.4-58.6%) had head CT with a yield of 1.1% (95% CI: 0.4-2.2%). The yield among studies that report only outcomes for CT head was 2.3% and the yield among patients’ ≥65 years was 7.7%. Conclusion: Our review found that a very high proportion of syncope patients had CT head performed during acute management with a very low diagnostic yield. The yield is higher among patients ≥65 years old. A robust tool to identify patients who require a CT head will reduce unnecessary testing.

scholarly journals Dose optimization in computed tomography of brain using CARE kV and CARE Dose 4D

2018 ◽  
Vol 4 (1) ◽  
pp. 9
Author(s):  
Pooja Shah ◽  
Amish Sharma ◽  
Jayanti Gyawali ◽  
Sharma Paudel ◽  
Shanta Lall Shrestha ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Ct Scan ◽  
The Body ◽  
University Teaching ◽  
Innovative Technology ◽  
Tube Current Modulation ◽  
Current Modulation ◽  
Tube Potential ◽  
Tube Current

Background: Computed Tomography (CT) scan of brain is the most widely used CT examination. Latest CT scanners have the potential to deliver very low radiation dose by utilizing tube potential and tube current modulation techniques. We aim to determine the application of CARE kV (tube potential modulation) and CARE Dose4D (tube current modulation) in CT scan of brain. Both CARE kV and CARE Dose4D are well-established innovative technology of Siemens Medical Solutions. Methodology: A prospective hospital-based study was conducted during four months at Tribhuvan University Teaching Hospital (TUTH). The data were collected on a Siemens Somatom Definition Edge 128 slices CT scanner. Non-random purposive sampling technique was employed. Ethical approval and consent to participate were taken for every participant. Non-contrast (NC) CT images were acquired without using CARE kV and CARE Dose4D, whereas during contrast-enhanced (CE) investigation, both were turned on keeping other scanning parameters constant for each individual. Results: A total of 72 patients, 42 males and 28 females - mean age 41y (range 16-87y) participated in this study. The Body Mass Index (BMI) was 22.0, range 20.1-25.0. The mean value of Computed Tomography Dose Index (CTDI), Dose Length Product (DLP) and Effective Dose (ED) before and after switching on both CARE kV and CARE Dose4D were 58.19±0.35 and 39.67±3.59 milli-Gray (mGy), 946.67 and 652.58 mGy-cm, and 1.98 and 1.36 milli-Sievert (mSv) respectively. Conclusion: CARE kV and CARE Dose4D can reduce radiation dose in CT scan of brain without loss of image quality.

A primer in interpretation of head CT scans

2019 ◽  
Vol 80 (11) ◽  
pp. C156-C161
Author(s):  
Saminderjit Kular ◽  
Andrew Martin
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Intracranial Haemorrhage ◽  
Skull Fracture ◽  
Ct Scans ◽  
Head Ct ◽  
Scanning Time ◽  
Stroke Team ◽  
Ct Head ◽  
The Brain

Over recent years with the development of increasingly efficient scanners, the computed tomography (CT) scan of the head has become one of the most commonly requested initial investigations, used to provide an overview of the brain and its surrounding structures. In particular, the CT head scan has become significant in the trauma setting. With short scanning time, an investigation to confirm or exclude intracranial haemorrhage, skull fracture or stroke can now be performed in a matter of seconds. This article provides physicians with a structure for reading a CT head scan, to help identify key findings that may warrant further specialist neurosurgical or stroke team referral.

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