scholarly journals Multi-detector computed tomography radiation doses in the follow-up of paediatric neurosurgery patients in KwaZulu-Natal: A dosimetric audit

2014 ◽  
Vol 18 (1) ◽  
Author(s):  
Christopher T. Sikwila ◽  
Khatija Amod ◽  
Brindley D. Cupido ◽  
Ali Sabri
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Radiation Doses ◽  
Current Time ◽  
Paediatric Neurosurgery ◽  
Radiology Reports ◽  
Clinical Scenarios ◽  
Multi Detector Computed Tomography ◽  
Scan Length

Background: Multi-detector computed tomography (MDCT) is the preferred modality for follow-up of paediatric neurosurgery patients. Serial imaging, however, has the disadvantage of an ionising radiation burden, which may be mitigated using the ‘as low as reasonably achievable’ (ALARA) principle. Objectives: The primary objectives were to determine the radiation dose exposure in paediatric patients subjected to MDCT imaging following neurosurgery and to compare these values with references in current literature. Our secondary objective was to assess the relationship between radiation dose and clinical scenario.Method: Retrospective descriptive data were collected from all paediatric postsurgical patients (n = 169) between the ages of 0 and 12 years who had their first followed-up scan in the year 2010 and were followed up for six months or less. Dose-length product (DLP) and current-time product were collected from the picture archiving and communication system. Demographic data including radiology reports were collected from the hospital information system. The effective doses (ED) were calculated from the corresponding DLP using age-adjusted conversion factors. For purposes of comparison with other studies, median dosimetric values were calculated and the children were grouped into three age ranges, namely younger than 3 years, 3–7 years and 8–12 years old.Results: The highest median radiation doses were noted in patients being followed-up for intracranial abscesses (1183 mGy cm) in the 8–12 year age group, most of whom were female. The lowest radiation doses were for intracranial shunt follow-ups (447 mGy cm). Median values for DLP, ED and current-time product (mAs) were comparable to reference doses in all three age groups. However, our study showed a much broader distribution of values with higher upper limits relative to reference values. Indications for follow-up included shunts (n = 110; 65%), intracranial abscess (n = 31; 18%), subdural haematoma (n = 13; 8%) and tumour (n = 6; 4%). Head trauma only accounted for 5% of the cases.Conclusion: The median radiation doses measured were comparable to values in literature and therefore deemed acceptable. The wider dose distributions of all three dosimetric parameters (DLP, ED and mAs) were attributed to inappropriate use of scan length and reference effective mAs. Adherence to recommended scan length protocols should be encouraged. Evaluation of the current use of reference effective mAs is needed and will require a separate study to determine the smallest value that can be used without compromising image quality. Further dose reductions could be achieved by omission of unenhanced scans in the follow-up of intracranial abscesses. It is recommended that diagnostic reference levels specific to South African clinical scenarios be developed to make local dosimetric audits more relevant.

scholarly journals Low-Dose Computed Tomography for the Optimization of Radiation Dose Exposure in Patients with Crohn’s Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Richard G. Kavanagh ◽  
John O’Grady ◽  
Brian W. Carey ◽  
Patrick D. McLaughlin ◽  
Siobhan B. O’Neill ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Crohn’S Disease ◽  
Image Quality ◽  
Crohn's Disease ◽  
Radiation Dose ◽  
Ionizing Radiation ◽  
Low Dose ◽  
Radiation Doses ◽  
Radiation Dose Exposure ◽  
Ct Technology

Magnetic resonance imaging (MRI) is the mainstay method for the radiological imaging of the small bowel in patients with inflammatory bowel disease without the use of ionizing radiation. There are circumstances where imaging using ionizing radiation is required, particularly in the acute setting. This usually takes the form of computed tomography (CT). There has been a significant increase in the utilization of computed tomography (CT) for patients with Crohn’s disease as patients are frequently diagnosed at a relatively young age and require repeated imaging. Between seven and eleven percent of patients with IBD are exposed to high cumulative effective radiation doses (CEDs) (>35–75 mSv), mostly patients with Crohn’s disease (Newnham E 2007, Levi Z 2009, Hou JK 2014, Estay C 2015). This is primarily due to the more widespread and repeated use of CT, which accounts for 77% of radiation dose exposure amongst patients with Crohn’s disease (Desmond et al., 2008). Reports of the projected cancer risks from the increasing CT use (Berrington et al., 2007) have led to increased patient awareness regarding the potential health risks from ionizing radiation (Coakley et al., 2011). Our responsibilities as physicians caring for these patients include education regarding radiation risk and, when an investigation that utilizes ionizing radiation is required, to keep radiation doses as low as reasonably achievable: the “ALARA” principle. Recent advances in CT technology have facilitated substantial radiation dose reductions in many clinical settings, and several studies have demonstrated significantly decreased radiation doses in Crohn’s disease patients while maintaining diagnostic image quality. However, there is a balance to be struck between reducing radiation exposure and maintaining satisfactory image quality; if radiation dose is reduced excessively, the resulting CT images can be of poor quality and may be nondiagnostic. In this paper, we summarize the available evidence related to imaging of Crohn’s disease, radiation exposure, and risk, and we report recent advances in low-dose CT technology that have particular relevance.

Comparison of Radiation Dose in CT Examinations At PIMS with European Commission Reference Doses

2021 ◽  
Vol 17 (3) ◽  
pp. 216-221
Author(s):  
Fawad Yasin ◽  
Anum Rasheed ◽  
Muhammad Nauman Malik ◽  
Farheen Raza ◽  
Ramish Riaz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
European Commission ◽  
Large Scale ◽  
Radiology Department ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Length Product ◽  
Ct Dose

OBJECTIVE - The purpose of this study was to assess the radiation dose levels from common computed tomography (CT) examinations performed in Radiology Department of Pakistan Institute of Medical Sciences (PIMS), and evaluate these according to diagnostic reference levels (DRLs) proposed by European Commission (EC) guidelines, and thus contributing towards the establishment of local and national DRLs. To the best of our knowledge, this is the first study of its kind to explore radiation doses from CT examinations in Pakistan. STUDY DESIGN - This was a quantitative study conducted at PIMS, Islamabad, spanning a duration of eight weeks. Scan parameters and dose profile data of 1506 adults undergoing examinations of head, neck, chest and abdomen-pelvis regions, comprising of single- and multi-phase, contrast-enhanced and unenhanced studies. Dose indicators utilized by EC guidelines for DRLs include volume CT dose index (CTDIvol) and Dose Length Product (DLP) for single slice and complete examination radiation doses, respectively. METHOD - Values of CTDIvol, DLP and scan lengths were extracted from the CT operators console. Other control variables included gender, contrast enhancement and phasicity of study. IBM SPSS package was used to obtain descriptive statistics such as mean and quartiles. RESULTS - DRLs calculated as 75th percentile of CTDIvol, DLP for various anatomical regions are by and far comparable to European DRLs. CONCLUSION – This study describes institutional diagnostic reference levels for common CT exams in Islamabad and provides benchmark values for future reference. Our DRL values are mostly comparable to European and international DRLs. Similar, albeit large scale, surveys are recommended for establishment of local and national DRLs, eventually contributing towards development of regional DRLs. KEYWORDS: CTDIvol, DLP, Diagnostic Reference Levels, Computed Tomography, Radiation Monitoring, Scan length

scholarly journals Reducing cranial computed tomography effective radiation dose by 30% using adaptive iterative dose reduction

2016 ◽  
Vol 25 (4) ◽  
pp. 230-234
Author(s):  
Wai-Yung Yu ◽  
Thye Sin Ho ◽  
Henry Ko ◽  
Wai-Yee Chan ◽  
Serene Ong ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Radiation Dose ◽  
Dose Reduction ◽  
Diagnostic Image Quality ◽  
Radiation Doses ◽  
Effective Radiation Dose ◽  
Diagnostic Image ◽  
Ct Head ◽  
Effective Radiation

Introduction: The use of computed tomography (CT) imaging as a diagnostic modality is increasing rapidly and CT is the dominant contributor to diagnostic medical radiation exposure. The aim of this project was to reduce the effective radiation dose to patients undergoing cranial CT examination, while maintaining diagnostic image quality. Methods: Data from a total of 1003, 132 and 27 patients were examined for three protocols: CT head, CT angiography (CTA), and CT perfusion (CTP), respectively. Following installation of adaptive iterative dose reduction (AIDR) 3D software, tube current was lowered in consecutive cycles, in a stepwise manner and effective radiation doses measured at each step. Results: Baseline effective radiation doses for CT head, CTA and CTP were 1.80, 3.60 and 3.96 mSv, at currents of 300, 280 and 130–150 mA, respectively. Using AIDR 3D and final reduced currents of 160, 190 and 70–100 mA for CT head, CTA and CTP gave effective doses of 1.29, 3.18 and 2.76 mSv, respectively. Conclusion: We demonstrated that satisfactory reductions in the effective radiation dose for CT head (28.3%), CTA (11.6%) and CTP (30.1%) can be achieved without sacrificing diagnostic image quality. We have also shown that iterative reconstruction techniques such as AIDR 3D can be effectively used to help reduce effective radiation dose. The dose reductions were performed within a short period and can be easily achievable, even in busy departments.

scholarly journals Cone-Beam Computed Tomography and Radiographs in Dentistry: Aspects Related to Radiation Dose

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Diego Coelho Lorenzoni ◽  
Ana Maria Bolognese ◽  
Daniela Gamba Garib ◽  
Fabio Ribeiro Guedes ◽  
Eduardo Franzotti Sant’Anna
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Radiation Dose ◽  
Cone Beam Computed Tomography ◽  
Field Of View ◽  
Cone Beam ◽  
Special Focus ◽  
Radiation Doses ◽  
Lower Effective Dose ◽  
Plain Radiographs

Introduction. The aim of this study was to discuss the radiation doses associated with plain radiographs, cone-beam computed tomography (CBCT), and conventional computed tomography (CT) in dentistry, with a special focus on orthodontics.Methods. A systematic search for articles was realized by MEDLINE from 1997–March 2011.Results. Twenty-seven articles met the established criteria. The data of these papers were grouped in a table and discussed.Conclusions. Increases in kV, mA, exposure time, and field of view (FOV) increase the radiation dose. The dose for CT is greater than other modalities. When the full-mouth series (FMX) is performed with round collimation, the orthodontic radiographs transmit higher dose than most of the large FOV CBCT, but it can be reduced if used rectangular collimation, showing lower effective dose than large FOV CBCT. Despite the image quality, the CBCT does not replace the FMX. In addition to the radiation dose, image quality and diagnostic needs should be strongly taken into account.

scholarly journals Computed Tomography Pulmonary Angiography during Pregnancy: Radiation Dose of Commonly Used Protocols and the Effect of Scan Length Optimization

2019 ◽  
Vol 20 (2) ◽  
pp. 313 ◽  
Author(s):  
Babs M.F. Hendriks ◽  
Roald S. Schnerr ◽  
Gianluca Milanese ◽  
Cécile R.L.P.N. Jeukens ◽  
Sandra Niesen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Pulmonary Angiography ◽  
Computed Tomography Pulmonary Angiography ◽  
Length Optimization ◽  
Scan Length

scholarly journals Local Bone Mineral Density, Subcutaneous and Visceral Adipose Tissue Measurements in Routine Multi Detector Computed Tomography—Which Parameter Predicts Incident Vertebral Fractures Best?

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 240
Author(s):  
Egon Burian ◽  
Lioba Grundl ◽  
Tobias Greve ◽  
Daniela Junker ◽  
Nico Sollmann ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Adipose Tissue ◽  
Visceral Adipose Tissue ◽  
Vertebral Fractures ◽  
Mineral Density ◽  
Visceral Adipose ◽  
Incident Vertebral Fractures ◽  
Multi Detector Computed Tomography

In this case-control study the value of bone mineral density (BMD) at different vertebral levels, subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) to identify patients with incident osteoporotic vertebral fractures in routine multi-detector computed tomography (MDCT) exams was assessed. Material and methods: Seventeen patients who underwent baseline and follow-up routine contrast-enhanced MDCT and had an incident osteoporotic vertebral fracture at follow-up were included. Seventeen age-, sex- and follow-up duration-matched controls were identified. Trabecular BMD (from Th5 to L5) as well as cross-sectional area of SAT and VAT were extracted. Results: BMD performed best to differentiate patients with an incident fracture from controls at the levels of Th5 (area under the curve [AUC] = 0.781, p = 0.014), Th7 (AUC = 0.877, p = 0.001), and Th9 (AUC = 0.818, p = 0.005). Applying multivariate logistic regression BMD at Th7 level remained the only significant predictor of incident vertebral fractures (Th5-L5) with an odds ratio of 1.07 per BMD SD decrease. VAT and SAT did not show significant differences between the fracture and control group (p > 0.05). Conclusion: The local BMD measurement appears to be more suitable than standard mean BMD from L1–L3 for fracture risk assessment.

scholarly journals Radiation Doses and Cancer Risk from CT Pulmonary Angiography Examinations

2019 ◽  
Author(s):  
Hanif Haspi Harun ◽  
Muhammad Khalis Abdul Karim ◽  
Zulkifly Abbas ◽  
Sarawana Chelwan Muniandy ◽  
Akmal Sabarudin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Cancer Risk ◽  
Organ Dose ◽  
Pulmonary Angiography ◽  
Effective Diameter ◽  
Radiological Protection ◽  
Radiation Doses ◽  
Dose Length Product ◽  
The Mean

The present study aims to investigate radiation doses from Computed Tomography Pulmonary Angiography (CTPA) examinations based on the patient’s size and to estimate the probability of cancer risk induced from the examination. Data from 100 patients who had undergone CTPA examinations, such as scanning acquisition parameters, patient demography, as well as radiation dose exposure, were collected and analysed. All subjects which aged above 18 y/o were scanned using a Philips Brilliance 128 multi-detector CT (MDCT) scanner. The mean dose value for Volume Computed Tomography Dose Index (CTDIvol), Dose-Length Product (DLP) and effective dose (E) were 11.06 ± 7.17 mGy, 400.38 ± 259.10 mGy.cm and 8.68 ± 5.47 mSv respectively. In addition, with respective of patient’s effective diameter, the mean SSDE value for Group 1, Group 2 and Group 3 were 9.93 ± 3.89, 13.70 ± 9.04 and 22.29 ± 7.35, respectively. Cancer risk per million procedure was calculated based on te recommendation by the International Commission on Radiological Protection Publication 103 report. The organ dose and cancer risk attained for breast, lung and liver were 17.05 ± 10.40 mGy (194 per one million procedure), 17.55 ± 10.86 mGy (192 per one million procedure) and 15.04 ± 9.75 mGy (53 per one million procedure), respectively. In conclusion, CTDIvol underestimated, and SSDE was more accurate in describing the radiation dose. Lung and breast with larger lung effective diameter received the highest dose exposure which increase the probability of the cancer risk. Therefore, it is important to apply optimised protocols in order to reduce patient’s exposure during CTPA examination.

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