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Alhailiy A, Alkhybari E, Alshuhri M, Al-Othman A, Hegazi T, Alsuhaimi M, Alghamdi S, Alenazi K, Alashban Y, Alghamdi S, Quzi O, Jaafari O, Alajlani S, Masmali A, Hadi Y, Manssor E, Mahmoud M. Proposing Multiregional Diagnostic Reference Levels for Common CT Angiography Examinations in Saudi Arabia. Diagnostics (Basel) 2024; 14:1523. [PMID: 39061660 PMCID: PMC11275626 DOI: 10.3390/diagnostics14141523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/03/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
OBJECTIVES Diagnostic reference levels (DRLs) are crucial tools for optimizing radiation exposure during different radiological examinations. This study aimed to establish preliminary DRLs for commonly performed computed tomographic angiography (CTA) examinations in Saudi Arabia. METHODS Data for three types of CTA examinations (cerebral, pulmonary, and lower-extremity) were collected from six medical cities across Saudi Arabia. Data sets related to 723 CTAs with a mean patient weight of 75 kg were analysed in detail. The DRL values were determined based on the 75th, median, and 25th CT dose index volume (CTDIvol) and dose length product (DLP) values. RESULTS The established DRLs were 1221 mGy cm for cerebral CTAs, 475 mGy cm for pulmonary CTAs, and 1040 mGy cm for lower-extremity CTAs. These values were comparable to those reported in other studies. CONCLUSIONS This study provides preliminary DRLs for three common CTA procedures in Saudi Arabia. The widespread implementation of a low kVp and a high level of image reconstruction (IR) presents an opportunity for further dose reduction. These findings can serve as a foundation for future nationwide DRL surveys and the optimization of CTA imaging protocols in Saudi Arabia.
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Affiliation(s)
- Ali Alhailiy
- Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (E.A.); (M.A.)
| | - Essam Alkhybari
- Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (E.A.); (M.A.)
| | - Mohammed Alshuhri
- Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (E.A.); (M.A.)
| | - Abdullah Al-Othman
- Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia; (A.A.-O.); (T.H.); (M.A.)
| | - Tarek Hegazi
- Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia; (A.A.-O.); (T.H.); (M.A.)
| | - Mohammed Alsuhaimi
- Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia; (A.A.-O.); (T.H.); (M.A.)
| | - Sultan Alghamdi
- Radiology and Nuclear Medicine Department, Security Force Hospital, Riyadh 11481, Saudi Arabia;
| | - Khaled Alenazi
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (K.A.); (Y.A.); (S.A.)
| | - Yazeed Alashban
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (K.A.); (Y.A.); (S.A.)
| | - Sami Alghamdi
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (K.A.); (Y.A.); (S.A.)
| | - Omar Quzi
- Department of Radiology and Medical Imaging, King Fahad Central Hospital, Jazan Health Cluster, Jazan 82725, Saudi Arabia;
| | - Osama Jaafari
- Radiology Department, Royal Commission Medical Centre, Industrial Yanbu, Yanbu 46451, Saudi Arabia; (O.J.); (S.A.); (A.M.)
| | - Saleh Alajlani
- Radiology Department, Royal Commission Medical Centre, Industrial Yanbu, Yanbu 46451, Saudi Arabia; (O.J.); (S.A.); (A.M.)
| | - Abdulrahman Masmali
- Radiology Department, Royal Commission Medical Centre, Industrial Yanbu, Yanbu 46451, Saudi Arabia; (O.J.); (S.A.); (A.M.)
| | - Yasser Hadi
- Department of Medical Imaging and Intervention, King Abdullah Medical City, Makkah 57657, Saudi Arabia;
- Discipline of Medical Imaging and Radiation Therapy, University College Cork, T12 K8AF Cork, Ireland
| | - Elbagir Manssor
- Department of Radiologic Technology, College of Applied Medical Sciences, University of Jeddah, Jeddah 23218, Saudi Arabia;
| | - Mustafa Mahmoud
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 62521, Saudi Arabia;
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Laad AP, Gnanasekaran TS, Shetty SK, Vidyan SK, Chodankar SS, Nalilu SK, Radhakrishna V. Assessment of Biological Damage Induced during Multidetector Computed Tomography (MDCT) Examination. Cell Biochem Biophys 2024:10.1007/s12013-024-01345-2. [PMID: 38858307 DOI: 10.1007/s12013-024-01345-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 06/12/2024]
Abstract
Computed tomography (CT) is known for its non-invasiveness, fast procedure, and also for providing detailed diagnostic information to physicians. It also utilises low-dose-rate ionising radiation (X-rays) as a source for imaging. Multidetector computed tomography (MDCT) is an advanced system that uses iodinated contrast media for more accurate diagnostic results. Studies suggest using these contrasts will lead to greater radiation adsorption with significant DNA damage. No studies have been taken comparing the physical dose with the biological effect. The present study sheds light on the same by assessing the biological effect of CT with and without contrast intervention. The present study is timebound; thus, 21 participants attending for CT thorax and abdomen with no history of any cancer were included. The same participants underwent both pre-contrast and post-contrast studies. The blood sample was taken before the procedure and used as a control. Physical parameters like DLP and CTDI obtained from the instrument were compared with the MN frequency obtained (CBMN Assay). The study showed a significant increase (p-value < 0.05) in the Physical and MN frequency in the Post-Contrast group compared to the pre-contrast group. Although a positive correlation was observed between pre and post-contrast groups, the results were not found to be statistically significant (p-value < 0.05). The study confirms increased physical dose and MN frequency upon contrast intervention. This study recommends the judicial use of MDCT in disease diagnostics.
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Affiliation(s)
- Amarja Pandurang Laad
- Department of Medical Imaging Technology, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India
| | - Tamizh Selvan Gnanasekaran
- Central Research Laboratory, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India
| | - Shashi Kumar Shetty
- Department of Medical Imaging Technology, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India.
| | - Savin Kotekar Vidyan
- Department of Medical Imaging Technology, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India
| | - Sayali Satish Chodankar
- Department of Medical Imaging Technology, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India
| | - Suchetha Kumari Nalilu
- Department of Biochemistry, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India
| | - Vishakh Radhakrishna
- Central Research Laboratory, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore, India.
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3
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Assessment of patients radiation doses associated with computed tomography coronary angiography. Appl Radiat Isot 2023; 192:110548. [PMID: 36527854 DOI: 10.1016/j.apradiso.2022.110548] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022]
Abstract
Computed tomography coronary angiography (CTCA) has generated tremendous interest over the past 20 years by using multidetector computed tomography (MDCT) because of its high diagnostic accuracy and efficacy in assessing patients with coronary artery disease. This technique is related to high radiation doses, which has raised serious concerns in the literature. Effective dose (E, mSv) may be a single parameter meant to reflect the relative risk from radiation exposure. Therefore, it is necessary to calculate this quantity to point to relative radiation risk. The objectives of this study are to evaluate patients' exposure during diagnostic CCTA procedures and to estimate the risks. Seven hundred ninety patients were estimated during three successive years. The patient's exposure was estimated based on a CT device's delivered radiation dose (Siemens Somatom Sensation 64 (64-MDCT)). The participating physicians obtained the parameters relevant to the radiation dose from the scan protocol generated by the CT system after each CCTA study. The parameters included the volume CT dose index (CTDIvol, mGy) and dose length product (DLP, mGy × cm). The mean and range of CTDIvol (mGy) and DLP (mGy × cm) for three respective year was (2018):10.8 (1.14-77.7) and 2369.8 ± 1231.4 (290.4-6188.9), (2019): 13.82 (1.13-348.5), and 2180.5 (501.8-9534.5) and (2020) 10.9 (0.7-52.9) and 1877.3 (149.4-5011.1), respectively. Patients' effective doses were higher compared to previous studies. Therefore, the CT acquisition parameter optimization is vital to reduce the dose to its minimal value.
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Hegazi TM, AlSharydah AM, Alfawaz I, Al-Muhanna AF, Faisal SY. The Impact of Data Management on the Achievable Dose and Efficiency of Mammography and Radiography During the COVID-19 Era: A Facility-Based Cohort Study. Risk Manag Healthc Policy 2023; 16:401-414. [PMID: 36941927 PMCID: PMC10024472 DOI: 10.2147/rmhp.s389960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 03/05/2023] [Indexed: 03/15/2023] Open
Abstract
Purpose To evaluate the impact of using computational data management resources and analytical software on radiation doses in mammography and radiography during the COVID-19 pandemic, develop departmental diagnostic reference levels (DRLs), and describe achievable doses (ADs) for mammography and radiography based on measured dose parameters. Patients and Methods This ambispective cohort study enrolled 795 and 12,115 patients who underwent mammography and radiography, respectively, at the King Fahd Hospital of the University, Al-Khobar City, Saudi Arabia between May 25 and November 4, 2021. Demographic data were acquired from patients' electronic medical charts. Data on mammographic and radiographic dose determinants were acquired from the data management software. Based on the time when the data management software was operational in the institute, the study was divided into the pre-implementation and post-implementation phases. Continuous and categorical variables were compared between the two phases using an unpaired t-test and the chi-square test. Results The median accumulated average glandular dose (AGD; a mammographic dose determinant) in the post-implementation phase was three-fold higher than that in the pre-implementation phase. The average mammographic exposure time in the post-implementation phase was 16.3 ms shorter than that in the pre-implementation phase. Furthermore, the median values of the dose area product ([DAP], a radiographic dose determinant) were 9.72 and 19.4 cGycm2 in the pre-implementation and post-implementation phases, respectively. Conclusion Although the data management software used in this study helped reduce the radiation exposure time by 16.3 ms in mammography, its impact on the mean accumulated AGD was unfavorable. Similarly, radiographic exposure indices, including DAP, tube voltage, tube current, and exposure time, were not significantly different after the data management software was implemented. Close monitoring of patient radiation doses in mammography and radiography, and dose reduction will become possible if imaging facilities use DRLs and ADs via automated systems.
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Affiliation(s)
- Tarek Mohammed Hegazi
- Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar City, Eastern Province, Saudi Arabia
- Correspondence: Tarek Mohammed Hegazi, Chairperson of the Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar City, Eastern Province, Saudi Arabia, Tel +966-0138966877 (EXT: 2007), Email
| | - Abdulaziz Mohammad AlSharydah
- Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar City, Eastern Province, Saudi Arabia
| | - Iba Alfawaz
- Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar City, Eastern Province, Saudi Arabia
| | - Afnan Fahad Al-Muhanna
- Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar City, Eastern Province, Saudi Arabia
| | - Sarah Yousef Faisal
- Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar City, Eastern Province, Saudi Arabia
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Tamam N, Sulieman A, Omer H, Toufig H, Alsaadi M, Salah H, Mattar EH, Khandaker MU, Bradley D. Assessment of breast dose and cancer risk for young females during CT chest and abdomen examinations. Appl Radiat Isot 2022; 190:110452. [DOI: 10.1016/j.apradiso.2022.110452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/01/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
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6
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Establishing diagnostic reference levels for CT examinations in the south region of Saudi Arabia. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110407] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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7
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Sulieman A, Almogren KS, Tamam N. Radiation exposure estimation in pediatric patients during computed tomography imaging procedures. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Alrehily F. DIAGNOSTIC REFERENCE LEVELS OF RADIOGRAPHIC AND CT EXAMINATIONS IN SAUDI ARABIA: A SYSTEMATIC REVIEW. RADIATION PROTECTION DOSIMETRY 2022; 198:1451-1461. [PMID: 36125219 DOI: 10.1093/rpd/ncac183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 07/16/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
A systematic search was conducted to explore the literature on the existing diagnostic reference level (DRL) of radiographic and computed tomography (CT) examinations in Saudi Arabia. The search was performed using Web of Science, Scopus and EBSCO. The search identified 19 studies that reported DRL values for radiographic and CT examinations in Saudi Arabia. Six of those studies reported DRL values for projection radiography, and the remaining studies reported DRL values for CT examinations (n = 13). The entrance surface dose, volume CT dose index (CTDIvol) and dose-length product (DLP) were the most common methods used for establishing the DRLs. Variations were observed in the Saudi DRL values, and this is consistent with the DRL values reported in the literature. Educating and training radiographers to better understand dose minimizing techniques may result in lower patient doses and lower variances in DRL values.
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Affiliation(s)
- Faisal Alrehily
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
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9
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Alhasan AS, Aalam WA. Eye lens opacities and cataracts among physicians and healthcare workers occupationally exposed to radiation: A systematic review and meta-analysis. Saudi Med J 2022; 43:665-677. [PMID: 35830987 PMCID: PMC9749701 DOI: 10.15537/smj.2022.43.7.20220022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/12/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To evaluate the risk of developing eye lens opacities and cataracts among physicians and healthcare workers occupationally exposed to radiation. METHODS Our literature search captured articles published in Embase, Web of Science, PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and Google Scholar databases until September 2021. Then, we retrieved articles reporting cataracts and eye lens opacities induced by radiation exposure among healthcare professionals. The outcomes of interest were cataracts, nuclear opacity, cortical opacity, posterior subcapsular opacity, and any lens opacity. RESULTS Of the 4123 articles identified, 15 studies met the inclusion criteria. Healthcare workers exposed to radiation had a significantly greater risk of posterior subcapsular cataracts (PSCs), cataracts, and any lens opacities than those of the non-exposed participants (p<0.05). The cortical opacity was not significantly different between the exposed and non-exposed participants (p>0.05). Radiation was not determined to be a risk factor for nuclear opacity as it was significantly greater in the control group than the exposed participants. Subgroup analysis revealed that nurses had the highest risk for PSCs (risk ratio = 4.00), followed by interventional cardiologists (risk ratio = 3.85). CONCLUSION The risk of posterior subcapsular opacities and cataracts is significantly higher in healthcare workers with occupational radiation exposure than in non-exposed workers, highlighting the necessity to enhance and promote the wearing of protective measures with high safety levels.
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Affiliation(s)
- Ayman S. Alhasan
- From the Department of Radiology and Medical Imaging (Alhasan), College of Medicine, Taibah University, Al Madinah Al Munawarah, and from the Department of Ophthalmology (Aalam), Faculty of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
- Address correspondence and reprint request to: Dr. Ayman S. Alhasan, Department of Radiology, College of Medicine, Taibah University, Al Madinah Al Munawarah, Kingdom of Saudi Arabia. E-mail: ORCID ID: https://orcid.org/0000-0001-8879-4017
| | - Waseem A. Aalam
- From the Department of Radiology and Medical Imaging (Alhasan), College of Medicine, Taibah University, Al Madinah Al Munawarah, and from the Department of Ophthalmology (Aalam), Faculty of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
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Almujally A, Tamam N, Sulieman A, Doung TT, Omer H, Abuhadi N, Salah H, Mattar E, Khandaker MU, Bradley D. Evaluation of paediatric computed tomography imaging for brain, abdomen procedures. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Osman H, Alosaimi M, Alghamdi F, Aljuaid A, Alqurashi M, Aldajani S, Faizo NL, Alamri S, Althobaiti YS, Khandaker MU, Suleiman A. Evaluation of CT dose and establishment of local DRLs for abdomen and pelvis examinations in hospitals in Taif City, Saudi Arabia. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Patch M, Dugan S, Green W, Anderson JC. Emergency Evaluation of Nonfatal Strangulation Patients: A Commentary on Controversy and Care Priorities. J Emerg Nurs 2022; 48:243-247. [DOI: 10.1016/j.jen.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/06/2022] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
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13
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Omer H, Tamam N, Alameen S, Algadi S, Thanh Tai D, Sulieman A. Elimination of biological and physical artifacts in abdomen and brain computed tomography procedures using filtering techniques. Saudi J Biol Sci 2022; 29:2180-2186. [PMID: 35531247 PMCID: PMC9073048 DOI: 10.1016/j.sjbs.2021.11.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 11/04/2021] [Accepted: 11/17/2021] [Indexed: 11/18/2022] Open
Abstract
Filters reduce the noise at the expense of visual image quality. Digital interpretation of images prevents misinterpretation of the images due to blurring of the images. Dose reduction without compromising the diagnostic.
Introduction Medical images are usually affected by biological and physical artifacts or noise, which reduces image quality and hence poses difficulties in visual analysis, interpretation and thus requires higher doses and increased radiographs repetition rate. Objectives This study aims at assessing image quality during CT abdomen and brain examinations using filtering techniques as well as estimating the radiogenic risk associated with CT abdomen and brain examinations. Materials and Methods The data were collected from the Radiology Department at Royal Care International (RCI) Hospital, Khartoum, Sudan. The study included 100 abdominal CT images and 100 brain CT images selected from adult patients. Filters applied are namely: Mean filter, Gaussian filter, Median filter and Minimum filter. In this study, image quality after denoising is measured based on the Mean Squared Error (MSE), Peak Signal-to-Noise Ratio (PSNR), and the Structural Similarity Index Metric (SSIM). Results The results show that the images quality parameters become higher after applications of filters. Median filter showed improved image quality as interpreted by the measured parameters: PSNR and SSIM, and it is thus considered as a better filter for removing the noise from all other applied filters. Discussion The noise removed by the different filters applied to the CT images resulted in enhancing high quality images thereby effectively revealing the important details of the images without increasing the patients’ risks from higher doses. Conclusions Filtering and image reconstruction techniques not only reduce the dose and thus the radiation risks, but also enhances high quality imaging which allows better diagnosis.
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Affiliation(s)
- Hiba Omer
- Department of Basic Sciences, Deanship of Preparatory Year and Supporting Studies, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 34212, Saudi Arabia
| | - Nissren Tamam
- Physics Department, College of Sciences, Princess Nourah bint Abdulrahman University, P.O Box 84428, Riyadh 11671, Saudi Arabia
- Corresponding author.
| | - Suhaib Alameen
- Sudan University of Science and Technology, College of Medical Radiologic Science, P.O.Box 1908, Khartoum, Sudan
| | - Sahar Algadi
- Department of Basic Sciences, Deanship of Preparatory Year and Supporting Studies, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 34212, Saudi Arabia
| | - Duong Thanh Tai
- Department of Industrial Electronics and Biomedical Engineering, HCMC University of Technology and Education, Ho Chi Minh 749000, Vietnam
| | - Abdelmoneim Sulieman
- Prince Sattam Bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, PO Box 422, Alkharj 11942, Saudi Arabia
- Basic Science Department, College of Medical Radiologic Science, Sudan University of Science and Technology, P.O.Box 1908, Khartoum 11111, Sudan
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Ngaile JE, Msaki PK, Suleiman SA, Chuma FM, Muhogora WE, Jusabani AM. ESTIMATION OF PATIENT RADIATION DOSES FROM MULTI-DETECTOR COMPUTED TOMOGRAPHY ANGIOGRAPHY PROCEDURES IN TANZANIA. RADIATION PROTECTION DOSIMETRY 2021; 197:63-77. [PMID: 34729602 DOI: 10.1093/rpd/ncab159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 09/08/2021] [Accepted: 10/05/2021] [Indexed: 06/13/2023]
Abstract
The aim of the present study was to estimate the volume CT dose index (CTDIvol), dose length product (DLP) and effective dose (ED) to patients from five multi-detector computed tomography angiography (MDCTA) procedures: brain, carotid, coronary, entire aorta and lower limb from four medical institutions in Tanzania; to compare these doses to those reported in the literature, and to compare the data obtained with ICRP 103 and Monte Carlo software. The radiation doses for 217 patients were estimated using patient demographics, patient-related exposure parameters, the geometry of examination and CT-Expo V 2.4 Monte Carlo-based software. The median values of the CTDIvol, DLP and ED for MDCTA procedures of the brain and carotids were 36.8 mGy, 1481.0 mGy∙cm and 5.2 mSv, and 15.9 mGy, 1224.0 mGy∙cm and 7.8 mSv, respectively; while for the coronary, entire aortic, and lower limbs were 49.4 mGy, 1493.0 mGy∙cm and 30.6 mSv; 16.2 mGy, 2287.0 mGy∙cm and 41.1 mSv; and 6.4 mGy, 1406.0 mGy∙cm and 10.5 mSv, respectively. The ratio of the maximum to minimum ED values to individual patients across the four medical centers were 41.4, 11.1, 4.6, 9.5 and 37.4, respectively, for the brain, carotid, coronary, entire aortic and lower limb CT angiography procedures. The mean values of CTDIvol, DLP and ED in the present study were typically higher than the values reported from Kenya, Korea and Saudi Arabia. The 75th percentile values of the DLP were above the preliminary diagnostic references levels proposed by Kenya, Switzerland and Korea. The observed wide range of examination scanning protocols and patient doses for similar MDCTA procedures within and across hospitals; and the observed relatively high patient doses compared to those reported in the literature, call for the need to standardize scanning protocols and optimise patient dose from MDCTA procedures.
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Affiliation(s)
- J E Ngaile
- Radiation Control Directorate, Tanzania Atomic Energy Commission, P O Box 743 Arusha, Tanzania
- Department of Physics, University of Dar es Salaam, P O Box 35063 Dar es Salaam, Tanzania
| | - P K Msaki
- Department of Physics, University of Dar es Salaam, P O Box 35063 Dar es Salaam, Tanzania
| | - S A Suleiman
- Radiation Control Directorate, Tanzania Atomic Energy Commission, P O Box 743 Arusha, Tanzania
| | - F M Chuma
- Radiation Control Directorate, Tanzania Atomic Energy Commission, P O Box 743 Arusha, Tanzania
| | - W E Muhogora
- Radiation Control Directorate, Tanzania Atomic Energy Commission, P O Box 743 Arusha, Tanzania
| | - A M Jusabani
- Department of Radiology, The Agha Khan Hospital, P O Box 2289 Dar es Salaam, Tanzania
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Loganovsky KM, Fedirko PA, Marazziti D, Kuts KV, Antypchuk KY, Perchuk IV, Babenko TF, Loganovska TK, Kolosynska OO, Kreinis GY, Masiuk SV, Zdorenko LL, Zdanevich NA, Garkava NA, Dorichevska RY, Vasilenko ZL, Kravchenko VI, Drosdova NV, Yefimova YV, Malinyak AV. BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT: PART II - RADIATION CEREBRO/OPHTALMIC EFFECTS IN CHILDREN, PERSONS EXPOSED IN UTERO, ASTRONAUTS AND INTERVENTIONAL RADIOLOGISTS. PROBLEMY RADIATSIINOI MEDYTSYNY TA RADIOBIOLOHII 2021; 26:57-97. [PMID: 34965543 DOI: 10.33145/2304-8336-2021-26-57-97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Ionizing radiation (IR) can affect the brain and the visual organ even at low doses, while provoking cognitive, emotional, behavioral, and visual disorders. We proposed to consider the brain and the visual organ as potential targets for the influence of IR with the definition of cerebro-ophthalmic relationships as the «eye-brain axis». OBJECTIVE The present work is a narrative review of current experimental, epidemiological and clinical data on radiation cerebro-ophthalmic effects in children, individuals exposed in utero, astronauts and interventional radiologists. MATERIALS AND METHODS The review was performed according to PRISMA guidelines by searching the abstract and scientometric databases PubMed/MEDLINE, Scopus, Web of Science, Embase, PsycINFO, Google Scholar, published from 1998 to 2021, as well as the results of manual search of peer-reviewed publications. RESULTS Epidemiological data on the effects of low doses of IR on neurodevelopment are quite contradictory, while data on clinical, neuropsychological and neurophysiological on cognitive and cerebral disorders, especially in the left, dominant hemisphere of the brain, are nore consistent. Cataracts (congenital - after in utero irradiation) and retinal angiopathy are more common in prenatally-exposed people and children. Astronauts, who carry out longterm space missions outside the protection of the Earth's magnetosphere, will be exposed to galactic cosmic radiation (heavy ions, protons), which leads to cerebro-ophthalmic disorders, primarily cognitive and behavioral disorders and cataracts. Interventional radiologists are a special risk group for cerebro-ophthalmic pathology - cognitivedeficits, mainly due to dysfunction of the dominant and more radiosensitive left hemisphere of the brain, andcataracts, as well as early atherosclerosis and accelerated aging. CONCLUSIONS Results of current studies indicate the high radiosensitivity of the brain and eye in different contingents of irradiated persons. Further research is needed to clarify the nature of cerebro-ophthalmic disorders in different exposure scenarios, to determine the molecular biological mechanisms of these disorders, reliable dosimetric support and taking into account the influence of non-radiation risk factors.
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Affiliation(s)
- K M Loganovsky
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - P A Fedirko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - D Marazziti
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry, University of Pisa, Via Roma, 67, I 56100, Pisa, Italy
| | - K V Kuts
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - K Yu Antypchuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - I V Perchuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - T F Babenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - T K Loganovska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - O O Kolosynska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - G Yu Kreinis
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - S V Masiuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - L L Zdorenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - N A Zdanevich
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - N A Garkava
- State Institution «Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine», 9 Vernadsky Str., Dnipro, 49044, Ukraine
| | - R Yu Dorichevska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - Z L Vasilenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - V I Kravchenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - N V Drosdova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - Yu V Yefimova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - A V Malinyak
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
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Elnour AR, Barakat M, Tamam N, Sulieman AM, Dinar H, Abuzaid MM. ESTIMATION OF RADIATION RISK AND ESTABLISHMENT OF DIAGNOSTIC REFERENCE LEVELS FOR PATIENTS UNDERGOING COMPUTED TOMOGRAPHY CHEST-ABDOMEN-PELVIC EXAMINATIONS IN SUDAN. RADIATION PROTECTION DOSIMETRY 2021; 196:104-109. [PMID: 34528102 DOI: 10.1093/rpd/ncab136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 08/04/2021] [Accepted: 08/26/2021] [Indexed: 06/13/2023]
Abstract
Establishment of diagnostic reference levels (DRLs) is an essential radiation optimization tool used to indicate optimum practice and radiation protection. This study aimed to report the current computed tomography (CT) of the chest-abdomen-pelvis radiation practice in Sudan as a part of the DRL establishment effort and dose optimization. CT radiation doses were collected from 530 patients of age ranging between 28 and 85 y and body weight ranging between 65 and 120 kg. DRLs were calculated based on the 75th percentile of dose length product (DLP) and CT dose index volume (CTDIvol). Effective and organ doses were calculated using the National Cancer Institute dosimetry system for the CT programme. The proposed DRLs are CTDIvol, 6 mGy, and DLP, 970 mGy.cm, and an effective dose of 9.9 mSv. Organ dose estimation showed that the thyroid received the highest dose during the scan.
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Affiliation(s)
- Abdel-Rahman Elnour
- Radiologic Science Department, National Ribat University, PO Box 407, Khartoum 55, Sudan
| | - Mustafa Barakat
- Diagnostic Radiology Department, College of Medical Radiological Sciences, Sudan University of Science and Technology, PO Box 407, Khartoum, Sudan
| | - Nissren Tamam
- Physics Department, College of Sciences, Princess Nourah Bint Abdulrahman University, PO Box 84428, Riyadh 11671, Saudi Arabia
| | - Abdel-Moneim Sulieman
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, PO Box 422, Alkharj 11942, Saudi Arabia
| | - Hussien Dinar
- Radiology and Medical Imaging College, National University, PO Box 3783, Khartoum, Sudan
| | - Mohamed M Abuzaid
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, PO Box 27272, Sharjah, UAE
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17
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Multiphase vascular lower limb computed tomography: Assessment of patients doses and radiogenic risk. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2021.109675] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Pfaff JAR, Füssel B, Harlan ME, Hubert A, Bendszus M. Variability of computed tomography angiography coverage of lung parenchyma in acute stroke. Neurol Res Pract 2021; 3:10. [PMID: 33648607 PMCID: PMC7920633 DOI: 10.1186/s42466-021-00109-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/25/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Computed tomography angiography (CTA) of the head and neck during acute ischemic stroke (AIS) usually includes visualization of lung apices. The possibility to evaluate for pulmonary changes, e.g. peripheral ground-glass and consolidative opacities suggestive of coronavirus disease 2019 (COVID-19)-related pneumonia, depends on the area of the lung covered by CTA. METHODS We performed an analysis of a real-world scenario assessing the variability of lung coverage on CTA in patients presenting with AIS to a comprehensive stroke center (CSC) or to one of eight primary stroke centers (PSC) within a teleradiological network covered by the comprehensive stroke center in 2019. RESULTS Our final analysis included n = 940 CTA, and in n = 573 (61%) merely lung apices were covered. In 19/940 (2%) of patients no lung tissue was covered by CTA. CTA scanning protocols in the CSC began significantly more frequently at the level of the ascending aorta (CSC: n = 180 (38.2%), PSC: n = 127 (27.1%), p-value < 0.001) and the aortic arch (CSC: n = 140 (29.7%), PSC: n = 83 (17.7%), p-value < 0.001), and by this covered less frequently the lower lobes compared to CTA acquired in one of the PSC. CONCLUSIONS In our pre-COVID-19 pandemic representative stroke patient cohort, CTA for AIS covered most often only lung apices. In 37% of the patients CTA visualized at least parts of the lower lobes, the lingula or the middle lobe allowing for a more extensive assessment of the lungs.
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Affiliation(s)
- Johannes A. R. Pfaff
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Bianka Füssel
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Marcial E. Harlan
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Alexander Hubert
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Mespreuve M, Waked K, Hendrickx B. Visualization techniques of the facial arteries. J Cosmet Dermatol 2021; 20:386-390. [PMID: 32459040 PMCID: PMC7891589 DOI: 10.1111/jocd.13477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/02/2020] [Accepted: 05/04/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND As the face is known for its extreme variation in vascular anatomy and the number of filler-associated complications due to intra-arterial injection is increasing, we are in need of a method to visualize anyone's individual arterial anatomy of the face in a completely harmless way. AIMS The different medical imaging methods and a recently developed MRA protocol are reviewed. METHODS The literature of the last twenty years-with special attention for the last five years-concerning the different medical imaging modalities of the facial arteries was reviewed. RESULTS A harmless visualisation of the facial arteries is currently only possible with US or MRA. US may identify single vessels but never the complete arterial network. A combination of IR "heat enhancement" and a MRA 3D-TOF sequence might make it feasible to visualize a large number of facial arteries in a risk-free, radiation-free, contrast-free and non-invasive way. CONCLUSION Currently, a new combination of IR "heat enhancement" and a MRA 3D-TOF sequence might be the only method to visualize a large number of facial arteries.
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Affiliation(s)
- Marc Mespreuve
- Department of Medical ImagingUniversity Hospital GhentGhentBelgium
- Department of Medical ImagingA.Z. St. MaartenMechelenBelgium
| | - Karl Waked
- Department of Plastic and Reconstructive SurgeryUniversity Hospital BrusselBrusselBelgium
| | - Benoit Hendrickx
- Department of Plastic and Reconstructive SurgeryUniversity Hospital BrusselBrusselBelgium
- Department of Plastic and Reconstructive SurgeryAZ ZenoKnokke‐HeistBelgium
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20
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Omer H, Alameen S, Mahmoud WE, Sulieman A, Nasir O, Abolaban F. Eye lens and thyroid gland radiation exposure for patients undergoing brain computed tomography examination. Saudi J Biol Sci 2021; 28:342-346. [PMID: 33424315 PMCID: PMC7783653 DOI: 10.1016/j.sjbs.2020.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 11/13/2022] Open
Abstract
This study aims to estimate the effective radiation dose and organ dose from head CT procedures. It was conducted in three main private hospitals in Khartoum State-Sudan, using Toshiba machines with 64 slices. The total number of patients included in this study was 142 patients (82 males and 60 females). The effective dose and organ dose were calculated by CT Expo software. The effective dose slightly varied among patients according to gender and age. The effective dose for female patients (5.99 mSv) was higher than that for male patients (5.84 mSv), and the pediatric dose (5.46 mSv) was lower than the adults' dose (5.94 mSv). The dose for eye lens was found lower for male patients (89.117 mSv) than the dose for female patients (94.62) mSv). According to patients' age: the dose received by the lens of the eye was much lower in pediatric (79.93 mSv) than the adults (92.41 mSv). The dose for thyroid in female patients (33.52 mSv) was higher than the male patients (28 mSv). The pediatric dose (28.34 mSv) was lower than the adults' dose (30.64 mSv). Departmental imaging protocol and lack of training among hospital staff are expected to be responsible for these variations. Therefore, this study recommends that the CT technologists be trained on suitable strategies to achieve dose optimization. Moreover, patients' doses must be monitored regularly.
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Affiliation(s)
- Hiba Omer
- Department of Basic Sciences, Deanship of Preparatory Year and Supporting Studies, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 34212, Saudi Arabia
| | - Suhaib Alameen
- Sudan University of Science and Technology College of Medical Radiologic Science, P.O. Box 1908, Khartoum, Sudan
| | - Waleed E. Mahmoud
- Sudan University of Science and Technology College of Medical Radiologic Science, P.O. Box 1908, Khartoum, Sudan
| | - Abdelmoneim Sulieman
- Prince Sattam Bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, PO Box 422, Alkharj 11942, Saudi Arabia
| | - Omaima Nasir
- Department of Biology, Turabah University College, Taif University, P.O.Box 11099, Taif 21944, Saudi Arabia
| | - Fouad Abolaban
- Nuclear Engineering Department, Faculty of Engineering, King Abdulaziz University, P.O. Box 80204 Jeddah 21589 Saudi Arabia
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21
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Alkhorayef M, Sulieman A, Alzahrani K, Abuzaid M, Alomair OI, Almuwannis M, Alghamdi S, Tamam N, Bradley DA. Radiation risk for patients undergoing cardiac computed tomography examinations. Appl Radiat Isot 2020; 168:109520. [PMID: 33307438 DOI: 10.1016/j.apradiso.2020.109520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 07/06/2020] [Accepted: 11/13/2020] [Indexed: 11/28/2022]
Abstract
The various technological advancements in computed tomography (CT) have resulted in remarkable growth in the use of CT imaging in clinical practice, not the least of which has been its establishment as the most valuable imaging examination for the assessment of cardiovascular system disorders. The objective of this study was to assess the effective radiation dose and radiation risk for patients during cardiac CT procedures, based on studies from four different hospitals equipped with 128 slice CT equipment. A total of eighty-three patients were investigated in this study with different clinical indications. Effective doses were also calculated using software based on Monte Carlo simulation. The mean patient age (years), weight (kg), and body mass index (BMI (kg/m2)) were 49 ± 11, 82 ± 12, and 31 ± 6, respectively. The results of the study revealed that the tube voltage (kVp) and tube current-exposure time product (mAs) ranged between 100 to 140 and 50 to 840 respectively. The overall average patient dose values for the volume CT dose index [(CTDIvol), in mGy)] and dose length product (DLP) (in mGy·cm) were 34.8 ± 15 (3.7-117.0) and 383.8 ± 354 (46.0-3277.0) respectively. The average effective dose (mSv) was 15.2 ± 8 (1.2-61.8). The radiation dose values showed wide variation between different hospitals and even within the same hospital. The results indicate the need to optimize radiation dose and to establish diagnostic reference levels (DRLs) for patients undergoing coronary computed tomography angiography (CCTA), also to harmonize the imaging protocols to ensure reduced radiation risk.
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Affiliation(s)
- M Alkhorayef
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, P.O Box 10219, Riyadh, 11433, Saudi Arabia; Centre for Nuclear and Radiation Physics, Department of Physics, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
| | - A Sulieman
- Prince Sattam Bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, P.O.Box 422, Alkharj, 11942, Saudi Arabia
| | - Khalid Alzahrani
- General Administration of Radiology and Applied Services, Ministry of Health, Riyadh, Saudi Arabia
| | - Mohamed Abuzaid
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, United Arab Emirates
| | - Othman I Alomair
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, P.O Box 10219, Riyadh, 11433, Saudi Arabia
| | - M Almuwannis
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, P.O Box 10219, Riyadh, 11433, Saudi Arabia
| | - Salem Alghamdi
- College of Applied Medical Sciences, Department of Medical Imaging and Radiation Sciences, University of Jeddah, Jeddah, Saudi Arabia
| | - Nissren Tamam
- Physics Department, College of Sciences, Princess Nourah Bint Abdulrahman University, P.O Box 84428, Riyadh, 11671, Saudi Arabia
| | - David A Bradley
- Centre for Nuclear and Radiation Physics, Department of Physics, University of Surrey, Guildford, Surrey, GU2 7XH, UK; Sunway University, Centre for Biomedical Physics, Jalan Universiti, 46150, PJ, Malaysia
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22
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Assessment of computed tomography radiation doses for paediatric head and chest examinations using paediatric phantoms of three different ages. Radiography (Lond) 2020; 27:332-339. [PMID: 32972850 DOI: 10.1016/j.radi.2020.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 09/04/2020] [Accepted: 09/06/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION With the rapid development of computed tomography (CT) scanners, the assessment of the radiation dose received by the patient has become a heavily researched topic and may result in a reduction in radiation exposure risk. In this study, radiation doses were measured using three paediatric phantoms for head and chest CT examinations in Najran, Saudi Arabia. METHODS Thirteen scanners were included in the study to estimate the CT radiation doses using three phantoms representing three age groups (1-, 5-, and 10-year-old patients). RESULTS The volume CT dose index (CTDIvol) estimated for each phantom ranged from 6.56 to 41.12 mGy and 0.292 to 11.10 mGy for the head and chest examinations, respectively. The estimation of lifetime attributable risk (LAR) indicated that the cancer risk could reach approximately 0.02-0.16% per 500 children undergoing head and chest CT examinations. CONCLUSION The comparison with the published data of the European Commission (EC) and countries reported in this study revealed that the mean CTDIvol for the head examinations was within the recommended dose reference levels (DRLs). Meanwhile, chest results exceeded the international DRLs for the one-year-old phantoms, suggesting that optimisation work is required at a number of sites. IMPLICATIONS FOR PRACTICE The variation among CT doses reported in this study showed that substantial standardisation is needed.
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23
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Diagnostic reference level for computed tomography abdominal examinations: A multicentre study. Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2020.108963] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Almohiy HM, Hussein K, Alqahtani M, Elshiekh E, Loaz O, Alasmari A, Saad M, Adam M, Mukhtar E, Alelyani M, Alshahrani M, Abuhadi N, Alshumrani G, Almazzah A, Alsleem H, Almohiy N, Alrwaili A, Alam MM, Asiri A, Khalil M, Rawashdeh M, Saade C. Radiologists' Knowledge and Attitudes towards CT Radiation Dose and Exposure in Saudi Arabia-A Survey Study. Med Sci (Basel) 2020; 8:E27. [PMID: 32698332 PMCID: PMC7563332 DOI: 10.3390/medsci8030027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 01/20/2023] Open
Abstract
Computed tomography (CT) is a key imaging technique in diagnostic radiology, providing highly sensitive and specific information. While its use has increased dramatically in recent years, the quantity and associated risks of radiation from CT scans present major challenges, particularly in paediatrics. The fundamental principles of radiation protection require that radiation quantities be as low as reasonably achievable and CT use must be justified, particularly for paediatric patients. CT radiation knowledge is a key factor in optimising and minimising radiation risk. The objective of this study was to analyse knowledge level, expertise, and competency regarding CT radiation dose and its hazards in paediatrics among radiologists in Saudi Arabian hospitals. A self-reported, multiple-choice questionnaire assessed the attitudes and opinions of radiologists involved in imaging studies using ionising radiation. Among the total respondents, 65% ± 13.5% had a good comprehension of the dangers of carcinogenicity to the patient resulting from CT scans, with 80% presuming that cancer risks were elevated. However, only 48.5%, 56.5%, and 65% of the respondents were aware of specific radiation risks in head, chest, and abdominal paediatric examinations, respectively. Regular, frequent, and specific training courses are suggested to improve the fundamental knowledge of CT radiation among radiologists and other physicians.
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Affiliation(s)
- Hussain M Almohiy
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Khalid Hussein
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
- Department of Medical Physics and Instrumentation, National Cancer Institute, University of Gezira, Wad Medani 20, Sudan
| | - Mohammed Alqahtani
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Elhussaien Elshiekh
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
- Radiation Safety Institute, Sudan Atomic Energy Commission, Khartoum 1111, Sudan
| | - Omer Loaz
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Azah Alasmari
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Mohamed Saad
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
- Faculty of Science, Department of Physics, Mansoura University, Mansoura 35516, Egypt
| | - Mohamed Adam
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Emad Mukhtar
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Magbool Alelyani
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Madshush Alshahrani
- Department of Radiology, Khamis Mushayt General Hospital, Khamis Mushayt 62457, Saudi Arabia;
| | - Nouf Abuhadi
- Diagnostic Radiology Department, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia;
| | - Ghazi Alshumrani
- Department of Radiology, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
| | - Alaa Almazzah
- Department of Radiology, Asir Central Hospital, Abha 62523, Saudi Arabia;
| | - Haney Alsleem
- Department of Radiological Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia;
| | - Nadiayah Almohiy
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
| | | | - Mohammad Mahtab Alam
- Department of Basic Medical Sciences, College of Applied medical Sciences, King Khalid University, Abha 61421, Saudi Arabia;
| | - Abdullah Asiri
- Department of Radiological Sciences, College of Applied Medical Sciences, Najran University, Najran 1988, Saudi Arabia; (A.A.); (M.K.)
| | - Mohammed Khalil
- Department of Radiological Sciences, College of Applied Medical Sciences, Najran University, Najran 1988, Saudi Arabia; (A.A.); (M.K.)
| | - Mohammad Rawashdeh
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Charbel Saade
- Department of Medical Imaging Sciences, American University of Beirut Medical Center, Beirut 11-0236, Lebanon;
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Assessment of imaging protocol and patient radiation exposure in pediatric computed tomography angiography. Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2020.108807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hendrickx B, Waked K, Mespreuve M. Infrared Thermally Enhanced 3-Dimensional Time of Flight Magnetic Resonance Angiography Imaging for the Visualization of the Arteries of the Face. Aesthet Surg J Open Forum 2020; 2:ojaa020. [PMID: 33791645 PMCID: PMC7671261 DOI: 10.1093/asjof/ojaa020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background The face is known for its extreme variation in vascular anatomy. Furthermore, the rapidly increasing number of filler treatments leads to an increase in severe filler-associated complications (such as skin necrosis and blindness) due to intra-arterial injection. Visualizing a patient’s individual complete facial arterial anatomy in a contrast- and radiation-free way has not been published before. This innovative imaging technique could, therefore, enhance the safety of minimally invasive surgical procedures as it provides a harmless way to map the arteries of the face. Objectives Evaluate a newly developed imaging technique to visualize the arteries of the face in a noninvasive and radiation-free manner. Methods The individual arterial facial anatomy of 20 volunteers was studied by an imaging technique, combining infrared (IR) facial warming and 3-dimensional (3D) time of flight (TOF) magnetic resonance angiography (MRA). The source and maximum intensity projection images were assessed by 2 investigators, familiar with the anatomy of the face. Results The MRA technique visualized most of the main facial arteries, albeit in a variable way. The main facial branches of the external carotid artery (facial, angular, supralabial, and superficial temporal arteries) were illustrated well, whereas the visualization of the internal carotid branches (supratrochlear and supraorbital arteries) and nasal branches (dorsal nasal and lateral nasal arteries) was less consistent. Conclusions The combination of IR “heat-induced enhancement” and a 3D-TOF MRA sequence may actually be an important step toward the visualization of the variable facial vascular anatomy in a noninvasive, radiation-free, and contrast-free manner.
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Affiliation(s)
- Benoit Hendrickx
- Department of Plastic and Reconstructive Surgery, AZ Zeno, Knokke-Heist, Belgium
| | - Karl Waked
- Department of Plastic and Reconstructive Surgery, UZ Brussel, Jette, Belgium
| | - Marc Mespreuve
- Department of Radiology, AZ Sint-Maarten, Mechelen, Belgium
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27
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Radiogenic risk assessment for abdominal vascular computed tomography angiography. Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2019.108523] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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28
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Sutanto H, Irdawati Y, Anam C, Fujibuchi T, Dougherty G, Hidayanto E, Arifin Z, Soedarsono JW, Bahrudin. An artifact-free thyroid shield in CT examination: a phantom study. Biomed Phys Eng Express 2020; 6:015029. [DOI: 10.1088/2057-1976/ab6ed1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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29
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Sulieman A, Serhan O, Al-Mohammed H, Mahmoud M, Alkhorayef M, Alonazi B, Manssor E, Yousef A. Estimation of cancer risks during mammography procedure in Saudi Arabia. Saudi J Biol Sci 2019; 26:1107-1111. [PMID: 31516336 PMCID: PMC6733693 DOI: 10.1016/j.sjbs.2018.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/28/2018] [Accepted: 10/02/2018] [Indexed: 11/28/2022] Open
Abstract
The aims of the present work were to quantify radiation doses arises from patients' exposure in mammographic X-ray imaging procedures and to estimate the radiation induced cancer risk. Sixty patients were evaluated using a calibrated digital mammography unit at King Khaled Hospital and Prince Sultan Center, Alkharj, Saudi Arabia. The average patient age (years) was 44.4 ± 10 (26-69). The average and range of exposure parameters were 29.1 ± 1.9 (24.0-33.0) and 78.4 ± 17.5 (28.0-173.0) for X-ray tube potential (kVp) and current multiplied by the exposure time (s) (mAs), respectively. The MGD (mGy) per single projection for craniocaudal (CC), Medio lateral oblique (MLO) and lateromedial (LM) was 1.02 ± 0.2 (0.4-1.8), 1.1 ± 0.3 (0.5-1.8), 1.1 ± 0.3 (0.5-1.9) per procedure, in that order. The average cancer risk per projection is 177 per million procedures. The cancer risk is significant during multiple image acquisition. The study revealed that 80% of the procedures with normal findings. However, precise justification is required especially for young patients.
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Affiliation(s)
- A. Sulieman
- Radiology & Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, P.O. Box 422, Alkharj 11942, Saudi Arabia
| | - O. Serhan
- Radiology Department, King Khaled Hospital and Prince Sultan Center for Health Services, Alkharj, Saudi Arabia
| | - H.I. Al-Mohammed
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - M.Z. Mahmoud
- Radiology & Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, P.O. Box 422, Alkharj 11942, Saudi Arabia
| | - M. Alkhorayef
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - B. Alonazi
- Radiology & Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, P.O. Box 422, Alkharj 11942, Saudi Arabia
| | - E. Manssor
- Radiology & Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, P.O. Box 422, Alkharj 11942, Saudi Arabia
| | - A. Yousef
- Radiology & Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, P.O. Box 422, Alkharj 11942, Saudi Arabia
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Chang KC, Chuang IC, Huang YC, Wu CY, Lin WC, Kuo YL, Lee TH, Ryu SJ. Risk factors outperform intracranial large artery stenosis predicting unfavorable outcomes in patients with stroke. BMC Neurol 2019; 19:180. [PMID: 31370812 PMCID: PMC6670158 DOI: 10.1186/s12883-019-1408-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 07/22/2019] [Indexed: 12/24/2022] Open
Abstract
Background This study examined how intracranial large artery stenosis (ILAS), symptomatic and asymptomatic ILAS, and risk factors affect unfavorable outcome events after medical treatment in routine clinical practice. Methods This was a 24-month prospective observational study of consecutively recruited stroke patients. All participants underwent magnetic resonance angiography, and their clinical characteristics were assessed. Outcome events were vascular outcome, recurrent stroke, and death. Cox regression analyses were performed to identify potential factors associated with an unfavorable outcome, which included demographic and clinical characteristics, the risk factors, and stenosis status. Results The analysis included 686 patients; among them, 371 were assessed as ILAS negative, 231 as symptomatic ILAS, and 84 as asymptomatic ILAS. Body mass index (p < .05), hypertension (p = .01), and old infarction (p = .047) were factors relating to vascular outcomes. Hypertension was the only factor for recurrent stroke (p = .035). Poor glomerular filtration rate (< 30 mL/min/1.73 m2) (p = .011) and baseline National Institutes of Health Stroke Scale scores (p < .001) were significant predictors of death. Conclusions This study extended previous results from clinical trials to a community-based cohort study by concurrently looking at the presence/absence of stenosis and a symptomatic/asymptomatic stenotic artery. Substantiated risk factors rather than the stenosis status were predominant determinants of adverse outcome. Although the degree of stenosis is often an indicator for treatment, we suggest risk factors, such as hypertension and renal dysfunction, should be monitored and intensively treated.
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Affiliation(s)
- K C Chang
- Division of Cerebrovascular Diseases, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Discharge Planning Service Center, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - I C Chuang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Y C Huang
- Division of Cerebrovascular Diseases, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Measurement and Statistics, Education, National University of Tainan, Tainan, Taiwan
| | - C Y Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Department of Physical Medicine and Rehabilitation, Healthy Aging Research Center at Chang Gung University, Chang Gung Memorial Hospital at Linkou, 259 Wen-hwa 1st Road, Taoyuan, Taiwan.
| | - W C Lin
- Department of Radiology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Y L Kuo
- Department of Radiology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - T H Lee
- Division of Cerebrovascular Diseases, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - S J Ryu
- Division of Cerebrovascular Diseases, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Nguyen TT, Simons JP, Podder S, Crawford AS, Judelson DR, Arous EJ, Aiello FA, Schanzer A. Imaging Obtained Up To 12 Months Preoperatively Is Adequate for Planning Fenestrated/Branched Endovascular Aortic Aneurysm Repair. Vasc Endovascular Surg 2019; 53:563-571. [PMID: 31362600 DOI: 10.1177/1538574419864769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Patients referred for fenestrated/branched endovascular aortic repair (F/BEVAR) often present with a previous computed tomography angiogram (CTA), but it is unknown how recent the CTA must be to ensure accurate F/BEVAR planning. We sought to determine whether anatomic planning parameters change significantly between a CTA used for F/BEVAR planning and a CTA obtained 6 to 12 months prior. METHODS Two blinded observers reviewed preoperative CTAs from 21 patients who underwent F/BEVAR. Each patient had a "recent" scan obtained 0 to 6 months before F/BEVAR planning and a "prior" scan obtained 6 to 12 months before the "recent" CTA. Standard measurements included (1) target vessel separation distances, (2) target vessel origin clock position, and (3) proximal F/BEVAR device diameter. Clinically significant differences for target vessel separation distance, target vessel origin clock position, and proximal F/BEVAR device diameter were predefined as >5 mm, >30 minutes, and >4 mm, respectively. Differences between "recent"/"prior" CTA scans were examined by paired t test. RESULTS Mean time interval between paired "recent"/"prior" CTAs was 8.0 months (standard deviation: ±1.7). Mean difference in paired "recent"/"prior" target vessel distance (relative to celiac artery [CA]) was 2.6 mm for the superior mesenteric artery (SMA), 2.5 mm for the right renal artery (RRA), and 3.3 mm for the left renal artery (LRA). Of the 21 paired "recent"/"prior" CTAs, clinically significant differences were observed in 2, 4, and 2 patients for SMA, RRA, and LRA target vessel distance, respectively. Target vessel clock position (SMA reference at 12:00) varied by 12 minutes for the CA, 13 minutes for the RRA, and 15 minutes for the LRA. One paired "recent"/"prior" CTA was found to have a clinically significant difference for the LRA. No clinically significant differences were observed for proximal device diameter. CONCLUSIONS In patients who underwent successful F/BEVAR, measurement comparisons between CTAs obtained up to 1 year prior were minor and unlikely to yield clinically significant changes to F/BEVAR design.
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Affiliation(s)
- Tammy T Nguyen
- 1 Division of Vascular and Endovascular Surgery, UMass Memorial Center for Complex Aortic Disease, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jessica P Simons
- 1 Division of Vascular and Endovascular Surgery, UMass Memorial Center for Complex Aortic Disease, University of Massachusetts Medical School, Worcester, MA, USA
| | - Sourav Podder
- 1 Division of Vascular and Endovascular Surgery, UMass Memorial Center for Complex Aortic Disease, University of Massachusetts Medical School, Worcester, MA, USA
| | - Allison S Crawford
- 1 Division of Vascular and Endovascular Surgery, UMass Memorial Center for Complex Aortic Disease, University of Massachusetts Medical School, Worcester, MA, USA
| | - Dejah R Judelson
- 1 Division of Vascular and Endovascular Surgery, UMass Memorial Center for Complex Aortic Disease, University of Massachusetts Medical School, Worcester, MA, USA
| | - Edward J Arous
- 1 Division of Vascular and Endovascular Surgery, UMass Memorial Center for Complex Aortic Disease, University of Massachusetts Medical School, Worcester, MA, USA
| | - Francesco A Aiello
- 1 Division of Vascular and Endovascular Surgery, UMass Memorial Center for Complex Aortic Disease, University of Massachusetts Medical School, Worcester, MA, USA
| | - Andres Schanzer
- 1 Division of Vascular and Endovascular Surgery, UMass Memorial Center for Complex Aortic Disease, University of Massachusetts Medical School, Worcester, MA, USA
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Prentice D, Wipke-Tevis DD. Diagnosis of pulmonary embolism: Following the evidence from suspicion to certainty. JOURNAL OF VASCULAR NURSING 2019; 37:28-42. [PMID: 30954195 DOI: 10.1016/j.jvn.2018.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/23/2018] [Accepted: 10/02/2018] [Indexed: 12/16/2022]
Abstract
Accurate, timely and cost-effective identification of pulmonary embolism remains a diagnostic challenge. This article reviews the pulmonary embolism diagnostic process with a focus on the best practice advice from the American College of Physicians. Benefits and risks of each diagnostic step are discussed. Emerging diagnostic tools, not included in the algorithm, are briefly reviewed.
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Affiliation(s)
- Donna Prentice
- Clinical Nurse Specialist, Barnes-Jewish Hospital, St. Louis, MO; PhD Candidate, Sinclair School of Nursing, University of Missouri, Columbia, MO.
| | - Deidre D Wipke-Tevis
- Associate Professor and PhD Program Director, Sinclair School of Nursing, University of Missouri, Columbia, MO
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Alkhorayef M, Sulieman A, Alonazi B, Alnaaimi M, Alduaij M, Bradley D. Estimation of radiation-induced cataract and cancer risks during routine CT head procedures. Radiat Phys Chem Oxf Engl 1993 2019. [DOI: 10.1016/j.radphyschem.2018.08.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Muftah M, Mulki R, Dhere T, Keilin S, Chawla S. Diagnostic and therapeutic considerations for obscure gastrointestinal bleeding in patients with chronic kidney disease. Ann Gastroenterol 2018; 32:113-123. [PMID: 30837783 PMCID: PMC6394262 DOI: 10.20524/aog.2018.0341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 11/18/2018] [Indexed: 12/12/2022] Open
Abstract
Recurrent obscure gastrointestinal bleeding amongst patients with chronic kidney disease is a challenging problem gastroenterologists are facing and is associated with an extensive diagnostic workup, limited therapeutic options, and high healthcare costs. Small-bowel angiodysplasia is the most common etiology of obscure and recurrent gastrointestinal bleeding in the general population. Chronic kidney disease is associated with a higher risk of gastrointestinal bleeding and of developing angiodysplasia compared with the general population. As a result, recurrent bleeding in this subgroup of patients is more prevalent and is associated with an increased number of endoscopic and radiographic procedures with uncertain benefit. Alternative medical therapies can reduce re-bleeding; however, more studies are needed to confirm their efficacy in this subgroup of patients.
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Affiliation(s)
- Mayssan Muftah
- Department of Medicine (Mayssan Muftah), Atlanta, United States
| | - Ramzi Mulki
- Medicine, Division of Digestive Diseases, Emory University School of Medicine (Ramzi Mulki, Tanvi Dhere, Steven Keilin, Saurabh Chawla), Atlanta, United States
| | - Tanvi Dhere
- Medicine, Division of Digestive Diseases, Emory University School of Medicine (Ramzi Mulki, Tanvi Dhere, Steven Keilin, Saurabh Chawla), Atlanta, United States
| | - Steven Keilin
- Medicine, Division of Digestive Diseases, Emory University School of Medicine (Ramzi Mulki, Tanvi Dhere, Steven Keilin, Saurabh Chawla), Atlanta, United States
| | - Saurabh Chawla
- Medicine, Division of Digestive Diseases, Emory University School of Medicine (Ramzi Mulki, Tanvi Dhere, Steven Keilin, Saurabh Chawla), Atlanta, United States.,Grady Memorial Hospital (Saurabh Chawla), Atlanta, United States
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Sulieman A, Mahmoud M, Serhan O, Alonazi B, Alkhorayef M, Alzimami K, Bradley D. CT examination effective doses in Saudi Arabia. Appl Radiat Isot 2018; 141:261-265. [DOI: 10.1016/j.apradiso.2018.07.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 06/14/2018] [Accepted: 07/10/2018] [Indexed: 11/26/2022]
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36
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Botwe BO. Running water sound technique in contrast-based voiding cystourethrogram: A case-control study. Radiography (Lond) 2018; 24:304-308. [PMID: 30292498 DOI: 10.1016/j.radi.2018.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/07/2018] [Accepted: 03/18/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND An intervention that can reduce the patient void time during a voiding cystourethrogram (VCUG) procedure can reduce the total radiation dose to the patient. This is because a delay in voiding leads to a high number of intermittent screenings to monitor if voiding occurs. This study assessed the impact of running-water sound (RWS) upon patients' voiding parameters and fluoroscopy screening times during VCUG examinations among children and adults. MATERIALS AND METHODS A case-control study involving 252 patients was undertaken which consisted two groups (control and test) of adults and children. The test groups underwent VCUG with RWS technique while the control groups underwent the procedure normally. T-test was used to compare the study parameters between the two groups and a p-value less than 0.05 was interpreted as significant. RESULTS The mean screening times (s) for children who underwent VCUG with and without RWS were 17.15 ± 2.5s and 30.61 ± 5.1s respectively (p = 0.0024). For adults, the RWS technique recorded a mean screening time of 37.36 ± 4.4s while the non-RWS procedures recorded 49.80 ± 5.2s (p = 0.001). The participants who received RWS intervention also felt the urge to void earlier than those who received no RWS intervention. The differences were also statistically significant for both children and adults. CONCLUSION The study being one of the first in this subject area indicates that the application of RWS technique induces early urge of iodinated-contrast voiding, and reduces voiding and fluoroscopy screening times during VCUG among children and adults. This simple technique can potentially enhance current practice.
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Affiliation(s)
- B O Botwe
- Department of Radiography, School of Biomedical & Allied Health Sciences, University of Ghana, Ghana.
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Tang H, Yu N, Jia Y, Yu Y, Duan H, Han D, Ma G, Ren C, He T. Assessment of noise reduction potential and image quality improvement of a new generation adaptive statistical iterative reconstruction (ASIR-V) in chest CT. Br J Radiol 2017; 91:20170521. [PMID: 29076347 DOI: 10.1259/bjr.20170521] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To evaluate the image quality improvement and noise reduction in routine dose, non-enhanced chest CT imaging by using a new generation adaptive statistical iterative reconstruction (ASIR-V) in comparison with ASIR algorithm. METHODS 30 patients who underwent routine dose, non-enhanced chest CT using GE Discovery CT750HU (GE Healthcare, Waukesha, WI) were included. The scan parameters included tube voltage of 120 kVp, automatic tube current modulation to obtain a noise index of 14HU, rotation speed of 0.6 s, pitch of 1.375:1 and slice thickness of 5 mm. After scanning, all scans were reconstructed with the recommended level of 40%ASIR for comparison purpose and different percentages of ASIR-V from 10% to 100% in a 10% increment. The CT attenuation values and SD of the subcutaneous fat, back muscle and descending aorta were measured at the level of tracheal carina of all reconstructed images. The signal-to-noise ratio (SNR) was calculated with SD representing image noise. The subjective image quality was independently evaluated by two experienced radiologists. RESULTS For all ASIR-V images, the objective image noise (SD) of fat, muscle and aorta decreased and SNR increased along with increasing ASIR-V percentage. The SD of 30% ASIR-V to 100% ASIR-V was significantly lower than that of 40% ASIR (p < 0.05). In terms of subjective image evaluation, all ASIR-V reconstructions had good diagnostic acceptability. However, the 50% ASIR-V to 70% ASIR-V series showed significantly superior visibility of small structures when compared with the 40% ASIR and ASIR-V of other percentages (p < 0.05), and 60% ASIR-V was the best series of all ASIR-V images, with a highest subjective image quality. The image sharpness was significantly decreased in images reconstructed by 80% ASIR-V and higher. CONCLUSION In routine dose, non-enhanced chest CT, ASIR-V shows greater potential in reducing image noise and artefacts and maintaining image sharpness when compared to the recommended level of 40%ASIR algorithm. Combining both the objective and subjective evaluation of images, non-enhanced chest CT images reconstructed with 60% ASIR-V have the highest image quality. Advances in knowledge: This is the first clinical study to evaluate the clinical value of ASIR-V in the same patients using the same CT scanner in the non-enhanced chest CT scans. It suggests that ASIR-V provides the better image quality and higher diagnostic confidence in comparison with ASIR algorithm.
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Affiliation(s)
- Hui Tang
- 1 College of Medical Technology, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Nan Yu
- 2 Department of Radiology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, China
| | - Yongjun Jia
- 2 Department of Radiology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, China
| | - Yong Yu
- 2 Department of Radiology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, China
| | - Haifeng Duan
- 2 Department of Radiology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, China
| | - Dong Han
- 2 Department of Radiology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, China
| | - Guangming Ma
- 2 Department of Radiology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, China
| | - Chenglong Ren
- 2 Department of Radiology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, China
| | - Taiping He
- 1 College of Medical Technology, Shaanxi University of Chinese Medicine, Xianyang, China.,2 Department of Radiology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, China
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