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Almohammed HI, Elshami W, Hamd ZY, Abuzaid M. Optimizing CT Abdomen-Pelvis Scan Radiation Dose: Examining the Role of Body Metrics (Waist Circumference, Hip Circumference, Abdominal Fat, and Body Mass Index) in Dose Efficiency. Tomography 2024; 10:643-653. [PMID: 38787009 PMCID: PMC11126040 DOI: 10.3390/tomography10050049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
Objective: This study investigates the correlation between patient body metrics and radiation dose in abdominopelvic CT scans, aiming to identify significant predictors of radiation exposure. Methods: Employing a cross-sectional analysis of patient data, including BMI, abdominal fat, waist, abdomen, and hip circumference, we analyzed their relationship with the following dose metrics: the CTDIvol, DLP, and SSDE. Results: Results from the analysis of various body measurements revealed that BMI, abdominal fat, and waist circumference are strongly correlated with increased radiation doses. Notably, the SSDE, as a more patient-centric dose metric, showed significant positive correlations, especially with waist circumference, suggesting its potential as a key predictor for optimizing radiation doses. Conclusions: The findings suggest that incorporating patient-specific body metrics into CT dosimetry could enhance personalized care and radiation safety. Conclusively, this study highlights the necessity for tailored imaging protocols based on individual body metrics to optimize radiation exposure, encouraging further research into predictive models and the integration of these metrics into clinical practice for improved patient management.
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Affiliation(s)
- Huda I. Almohammed
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Wiam Elshami
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah P.O Box 27272, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah P.O Box 27272, United Arab Emirates
| | - Zuhal Y. Hamd
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Mohamed Abuzaid
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah P.O Box 27272, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah P.O Box 27272, United Arab Emirates
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Ngoye W, Ndukeki M, Muhogora W, Jusabani A, Ngaile J, Ngoya P, Sungura R, Ngatunga C, Hashmi N, Makungu H, Onoka E, Amirali M, Kileo A, Makoba A, Muhulo A, Ngulimi M, Balobegwa V, Edmund E, Masoud A, Matulanya M. Radiation exposure during CT procedures in Tanzania. RADIATION PROTECTION DOSIMETRY 2023; 200:97-105. [PMID: 37981295 DOI: 10.1093/rpd/ncad274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 09/03/2023] [Accepted: 10/02/2023] [Indexed: 11/21/2023]
Abstract
The aim of this study was to evaluate optimisation status during common computed tomography (CT) procedures by determining values of volume computed tomography dose index (CTDIvol) and dose-length product (DLP) per examination. Patient and exposure data were collected from the CT console during various CT procedures. The results show that variations in CTDIvol and DLP values were mainly because of differences in the techniques used. The 75th percentile values were set as the third quartile of the median CTDIvol or DLP values for all hospitals. These values of 40.9, 9.0, 9.4 and 16.2 mGy for CTDIvol were determined for head, high-resolution chest, abdomen-pelvis and lumbar spine, respectively. The corresponding DLP values for the same sequence of CT procedures were 900, 360, 487 and 721 mGy.cm, respectively. The updated results provide a basis for optimising the procedures of CT in this country.
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Affiliation(s)
- Wilson Ngoye
- Tanzania Atomic Energy Commission, P.O. Box 743, Block J, Njiro, 23114 Arusha, Tanzania
| | - Mussa Ndukeki
- Muhimbili National Hospital, Malik Road, P.O. Box 65000, West Upanga, 8920 Dar es Salaam, Tanzania
| | - Wilbroad Muhogora
- Tanzania Atomic Energy Commission, P.O. Box 743, Block J, Njiro, 23114 Arusha, Tanzania
| | - Ahmed Jusabani
- Aga Khan Medical Centre, P.O. Box 2289, Baraka Obama Road, 11103 Dar es Salaam, Tanzania
| | - Justine Ngaile
- Tanzania Atomic Energy Commission, P.O. Box 743, Block J, Njiro, 23114 Arusha, Tanzania
| | - Patrick Ngoya
- Bugando Medical Centre, P.O. Box 1370, Makongoro Road, 33109 Mwanza, Tanzania
| | - Richard Sungura
- Arusha Lutheran Medical Centre, P.O. Box 17047, Fr. Babu Road, Block No. 54 Levolosi, 23104 Arusha, Tanzania
| | - Cecilia Ngatunga
- Mbeya Zonal Referral Hospital, P.O. Box 419, Hospital Hill Road, 53107 Mbeya, Tanzania
| | - Nazrina Hashmi
- TMJ Hospital, Mwai Kibaki Road, P.O. Box 20439, Mikocheni, 14112 Dar es Salaam, Tanzania
| | - Hilda Makungu
- Muhimbili National Hospital, Malik Road, P.O. Box 65000, West Upanga, 8920 Dar es Salaam, Tanzania
| | - Erick Onoka
- Arusha Lutheran Medical Centre, P.O. Box 17047, Fr. Babu Road, Block No. 54 Levolosi, 23104 Arusha, Tanzania
| | - Mudassir Amirali
- Muhimbili National Hospital, Malik Road, P.O. Box 65000, West Upanga, 8920 Dar es Salaam, Tanzania
| | - Abdallah Kileo
- Tanzania Atomic Energy Commission, P.O. Box 743, Block J, Njiro, 23114 Arusha, Tanzania
| | - Atumaini Makoba
- Tanzania Atomic Energy Commission, P.O. Box 743, Block J, Njiro, 23114 Arusha, Tanzania
| | - Alex Muhulo
- Tanzania Atomic Energy Commission, P.O. Box 743, Block J, Njiro, 23114 Arusha, Tanzania
| | - Miguta Ngulimi
- Tanzania Atomic Energy Commission, P.O. Box 743, Block J, Njiro, 23114 Arusha, Tanzania
| | - Vitus Balobegwa
- Tanzania Atomic Energy Commission, P.O. Box 743, Block J, Njiro, 23114 Arusha, Tanzania
| | - Elisha Edmund
- Tanzania Atomic Energy Commission, P.O. Box 743, Block J, Njiro, 23114 Arusha, Tanzania
| | - Ali Masoud
- Tanzania Atomic Energy Commission, P.O. Box 743, Block J, Njiro, 23114 Arusha, Tanzania
| | - Machibya Matulanya
- Tanzania Atomic Energy Commission, P.O. Box 743, Block J, Njiro, 23114 Arusha, Tanzania
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Efthymiou FO, Metaxas VI, Dimitroukas CP, Delis HB, Zikou KD, Ntzanis ES, Zampakis PE, Panayiotakis GS, Kalogeropoulou CP. A retrospective survey to establish institutional diagnostic reference levels for CT urography examinations based on clinical indications: preliminary results. Biomed Phys Eng Express 2023; 9:065005. [PMID: 37651989 DOI: 10.1088/2057-1976/acf582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/31/2023] [Indexed: 09/02/2023]
Abstract
Objective. To establish institutional diagnostic reference levels (IDRLs) based on clinical indications (CIs) for three- and four-phase computed tomography urography (CTU).Methods. Volumetric computed tomography dose index (CTDIvol), dose-length product (DLP), patients' demographics, selected CIs like lithiasis, cancer, and other diseases, and protocols' parameters were retrospectively recorded for 198 CTUs conducted on a Toshiba Aquilion Prime 80 scanner. Patients were categorised based on CIs and number of phases. These groups' 75th percentiles of CTDIvoland DLP were proposed as IDRLs. The mean, median and IDRLs were compared with previously published values.Results. For the three-phase protocol, the CTDIvol(mGy) and DLP (mGy.cm) were 22.7/992 for the whole group, 23.4/992 for lithiasis, 22.8/1037 for cancer, and 21.2/981 for other diseases. The corresponding CTDIvol(mGy) and DLP (mGy.cm) values for the four-phase protocol were 28.6/1172, 30.6/1203, 27.3/1077, and 28.7/1252, respectively. A significant difference was found in CTDIvoland DLP between the two protocols, among the phases of three-phase (except cancer) and four-phase protocols (except DLP for other diseases), and in DLP between the second and third phases (except for cancer group). The results are comparable or lower than most studies published in the last decade.Conclusions. The CT technologist must be aware of the critical dose dependence on the scan length and the applied exposure parameters for each phase, according to the patient's clinical background and the corresponding imaging anatomy, which must have been properly targeted by the competent radiologist. When clinically feasible, restricting the number of phases to three instead of four could remarkably reduce the patient's radiation dose. CI-based IDRLs will serve as a baseline for comparison with CTU practice in other hospitals and could contribute to national DRL establishment. The awareness and knowledge of dose levels during CTU will prompt optimisation strategies in CT facilities.
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Affiliation(s)
- Fotios O Efthymiou
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
| | - Vasileios I Metaxas
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
| | - Christos P Dimitroukas
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
- Department of Medical Physics, University Hospital of Patras, 26504 Patras, Greece
| | - Harry B Delis
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
| | - Kiriaki D Zikou
- Department of Radiology, University Hospital of Patras, 26504 Patras, Greece
| | | | - Petros E Zampakis
- Department of Radiology, University Hospital of Patras, 26504 Patras, Greece
- Department of Radiology, School of Medicine, University of Patras, 26504 Patras, Greece
| | - George S Panayiotakis
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
- Department of Medical Physics, University Hospital of Patras, 26504 Patras, Greece
| | - Christina P Kalogeropoulou
- Department of Radiology, University Hospital of Patras, 26504 Patras, Greece
- Department of Radiology, School of Medicine, University of Patras, 26504 Patras, Greece
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Establishment of Diagnostic Reference Levels in Cone Beam Computed Tomography Scans in the United Arab Emirates. Tomography 2022; 8:2939-2945. [PMID: 36548539 PMCID: PMC9783302 DOI: 10.3390/tomography8060247] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/08/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022] Open
Abstract
This study aimed to address the knowledge gap in assessing the radiation doses from cone beam computed tomography (CBCT) procedures, establishing a typical value, and estimating effective and organ doses. A total of 340 patients aged 18-80 years were included in this study. Organ doses were estimated using VirtualDose IR software. The typical values were based on median values estimated as 1000 mGy cm2. The mean ED (µSv) per procedure was 149.5 ± 56, and the mean of the peak skin dose during the CBCT examination was 39.29 mGy. The highest organ dose was received by the salivary glands (2.71 mGy), the extrathoracic region (1.64 mGy), thyroid (1.24 mGy) and eyes (0.61 mGy). The patients' doses were higher than in previous studies. Staff awareness, education, training and dose optimisation are highly recommended. With the establishment of local DRLs, patient dosages can be reduced successfully without compromising image quality.
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Radiation dose assessment in multiple injured patients using whole-body computed tomography. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2022. [DOI: 10.1016/j.jrras.2022.100465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Estimation of effective and organ dose from chest CT. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abuzaid MM, Elshami W, Sulieman A, Bradley D. Cumulative radiation exposure, effective and organ dose estimation from multiple head CT scans in stroke patients. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Elshami W, Abuzaid M, Joseph DZ, Tekin HO, Ghonim H. Development of acceptable quality radiation dose levels for common computed tomography examinations: A focused multicenter study in United Arab Emirates. Front Public Health 2022; 10:964104. [PMID: 36211693 PMCID: PMC9538773 DOI: 10.3389/fpubh.2022.964104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/05/2022] [Indexed: 01/24/2023] Open
Abstract
Purpose Diagnostic Reference Level (DRL) is a practical tool for radiation dose optimization, yet it does not indicate the patient size or image quality. The Acceptable Quality Dose (AQD) introduced to address the limitations of the DRLs and it is based on image quality, radiation dose, and patient weight. The aim of this study is to establish the AQD for adult patients' undergoing Computed Tomography (CT) examinations (Head, chest, abdomen). Methods This study is conducted in the four main hospitals at the Ministry of Health and Prevention. Patient information and exposure parameters were extracted. All the acceptable images are scored for their quality assessments. Data is classified as seven weight groups, <50, 50-59, 60-69, 70-79, 80-89, 90-99, and ≥100 kg. The mean ± SD, median, and 75th are calculated for the CTDIvol and DLP for each weight group per examination. Results Out of 392, 358 CT examinations are scored with acceptable quality. The median CTDIvol values for the weight groups are obtained as 24.6, 25.4, 25.4, 25.0, 26.0, 27.0, and 29.0 mGy. Moreover, median DLP values are obtained as 576.7, 601.0, 616.5, 636.1, 654.0, 650.0, 780.0, and 622.5 mGy.cm, respectively, for head CT without Contrast Media (CM). Similar calculation for head CT with (CM), chest without CM, abdomen without CM, and chest and abdomen (with and without CM) CTs are presented. Conclusion Images with bad, unacceptable and higher than necessary qualities contribute to increasing patient dose and increasing the DRLs. The AQD for the selected examinations were lower than the proposed DRLs in the United Arab Emirates. The integration of image quality and patients size in the assessment of the AQD values provide effective model to compare radiation dose indices within facility and compare with others. The obtained results may be useful in terms of improving dose and the diagnostic quality in the national and international levels.
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Affiliation(s)
- Wiam Elshami
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates,*Correspondence: Wiam Elshami
| | - Mohamed Abuzaid
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Dlama Z. Joseph
- Department of Radiology, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | - H. O. Tekin
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates,Computer Engineering Department, Faculty of Engineering and Natural Sciences, Istinye University, Istanbul, Turkey
| | - Hatem Ghonim
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Elshami W, Abuzaid MM, McConnell J, Baird M. Changing the model of radiography practice: Challenges of role advancement and future needs for radiographers working in the UAE. Radiography (Lond) 2022; 28:949-954. [PMID: 35841689 DOI: 10.1016/j.radi.2022.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/04/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The radiographers' role in the United Arab Emirates (UAE) is focused on image acquisition with a willingness to accept advanced practice roles after appropriate education and training. Radiographers working in the UAE are highly motivated and ambitious to achieve those internationally identified levels of professional recognition and opportunities for role advancement. This study investigates the radiographers' perspectives, perceptions and hopes for role advancement in the UAE. METHODS A qualitative research study design using Focus Group Discussions (FGD) was used to elicit the perceptions of radiographers. Participants were radiographers working in the hospitals and clinics supervised by the Ministry of Health and Prevention. Participants were asked about the recognized tasks defined as advancement roles, needs for roles clinically, challenges and requirements to prepare radiographers to participate in extended/developed roles. The discussions were audio recorded and later transcribed by an independent research assistant. Thematic analysis was used for data analysis RESULTS: 29 radiographers participated in the FGDs, and 83% (n = 24) were interested in role advancement. FGD revealed that their current practice showed some informal extended role that may promote career progression. The most significant challenges identified by participants was their knowledge level as provided by the current curriculum and the need for education and licensing body support to accommodate change. CONCLUSION The study identified a need for education and licensing body support to enable change in roles by radiographers, through improving radiographer knowledge and experience for role advancement. IMPLICATIONS FOR PRACTICE To sustain role advancement, formal intense training and education are necessary, normally above bachelor's degree level. Furthermore, establishing standards, licensing organizations/professional bodies should be part of the transformation of the profession to enable internationally recognized models to be followed.
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Affiliation(s)
- W Elshami
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - M M Abuzaid
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - J McConnell
- Yorkshire Imaging Collaborative, United Kingdom.
| | - M Baird
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
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Hasan N, Rizk C, Babikir E. National diagnostic reference levels based on clinical indications and patient size for adults’ computed tomography in the Kingdom of Bahrain. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110147] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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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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