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Golbus AE, Schuzer JL, Steveson C, Rollison SF, Matthews J, Henry-Ellis J, Razeto M, Chen MY. Reduced dose helical CT scout imaging on next generation wide volume CT system decreases scan length and overall radiation exposure. Eur J Radiol Open 2024; 13:100578. [PMID: 38993285 PMCID: PMC11237680 DOI: 10.1016/j.ejro.2024.100578] [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: 03/27/2024] [Revised: 05/24/2024] [Accepted: 06/02/2024] [Indexed: 07/13/2024] Open
Abstract
Purpose Traditional CT acquisition planning is based on scout projection images from planar anterior-posterior and lateral projections where the radiographer estimates organ locations. Alternatively, a new scout method utilizing ultra-low dose helical CT (3D Landmark Scan) offers cross-sectional imaging to identify anatomic structures in conjunction with artificial intelligence based Anatomic Landmark Detection (ALD) for automatic CT acquisition planning. The purpose of this study is to quantify changes in scan length and radiation dose of CT examinations planned using 3D Landmark Scan and ALD and performed on next generation wide volume CT versus examinations planned using traditional scout methods. We additionally aim to quantify changes in radiation dose reduction of scans planned with 3D Landmark Scan and performed on next generation wide volume CT. Methods Single-center retrospective analysis of consecutive patients with prior CT scan of the same organ who underwent clinical CT using 3D Landmark Scan and automatic scan planning. Acquisition length and dose-length-product (DLP) were collected. Data was analyzed by paired t-tests. Results 104 total CT examinations (48.1 % chest, 15.4 % abdomen, 36.5 % chest/abdomen/pelvis) on 61 individual consecutive patients at a single center were retrospectively analyzed. 79.8 % of scans using 3D Landmark Scan had reduction in acquisition length compared to the respective prior acquisition. Median acquisition length using 3D Landmark Scan was 26.7 mm shorter than that using traditional scout methods (p < 0.001) with a 23.3 % median total radiation dose reduction (245.6 (IQR 150.0-400.8) mGy cm vs 320.3 (IQR 184.1-547.9) mGy cm). CT dose index similarly was overall decreased for scans planned with 3D Landmark and ALD and performed on next generation CT versus traditional methods (4.85 (IQR 3.8-7) mGy vs. 6.70 (IQR 4.43-9.18) mGy, respectively, p < 0.001). Conclusion Scout imaging using reduced dose 3D Landmark Scan images and Anatomic Landmark Detection reduces acquisition range in chest, abdomen, and chest/abdomen/pelvis CT scans. This technology, in combination with next generation wide volume CT reduces total radiation dose.
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Affiliation(s)
- Alexa E Golbus
- Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Shirley F Rollison
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Marco Razeto
- Canon Medical Research Europe, Edinburgh, Scotland, UK
| | - Marcus Y Chen
- Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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Botwe BO, Schandorf C, Inkoom S, Faanu A. Variability of redundant scan coverages along the Z-axis and dose implications for common computed tomography examinations. J Med Imaging Radiat Sci 2021; 53:113-122. [PMID: 34836834 DOI: 10.1016/j.jmir.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Scan length optimization is a method of optimization which ensures that, imaging is performed to cover just the area of interest without unnecessarily exposing structures that would not add value to answer a given clinical question. PURPOSE This study assessed the variability and degree of redundant scan coverages along the z-axis of CT examinations of common indications and the associated radiation dose implications in CT facilities in Ghana for optimization measures to be recommended. METHODS On reconstructed acquired CT images, the study measured extra distances covered above and below anatomical targets for common indications with calibrated calipers across 25 CT facilities. The National Cancer Institute Dosimetry System for CT (NCICT) (Monte Carlo-based-software) was used to simulate the scanning situations and organ dose implications for scans with and without the inclusion of the redundant scan areas. RESULTS A total of 1,640 patients' CT data sets were used in this study. The results demonstrated that CT imaging utilized varying scan lengths (16.45±21.0-45.99±4.3 cm), and 70.6% of the scans exceeded their pre-defined anatomic boundaries by a mean range of 2.86±1.07-5.81±1.66 cm, thereby resulting in extra patient radiation dose. Hence, scanning without the redundant coverages could generate a dose length product (DLP) reduction of 17.5%, 18.8%, 15.5% and 9.0% without degrading image quality for brain lesion, lung lesion, pulmonary embolism and abdominopelvic lesion CT imaging, respectively, whilst ensuring organ dose reduction of0.8%-79.1%. CONCLUSION The study strongly recommends that radiographers should avoid the inclusion of redundant areas in CT examinations to reduce organ doses.
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Affiliation(s)
- Benard Ohene Botwe
- Radiography Department, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O Box KB 143, Korle-Bu Campus, Accra, Ghana..
| | - Cyril Schandorf
- Department of Nuclear Safety and Security, School of Nuclear and Allied Sciences, University of Ghana, Atomic Campus, Accra, Ghana, Legon
| | - Stephen Inkoom
- Medical Physics Department, School of Nuclear and Allied Sciences, University of Ghana, Atomic Campus, Accra, Ghana.; Radiation Protection Institute (RPI), Ghana Atomic Energy Commission, Accra, Ghana
| | - Augustine Faanu
- Radiation Protection Institute (RPI), Ghana Atomic Energy Commission, Accra, Ghana.; Radiological and Non-ionizing Radiation Directorate, Nuclear Regulatory Authority, Accra, Ghana
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Salimi Y, Shiri I, Akhavanallaf A, Mansouri Z, Saberi Manesh A, Sanaat A, Pakbin M, Askari D, Sandoughdaran S, Sharifipour E, Arabi H, Zaidi H. Deep learning-based fully automated Z-axis coverage range definition from scout scans to eliminate overscanning in chest CT imaging. Insights Imaging 2021; 12:162. [PMID: 34743251 PMCID: PMC8572075 DOI: 10.1186/s13244-021-01105-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/09/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Despite the prevalence of chest CT in the clinic, concerns about unoptimized protocols delivering high radiation doses to patients still remain. This study aimed to assess the additional radiation dose associated with overscanning in chest CT and to develop an automated deep learning-assisted scan range selection technique to reduce radiation dose to patients. RESULTS A significant overscanning range (31 ± 24) mm was observed in clinical setting for over 95% of the cases. The average Dice coefficient for lung segmentation was 0.96 and 0.97 for anterior-posterior (AP) and lateral projections, respectively. By considering the exact lung coverage as the ground truth, and AP and lateral projections as input, The DL-based approach resulted in errors of 0.08 ± 1.46 and - 1.5 ± 4.1 mm in superior and inferior directions, respectively. In contrast, the error on external scout views was - 0.7 ± 4.08 and 0.01 ± 14.97 mm for superior and inferior directions, respectively.The ED reduction achieved by automated scan range selection was 21% in the test group. The evaluation of a large multi-centric chest CT dataset revealed unnecessary ED of more than 2 mSv per scan and 67% increase in the thyroid absorbed dose. CONCLUSION The proposed DL-based solution outperformed previous automatic methods with acceptable accuracy, even in complicated and challenging cases. The generizability of the model was demonstrated by fine-tuning the model on AP scout views and achieving acceptable results. The method can reduce the unoptimized dose to patients by exclunding unnecessary organs from field of view.
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Affiliation(s)
- Yazdan Salimi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, 1211, Geneva, Switzerland
| | - Isaac Shiri
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, 1211, Geneva, Switzerland
| | - Azadeh Akhavanallaf
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, 1211, Geneva, Switzerland
| | - Zahra Mansouri
- Department of Biomedical Engineering and Medical Physics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdollah Saberi Manesh
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, 1211, Geneva, Switzerland
| | - Amirhossein Sanaat
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, 1211, Geneva, Switzerland
| | - Masoumeh Pakbin
- Imaging Department, Qom University of Medical Sciences, Qom, Iran
| | - Dariush Askari
- Department of Radiology Technology, Shahid Beheshti University of Medical, Tehran, Iran
| | - Saleh Sandoughdaran
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Sharifipour
- Neuroscience Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Hossein Arabi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, 1211, Geneva, Switzerland
| | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, 1211, Geneva, Switzerland.
- Geneva University Neurocenter, Geneva University, Geneva, Switzerland.
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
- Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark.
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Yar O, Onur MR, İdilman İS, Akpınar E, Akata D. Excessive z-axis scan coverage in body CT: frequency and causes. Eur Radiol 2020; 31:4358-4366. [PMID: 33241517 DOI: 10.1007/s00330-020-07510-4] [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: 08/27/2020] [Accepted: 11/11/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The aim of this study was to determine the frequency and causing factors of excessive z-axis coverage in body CT examinations. METHODS A total of 2032 body CT examinations performed between 1 March and 1 April 2018 in 1531 patients were included in this study. The over-scanned length values in the z-axis for each CT examination on each patient were determined by calculating the difference between the actual scanned length and optimal scan length in the z-axis. Over-scanning and over-scanning ratios were interrogated in terms of potential underlying factors that can be affected by patient demography, time, the throughput of CT, and the experience of technologists. RESULTS Over-scanned CTs in z-axis were 66% of all CTs performed. CT scans were over-scanned in the cranial side in 18.4% and caudal side in 48.5% of patients. Over-scanning was found to be more frequent in 55-64-year-old age group (74%), thorax CTs (89.2%), patients with consciousness change (88.9%), patients with misleading findings related to lung apex or diaphragm on the scout images (76.6%), CTs performed in day shift (66.8 %), in CT with low daily scan (72.4%), and CT scans performed by less-experienced technologists (75.9%). CONCLUSIONS Over-scanning in z-axis in body CT examinations is not infrequently encountered in routine practice. Awareness of causes of over-scanning in z-axis can be helpful to prevent over-scanning in CT and unnecessary ionizing radiation exposure in patients. KEY POINTS • Over-scanning in z-axis frequently occurs in body CT. • The frequency of over-scanning in caudal side is higher than cranial side. • Chest CT and any CT performed in following situation were more prone to over-scanning: older patients, patients with consciousness change, presence of misleading findings on the scout images related to lung apex or diaphragm, day shift, CT with low daily scan, less-experienced technologist.
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Affiliation(s)
- Ozan Yar
- Department of Radiology, Artvin Public Hospital, 08000, Artvin, Turkey
| | - Mehmet Ruhi Onur
- Hacettepe University Faculty of Medicine, Department of Radiology, Hacettepe Universitesi Tıp Fakultesi Hastanesi Sıhhiye, 06100, Ankara, Turkey.
| | | | - Erhan Akpınar
- Faculty of Medicine, Department of Radiology, Hacettepe University, Ankara, Turkey
| | - Deniz Akata
- Faculty of Medicine, Department of Radiology, Hacettepe University, Ankara, Turkey
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Cohen SL, Ward TJ, Makhnevich A, Richardson S, Cham MD. Retrospective analysis of 1118 outpatient chest CT scans to determine factors associated with excess scan length. Clin Imaging 2020; 62:76-80. [PMID: 32200203 PMCID: PMC7598945 DOI: 10.1016/j.clinimag.2019.11.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/11/2019] [Accepted: 11/25/2019] [Indexed: 02/07/2023]
Abstract
RATIONALE OBJECTIVES Excess z-axis scanning continues as an unnecessary source of radiation. This study seeks to determine patient, technologist and CT factors that affect excess scan length for chest CT. MATERIALS AND METHODS Retrospective evaluation of 1118 consecutive noncontrast chest CT scans, over twelve consecutive months, was performed for evaluation of scan length above and below the lung parenchyma. Scan length >2 cm was considered excessive. Bivariate analysis for mean excess scan length and presence of excess scan length analyzed technologist's exam volume during the study period, patient age, patient gender, day of week, and time of day as categorical variables. Technologists performing >100 chest CT scans during the study period were considered high-volume while all others were considered low-volume. RESULTS Mean excess scan length was 5 mm, 29 mm, and 33 mm above the lungs, below the lungs, and total. 81% and 95% of studies had excess scanning above the lungs and below the lungs respectively. Multivariable analysis showed that high volume technologists, male patients, and patients younger than 65 had a greater amount of excess scan length and presence of excessive scanning above the lungs; high volume technologists and male patients had a greater amount of excess scan length below the lungs, and high volume technologists and patients older than 65 had greater presence of excessive scanning below the lungs, each p < 0.001. CONCLUSIONS Excess scanning on chest CT is common, varies by patient age and gender and was significantly greater for high volume technologists.
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Affiliation(s)
- Stuart L Cohen
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America; Northwell Health Imaging, Manhasset, NY, United States of America; Imaging Clinical Effectiveness & Outcomes Research Program at Northwell Health, Manhasset, NY, United States of America; Center for Health Innovations and Outcomes Research, Feinstein Institute for Medical Research at Northwell Health, Manhasset, NY, United States of America.
| | - Thomas J Ward
- Florida Hospital Radiology, Orlando, FL, United States of America
| | - Alex Makhnevich
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America; Center for Health Innovations and Outcomes Research, Feinstein Institute for Medical Research at Northwell Health, Manhasset, NY, United States of America; Northwell Health Internal Medicine, Manhasset, NY, United States of America
| | - Safiya Richardson
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America; Center for Health Innovations and Outcomes Research, Feinstein Institute for Medical Research at Northwell Health, Manhasset, NY, United States of America; Northwell Health Internal Medicine, Manhasset, NY, United States of America
| | - Matthew D Cham
- University of Washington Radiology, Seattle, WA, United States of America
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Cohen SL, Ward TJ, Jacobi AH, Cham M. Institutional Impact of a Personalized Technologist Feedback Program on Scan Length and Radiation Dose. J Am Coll Radiol 2019; 16:1073-1076. [PMID: 30910576 DOI: 10.1016/j.jacr.2019.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/04/2019] [Accepted: 02/06/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Stuart Lance Cohen
- Imaging Clinical Effectiveness and Outcomes Research (ICEOR), Department of Radiology, Northwell Health, Manhasset, New York; Center for Health Innovations and Outcomes Research (CHIOR), Feinstein Institute for Medical Research and Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York.
| | | | | | - Matthew Cham
- Department of Radiology, University of Washington Medical Center, Seattle, Washington
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"Scout No Scan" Technique Reduces Patient Radiation Exposure During CT-Guided Spine Biopsy. AJR Am J Roentgenol 2017; 209:1158-1161. [PMID: 28834446 DOI: 10.2214/ajr.16.17404] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of this article is to report our experience with a technique for CT-guided spine biopsies that we refer to as the "scout no scan" technique. CONCLUSION The scout no scan technique can significantly lower radiation exposure while maintaining high diagnostic yields for CT-guided spinal biopsies.
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Reducing Patient Radiation Exposure From CT Fluoroscopy-Guided Lumbar Spine Pain Injections by Targeting the Planning CT. AJR Am J Roentgenol 2016; 206:390-4. [PMID: 26797369 DOI: 10.2214/ajr.15.14436] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE CT fluoroscopy-guided lumbar spine pain injections typically include a preprocedural planning CT that contributes considerably to patient dose. The purpose of this study was to quantify the degree of radiation exposure reduction achieved by modifying only the planning CT component of the examination. MATERIALS AND METHODS A retrospective review was performed of 80 CT fluoroscopy-guided lumbar spine injections. Forty patients were scanned with a standard protocol using automatic tube current modulation (method A). Another 40 patients were scanned using a new technique that fixed the tube current of the planning CT to either 50 or 100 mA on the basis of the patient's anteroposterior diameter and that reduced the z-axis coverage (method B). Dose-length products (DLPs) were compared for the two methods. RESULTS The mean maximal tube current for the planning CT was 435.0 mA for method A and 67.5 mA for method B. The mean z-axis was shorter for method B at 6.5 cm than for method A at 9.6 cm (p < 0.0001). The mean DLP for the planning CT was 11 times lower for method B than for method A: 27.9 versus 313.1 mGy × cm, respectively (p < 0.0001). When method B was used, the mean DLP for the total procedure (i.e., planning CT plus CT fluoroscopy components) was reduced by 78%. There was no significant difference between methods A and B in CT fluoroscopy time (p = 0.37). All procedures were technically successful. CONCLUSION A nearly fivefold reduction in radiation exposure can be achieved in CT fluoroscopy-guided lumbar spine pain injections through modifications to the planning CT alone.
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Zhang M, Wellnitz C, Cui C, Pavlicek W, Wu T. Automated detection of z-axis coverage with abdomen-pelvis computed tomography examinations. J Digit Imaging 2016; 28:362-7. [PMID: 25413130 DOI: 10.1007/s10278-014-9743-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Excessive cephalocaudal anatomic (Z-axis) coverage can lead to unnecessary radiation exposure to a patient. In this study, an automated computing model was developed for identifying instances of potentially excessive Z-axis coverage with abdomen-pelvis examinations. Eight patient and imaging attributes including patient gender, age, height, weight, volume CT dose index (CTDIvol), dose length product (DLP), maximum abdomen width, and maximum abdomen thickness were used to build a feedforward neural network model to predict a target Z-axis coverage whether it is an excessive or non-excessive Z-axis coverage scans. 264 CT abdomen-pelvis exams were used to develop the model which is validated using 10-fold cross validation. The result showed that 244 out of 264 exams (92.4%) correctly predicted Z-axis excessive coverage. The promising results indicate that this tool has the potential to be used for CT exams of the chest and colon, urography, and other site-specified CT studies having defined limited length.
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Affiliation(s)
- Min Zhang
- School of Computing, Informatics Decisions and System Engineering, Arizona State University, Tempe, AZ, USA
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10
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Martin Weber Kusk R. Incorrectly placed gonad shields: Effect on CT automatic exposure correction from four different scanners. Radiography (Lond) 2014. [DOI: 10.1016/j.radi.2014.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Achieving Ideal Computed Tomographic Scan Length in Patient With Suspected Urolithiasis. J Comput Assist Tomogr 2014; 38:264-7. [DOI: 10.1097/rct.0000000000000016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Brassart N, Winant C, Tack D, Gevenois PA, De Maertelaer V, Keyzer C. Optimised z-axis coverage at multidetector-row CT in adults suspected of acute appendicitis. Br J Radiol 2013; 86:20130115. [PMID: 23690436 DOI: 10.1259/bjr.20130115] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To compare diagnostic performances of two reduced z-axis coverages to full coverage of the abdomen and pelvis for the diagnosis of acute appendicitis and alternative diseases at unenhanced CT. METHODS This study included 152 adults suspected of appendicitis who were enrolled in two ethical committee-approved previous prospective trials. Based on scans covering the entire abdomen and pelvis (set L), two additional sets of images were generated, each with reduced z-axis coverages: (1) from the top of the iliac crests to the pubis (set S) and (2) from the diaphragmatic crus to the pubis (set M). Two readers independently coded the visualisation of the appendix, measured its diameter and proposed a diagnosis (appendicitis or alternative). Final diagnosis was based on surgical findings or clinical follow-up. Fisher exact and McNemar tests and logistic regression were used. RESULTS 46 patients had a definite diagnosis of appendicitis and 53 of alternative diseases. The frequency of appendix visualisation was lower for set S than set L for both readers (89% and 84% vs 95% and 91% by Readers A and B, respectively; p=0.021 and 0.022). The probability of giving a correct diagnosis was lower for set S (68%) than set L (78%; odds ratio, 0.611; p=0.008) for both readers, without significant difference between sets L and M (77%, p=0.771); z-axis coverage being reduced by 25% for set M. CONCLUSION Coverage from diaphragmatic crus to pubis, but not focused on pelvis only, can be recommended in adults suspected of appendicitis. ADVANCES IN KNOWLEDGE In suspected appendicitis, CT-coverage can be reduced from diaphragmatic crus to pubis.
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Affiliation(s)
- N Brassart
- Department of Radiology, Hôpital Erasme, Université libre de Bruxelles, Brussels, Belgium
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Zanca F, Demeter M, Oyen R, Bosmans H. Excess radiation and organ dose in chest and abdominal CT due to CT acquisition beyond expected anatomical boundaries. Eur Radiol 2011; 22:779-88. [DOI: 10.1007/s00330-011-2332-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 09/12/2011] [Accepted: 09/18/2011] [Indexed: 10/15/2022]
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