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Açıkgöz G. Investigating the Effects of Tube Current and Tube Voltage on Patient Dose in Computed Tomography Examinations with Principial Component Analysis and Cluster Analysis: Phantom Study. HEALTH PHYSICS 2024; 127:513-519. [PMID: 38787573 DOI: 10.1097/hp.0000000000001830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
ABSTRACT The aim of this study was to investigate the effects of tube current and tube voltage choices on patient dose in adult and pediatric CT protocols by qualitative analysis using Principal Component Analysis (PCA), cluster analysis, and statistical analysis.Dose length product (DLP), Effective mAs (Eff. mAs), and volume-weighted CT dose index (CTDIvol) dose descriptors were obtained from 16 adult and pediatric head phantom CT examinations. Different tube voltage and tube current values were selected in both pediatric head and adult head CT imaging protocols, and PCA and cluster analysis were applied to the data obtained for qualitative analysis of the relationship between CTDIvol, Eff. mAs and Total DLP values. The two principial components (PC) with the highest values among those obtained as a result of the PCA method were used. PC1 was 70.97%, and PC2 was 28.03%. In the cluster analysis, it was observed that the values obtained from pediatric and adult phantom CT scans were classified into two different clusters. The correlation coefficient for adult patients was r = 0.998, and for pediatric patients, the correlation coefficient was r = 0.947. When the obtained clusters were examined, the degree of closeness or distance of the variables could be observed. In the study, as a result of the analysis of CTDIvol, Eff. mAs and Total DLP data based on manufacturer data at different kV and mA values with PCA and cluster analysis, it was shown that pediatric patients could be exposed to more radiation than the adult patients.
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Affiliation(s)
- Güneş Açıkgöz
- Hatay Mustafa Kemal University Vocational School of Health Services, Hatay/Turkey. Güneş Açıkgöz, Hatay MKÜ: Hatay Mustafa Kemal Universitesi, Serinyol HMKU campus, Hatay 31100 (ORCID: 0000-0001-9118-3153 )
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Zhao A, Resnick S, Burton CS, Fadhel M. Deciphering the Radiation Dose Summary Page in Interventional Fluoroscopy. Radiographics 2024; 44:e230197. [PMID: 39088363 DOI: 10.1148/rg.230197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
Fluoroscopy is an advanced medical imaging modality that utilizes x-rays to acquire real-time images throughout a medical examination. It is commonly used in various procedures such as in interventional radiology, cardiac catheterization, and gastrointestinal and genitourinary studies. While fluoroscopy is a valuable diagnostic and therapeutic tool, it exposes patients and medical staff to ionizing radiation, which carries health risks. A radiation dose summary page is a report generated by the fluoroscope that displays important information about the procedure. It provides an overview of the radiation doses administered during a fluoroscopic procedure, as well as certain technical parameters used during the irradiation events. The contents of a radiation dose summary page may vary depending on the make and model of the fluoroscope but some common elements include the cumulative reference air kerma, which serves as a surrogate of radiation dose delivered to the patient, and the dose-area product, which takes account of the x-ray beam area and is a measure of the total amount of energy imparted on the patient. Other imaging acquisition parameters may be also included in the dose summary page, including tube voltage, tube current, pulse width, pulse rate, spectral filters, primary and secondary angles, and source-to-image distance. The radiation dose summary page for fluoroscopy is a useful tool for physicians, technologists, and medical physicists, allowing them to comprehend the technical details of a fluoroscopically guided procedure. ©RSNA, 2024.
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Affiliation(s)
- Anzi Zhao
- From the Department of Radiation Safety (A.Z., C.S.B., M.F.), Northwestern Memorial Hospital and the Department of Radiology (S.R.), Northwestern University Feinberg School of Medicine, 676 N St. Clair St, Ste 401, Chicago, IL 60611
| | - Scott Resnick
- From the Department of Radiation Safety (A.Z., C.S.B., M.F.), Northwestern Memorial Hospital and the Department of Radiology (S.R.), Northwestern University Feinberg School of Medicine, 676 N St. Clair St, Ste 401, Chicago, IL 60611
| | - Christiane Sarah Burton
- From the Department of Radiation Safety (A.Z., C.S.B., M.F.), Northwestern Memorial Hospital and the Department of Radiology (S.R.), Northwestern University Feinberg School of Medicine, 676 N St. Clair St, Ste 401, Chicago, IL 60611
| | - Muhannad Fadhel
- From the Department of Radiation Safety (A.Z., C.S.B., M.F.), Northwestern Memorial Hospital and the Department of Radiology (S.R.), Northwestern University Feinberg School of Medicine, 676 N St. Clair St, Ste 401, Chicago, IL 60611
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Rizzo S, Bellesi L, D'Ermo A, Bonomo L, D'Ecclesiis O, Magoga F, Presilla S, Spanò A, Minzolini V, Lo Piccolo F, Heinkel J, Rezzonico E, Del Grande M, Merli M, Del Grande F. Body CT examinations in oncologic patients: the impact of subspecialty radiology on radiation exposure in the clinical practice. A quality care study. LA RADIOLOGIA MEDICA 2024; 129:429-438. [PMID: 38341817 PMCID: PMC10943144 DOI: 10.1007/s11547-024-01790-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/15/2024] [Indexed: 02/13/2024]
Abstract
PURPOSES The primary objective of this retrospective study was to assess whether the CT dose delivered to oncologic patients was different in a subspecialty radiology department, compared to a general radiology department. The secondary explorative objective was to assess whether the objective image quality of CT examinations was different in the two settings. MATERIALS AND METHODS Chest and abdomen CT scans performed for oncologic indications were selected from a general radiology department and a subspecialty radiology department. By using a radiation dose management platform, we extracted and compared CT dose index (CTDIvol) and dose length product (DLP) both for each phase and for the entire CT exams. For objective image quality evaluation, we calculated the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) at the level of the liver and of the aorta. A P-value < 0.05 was considered significant. RESULTS A total of 7098 CT examinations were included. CTDIvol was evaluated in 12,804 phases; DLP in 10,713 phases and in 6714 examinations. The CTDIvol and DLP overall were significantly lower in the subspecialty radiology department compared to the general radiology department CTDI median (IQR) 5.19 (3.91-7.00) and 5.51 (4.17-7.72), DLP median and IQR of 490.0 (342.4-710.6) and 503.4 (359.9-728.8), p < 0.001 and p = 0.01, respectively. The objective image quality showed no significant difference in the general and subspecialty radiology departments, with median and IQR of 4.03 (2.82-5.51) and 3.84 (3.09-4.94) for SNRLiv (p = 0.58); 4.81 (2.70-7.62) and 4.34 (3.05-6.25) for SNRAo (p = 0.30); 0.83 (0.20-1.89) and 1.00 (0.35-1.57) for CNRLiv (p = 0.99); 2.23 (0.09-3.83) and 1.01 (0.15-2.84) for CNRAo (p = 0.24) with SNRLiv (p = 0.58), SNRAo (p = 0.30), CNRLiv (p = 0.99) and CNRAo (p = 0.24). CONCLUSION In a subspecialty radiology department, CT protocols are optimized compared to a general radiology department leading to lower doses to oncologic patients without significant objective image quality degradation.
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Affiliation(s)
- Stefania Rizzo
- Clinic of Radiology, Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland.
- Faculty of Biomedical Sciences, Università Della Svizzera Italiana (USI), Via G. Buffi 13, 6904, Lugano, Switzerland.
| | - Luca Bellesi
- Service of Medical Physics, Maging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| | - Andrea D'Ermo
- Service of Process Organization and Information, EOC, Support Area, Via Lugano 4D, 6500, Bellinzona, Switzerland
| | - Luca Bonomo
- Clinic of Radiology, Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland
| | - Oriana D'Ecclesiis
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesco Magoga
- Clinic of Radiology, Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland
| | - Stefano Presilla
- Service of Medical Physics, Maging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| | - Arturo Spanò
- Clinic of Radiology, Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland
| | - Veronica Minzolini
- Clinic of Radiology, Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland
| | - Francesca Lo Piccolo
- Clinic of Radiology, Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland
| | - Jurgen Heinkel
- Clinic of Radiology, Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland
| | - Ermidio Rezzonico
- Clinic of Radiology, Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland
| | - Maria Del Grande
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
| | - Matteo Merli
- Clinic of Radiology, Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland
| | - Filippo Del Grande
- Clinic of Radiology, Imaging Institute of Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università Della Svizzera Italiana (USI), Via G. Buffi 13, 6904, Lugano, Switzerland
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