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Ria F, Rehani MM, Samei E. Characterizing imaging radiation risk in a population of 8918 patients with recurrent imaging for a better effective dose. Sci Rep 2024; 14:6240. [PMID: 38485712 PMCID: PMC10940310 DOI: 10.1038/s41598-024-56516-1] [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: 12/13/2023] [Accepted: 03/07/2024] [Indexed: 03/18/2024] Open
Abstract
An updated extension of effective dose was recently introduced, namely relative effective dose ( E r ), incorporating age and sex factors. In this study we extended E r application to a population of about 9000 patients who underwent multiple CT imaging exams, and we compared it with other commonly used radiation protection metrics in terms of their correlation with radiation risk. Using Monte Carlo methods, E r , dose-length-product based effective dose ( E DLP ), organ-dose based effective dose ( E OD ), and organ-dose based risk index ( RI ) were calculated for each patient. Each metric's dependency to RI was assessed in terms of its sensitivity and specificity. E r showed the best sensitivity, specificity, and agreement with RI (R2 = 0.97); while E DLP yielded the lowest specificity and, along with E OD , the lowest sensitivity. Compared to other metrics, E r provided a closer representation of patient and group risk also incorporating age and sex factors within the established framework of effective dose.
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Affiliation(s)
- Francesco Ria
- Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Labs, Clinical Imaging Physics Group, Departments of Radiology, Duke University Health System, 2424 Erwin Road, Suite 302, Durham, NC, 27710, USA.
| | - Madan M Rehani
- Radiology Department, Massachusetts General Hospital, 175 Cambridge Str. Suite 0244, Boston, USA
| | - Ehsan Samei
- Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Labs, Clinical Imaging Physics Group, Medical Physics Graduate Program, Departments of Radiology, Physics, Biomedical Engineering, and Electrical and Computer Engineering, Duke University, 2424 Erwin Road, Suite 302, Durham, NC, 27710, USA
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Costa PR, Tomal A, de Oliveira Castro JC, Nunes IPF, Nersissian DY, Sawamura MVY, Leão Filho H, Lee C. Diagnostic reference level quantities for adult chest and abdomen-pelvis CT examinations: correlation with organ doses. Insights Imaging 2023; 14:60. [PMID: 37024637 PMCID: PMC10079797 DOI: 10.1186/s13244-023-01403-y] [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: 10/12/2022] [Accepted: 03/11/2023] [Indexed: 04/08/2023] Open
Abstract
OBJECTIVES To evaluate correlations between DRL quantities (DRLq) stratified into patient size groups for non-contrast chest and abdomen-pelvis CT examinations in adult patients and the corresponding organ doses. METHODS This study presents correlations between DRLq (CTDIvol, DLP and SSDE) stratified into patient size ranges and corresponding organ doses shared in four groups: inside, peripheral, distributed and outside. The demographic, technical and dosimetric parameters were used to identify the influence of these quantities in organ doses. A robust statistical method was implemented in order to establish these correlations and its statistical significance. RESULTS Median values of the grouped organ doses are presented according to the effective diameter ranges. Organ doses in the regions inside the imaged area are higher than the organ doses in peripheral, distributed and outside regions, excepted to the peripheral doses associated with chest examinations. Different levels of statistical significance between organ doses and the DRLq were presented. CONCLUSIONS Correlations between DRLq and target-organ doses associated with clinical practice can support guidance's to the establishment of optimization criteria. SSDE demonstrated to be significant in the evaluation of organ doses is also highlighted. The proposed model allows the design of optimization actions with specific risk-reduction results.
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Affiliation(s)
- Paulo Roberto Costa
- Institute of Physics, University of São Paulo, R. Do Matão, 1371, Butantã, São Paulo, SP, 05508-090, Brazil.
| | - Alessandra Tomal
- Institute of Physics Gleb Watagin, University of Campinas, Campinas, Brazil
| | | | | | - Denise Yanikian Nersissian
- Institute of Physics, University of São Paulo, R. Do Matão, 1371, Butantã, São Paulo, SP, 05508-090, Brazil
| | | | - Hilton Leão Filho
- Division of Radiology, Medical School, University of São Paulo, São Paulo, Brazil
| | - Choonsik Lee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD, USA
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Alsaihati N, Ria F, Solomon J, Ding A, Frush D, Samei E. Making CT Dose Monitoring Meaningful: Augmenting Dose with Imaging Quality. Tomography 2023; 9:798-809. [PMID: 37104136 PMCID: PMC10145563 DOI: 10.3390/tomography9020065] [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: 03/13/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/28/2023] Open
Abstract
Due to the concerns about radiation dose associated with medical imaging, radiation dose monitoring systems (RDMSs) are now utilized by many radiology providers to collect, process, analyze, and manage radiation dose-related information. Currently, most commercially available RDMSs focus only on radiation dose information and do not track any metrics related to image quality. However, to enable comprehensive patient-based imaging optimization, it is equally important to monitor image quality as well. This article describes how RDMS design can be extended beyond radiation dose to simultaneously monitor image quality. A newly designed interface was evaluated by different groups of radiology professionals (radiologists, technologists, and physicists) on a Likert scale. The results show that the new design is effective in assessing both image quality and safety in clinical practices, with an overall average score of 7.8 out of 10.0 and scores ranging from 5.5 to 10.0. Radiologists rated the interface highest at 8.4 out of 10.0, followed by technologists at 7.6 out of 10.0, and medical physicists at 7.5 out of 10.0. This work demonstrates how the assessment of the radiation dose can be performed in conjunction with the image quality using customizable user interfaces based on the clinical needs associated with different radiology professions.
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Affiliation(s)
- Njood Alsaihati
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA; (F.R.); (J.S.); (A.D.); (D.F.); (E.S.)
- Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Francesco Ria
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA; (F.R.); (J.S.); (A.D.); (D.F.); (E.S.)
- Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
- Center for Virtual Imaging Trials, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Justin Solomon
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA; (F.R.); (J.S.); (A.D.); (D.F.); (E.S.)
- Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
- Center for Virtual Imaging Trials, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Aiping Ding
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA; (F.R.); (J.S.); (A.D.); (D.F.); (E.S.)
- Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Donald Frush
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA; (F.R.); (J.S.); (A.D.); (D.F.); (E.S.)
- Center for Virtual Imaging Trials, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Ehsan Samei
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA; (F.R.); (J.S.); (A.D.); (D.F.); (E.S.)
- Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
- Center for Virtual Imaging Trials, Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
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