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McLean D, Delfino O, Vozzo M, Moorin R. Estimation of maternal and foetal risk of radiation-induced cancer from a survey of computed tomography pulmonary angiography and ventilation/perfusion lung scanning for diagnosing pulmonary embolism during pregnancy. J Med Imaging Radiat Oncol 2024; 68:385-392. [PMID: 38687690 DOI: 10.1111/1754-9485.13661] [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: 11/20/2023] [Accepted: 04/05/2024] [Indexed: 05/02/2024]
Abstract
INTRODUCTION While there are many papers on maternal and foetal radiation doses from computed tomography pulmonary angiography (CTPA) and ventilation/perfusion (V/Q) lung scanning examinations for diagnosing pulmonary embolism in pregnant patients, few have used clinical data to examine the patient lifetime attributable risk (LAR) of different cancer types. This paper aims to estimate the cancer risk from maternal radiation doses from CTPA and V/Q examinations and associated foetal doses. METHODS Dosimetric data were determined for 267 pregnant patients who received CTPA and/or V/Q examinations over 8 years. Organ and foetal doses were determined using software allowing patient size variations for CTPA and using two different activity-to-organ dose conversion methods for V/Q scans. The LAR of cancer incidence was estimated using International Commission on Radiological Protection (ICRP) modelling including estimates of detriment. RESULTS Estimated total cancer incidence was 23 and 22 cases per 100,000 for CTPA and V/Q examinations, respectively, with detriment estimates of 18 and 20 cases. Cancer incidence was evenly divided between lung and breast cancer for CTPA with lung cancer being 80% of all cancer for V/Q. The median foetal doses were 0.03 mSv for CTPA and 0.29 mSv for V/Q. Significant differences in estimated foetal dose for V/Q scans were obtained by the two different methods used. The differences in dose between the modes of CTPA scan acquisition highlight the importance of optimisation. CONCLUSION Maternal cancer incidence and detriment were remarkably similar for each examination. Optimisation of examinations is critical for low-dose outcomes, particularly for CTPA examination.
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Affiliation(s)
- Donald McLean
- Medical Physics and Radiation Engineering, Canberra Health Services, Canberra, Australian Capital Territory, Australia
| | - Olivia Delfino
- Medical Physics and Radiation Engineering, Canberra Health Services, Canberra, Australian Capital Territory, Australia
| | - Marie Vozzo
- Medical Physics and Radiation Engineering, Canberra Health Services, Canberra, Australian Capital Territory, Australia
| | - Rachael Moorin
- Discipline of Health Economics & Data Analytics, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
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Alhorani Q, Alkhybari E, Rawashdeh M, Sabarudin A, Latiff RA, Al-Ibraheem A, Mohamad M. National and local diagnostic reference levels for adult 18F-FDG and CT in Jordanian PET/CT: findings and implications in practice. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2024; 44:011512. [PMID: 38387102 DOI: 10.1088/1361-6498/ad2c62] [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: 10/05/2023] [Accepted: 02/22/2024] [Indexed: 02/24/2024]
Abstract
This study aims to report the findings of Jordanian national diagnostic reference level (NDRL) survey for fluorodeoxyglucose (18F-FDG) and local diagnostic reference level (LDRL) of computed tomography (CT) used for attenuation correction and anatomical localisation (AC-AL); and AC and diagnostic CT (AC-DX) within the context of whole-body WB and half-body HB adult oncology PET/CT scanning. Two-structured questionnaires were prepared to gather the necessary information: dosimetry data, patient demographics, equipment specification, and acquisition protocols for identified18F-FDG PET/CT procedures. The NDRL and achievable dose were reported based on the 75th and 50th percentiles for18F-FDG administered activity (AA), respectively. The LDRL was reported based on the 50th percentile for (CTDIvol) and (DLP). Data from 562 patients from four Jordanian PET/CT centres were collected. The survey revealed that Jordanian NDRL for AA (303 MBq) was within the acceptable range compared to the published-peer NDRL data (240-590 MBq). However, the18F-FDG AA varied across the participated PET/CT centres. The reported LDRL CTDIvoland DLP of CT used for (AC-AL) was 4.3 mGy and 459.3 mGy.cm for HB CT scan range, and 4.1 mGy and 659.9 mGy.cm for WB CT scans. The reported LDRL for CTDIvoland DLP for HB CT was higher when compared with the United Kingdom (3.2 mGy and 310 mGy.cm). Concurrently, in the context of WB CT, the reported values (i.e. CTDIvol and DLP) were also higher than both Kuwait (3.6 mGy and 659 mGy.cm) and Slovenia (3.6 mGy and 676 mGy.cm). The reported HB CT(AC-DX) was higher than Nordic, New Zealand and Swiss NDRLs and for WB (AC-DX) CT it was higher than Swiss NDRLs. This study reported the first Jordanian NDRL for18F-FDG and LDRL for HB and WB CT associated with18F-FDG PET/CT scans. This data is useful for Jordanian PET/CT centres to compare their LDRL to the suggested DRLs and utilise it in the process of optimising CT radiation doses.
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Affiliation(s)
- Qays Alhorani
- Diagnostic Imaging & Radiotherapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Essam Alkhybari
- Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mohammad Rawashdeh
- Radiologic Technology Program, Applied Medical Sciences College, Jordan University of Science and Technology, Irbid, Jordan
- Faculty of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates
| | - Akmal Sabarudin
- Diagnostic Imaging & Radiotherapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rukiah A Latiff
- Diagnostic Imaging & Radiotherapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Mazlyfarina Mohamad
- Diagnostic Imaging & Radiotherapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Alhorani Q, Alkhybari E, Rawashdeh M, Sabarudin A, Latiff RA, Al-Ibraheem A, Vinjamuri S, Mohamad M. Revising and exploring the variations in methodologies for establishing the diagnostic reference levels for paediatric PET/CT imaging. Nucl Med Commun 2023; 44:937-943. [PMID: 37615527 DOI: 10.1097/mnm.0000000000001748] [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: 08/25/2023]
Abstract
PET-computed tomography (PET/CT) is a hybrid imaging technique that combines anatomical and functional information; to investigate primary cancers, stage tumours, and track treatment response in paediatric oncology patients. However, there is debate in the literature about whether PET/CT could increase the risk of cancer in children, as the machine is utilizing two types of radiation, and paediatric patients have faster cell division and longer life expectancy. Therefore, it is essential to minimize radiation exposure by justifying and optimizing PET/CT examinations and ensure an acceptable image quality. Establishing diagnostic reference levels (DRLs) is a crucial quantitative indicator and effective tool to optimize paediatric imaging procedures. This review aimed to distinguish and acknowledge variations among published DRLs for paediatric patients in PET/CT procedures. A search of relevant articles was conducted using databases, that is, Embase, Scopus, Web of Science, and Medline, using the keywords: PET-computed tomography, computed tomography, PET, radiopharmaceutical, DRL, and their synonyms. Only English and full-text articles were included, with no limitations on the publication year. After the screening, four articles were selected, and the review reveals different DRL approaches for paediatric patients undergoing PET/CT, with primary variations observed in patient selection criteria, reporting of radiation dose values, and PET/CT equipment. The study suggests that future DRL methods for paediatric patients should prioritize data collection in accordance with international guidelines to better understand PET/CT dose discrepancies while also striving to optimize radiation doses without compromising the quality of PET/CT images.
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Affiliation(s)
- Qays Alhorani
- Center for Diagnostics, Therapeutics and Investigative, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Essam Alkhybari
- Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Saudi Arabia
| | - Mohammad Rawashdeh
- Radiologic Technology Program, Applied Medical Sciences College, Jordan University of Science and Technology, Irbid
| | - Akmal Sabarudin
- Center for Diagnostics, Therapeutics and Investigative, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rukiah A Latiff
- Center for Diagnostics, Therapeutics and Investigative, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Centre, Amman, Jordan
| | - Sobhan Vinjamuri
- Department of Nuclear Medicine, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Mazlyfarina Mohamad
- Center for Diagnostics, Therapeutics and Investigative, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Husain I, O’Neill JC, Schoeneck JH, Alexander Soltany K, Clark H, Weidman Rice E, Gross A, Redding J, Cline DM. Clinical Characteristics of SARS-CoV-2 Acute Pulmonary Embolism and Adjusted D-dimer for Emergency Department Patients. West J Emerg Med 2023; 24:1043-1048. [PMID: 38165185 PMCID: PMC10754201 DOI: 10.5811/westjem.58619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/31/2023] [Accepted: 03/12/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and acute pulmonary embolism (APE) present a diagnostic challenge in the emergency department (ED) setting. We aimed to identify key clinical characteristics and D-dimer thresholds associated with APE in SARS-CoV-2 positive ED patients. Methods We performed a multicenter, retrospective cohort study for adult patients who were diagnosed with coronavirus 2019 (COVID-19) and had computed tomography pulmonary angiogram (CTPA) performed between March 17, 2020-January 31, 2021. We performed univariate analysis to determine numeric medians, chi-square values for association between clinical characteristic and positive CTPA. Logistic regression was used to determine the odds of a clinical characteristic being associated with a diagnosis of APE. Results Of 408 patients who underwent CTPA, 29 (7.1%) were ultimately found to have APE. In multivariable analysis, patients with a body mass index greater than 32 (odds ratio [OR] 4.4, 95% confidence interval [CI] 1.0 -19.3), a heart rate greater than 90 beats per minute (bpm) (OR 5.0, 95% CI 1.0-24.9), and a D-dimer greater than 1,500 micrograms per liter (μg/L) (OR 5.6, 95% CI 1.6-20.2) were significantly associated with pulmonary embolism. In our population that received a D-dimer and was SARS-CoV-2 positive, limiting CTPA to patients with a heart rate over 90 or a D-dimer value over 1500 μg/L would reduce testing 27.2% and not miss APE. Conclusion In patients with acute COVID-19 infections, D-dimer at standard cutoffs was not usable. Limiting CTPA using a combination of heart rate greater than 90 bpm or D-dimer greater than 1,500 μg/L would significantly decrease imaging in this population.
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Affiliation(s)
- Iltifat Husain
- Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina
| | - James C. O’Neill
- Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina
| | - Jacob H. Schoeneck
- Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina
| | - K. Alexander Soltany
- Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina
| | - Hollins Clark
- University of North Carolina Chapel Hill, Department of Radiology, Chapel Hill, North Carolina
| | - Erika Weidman Rice
- Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina
| | - Alex Gross
- Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina
| | - Jonathan Redding
- Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina
| | - David M. Cline
- Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina
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Wei W, Wang SG, Zhang JY, Togn XY, Li BB, Fang X, Pu RW, Zhou YJ, Liu YJ. Implementation of Individualized Low-Dose Computed Tomography-Guided Hook Wire Localization of Pulmonary Nodules: Feasibility and Safety in the Clinical Setting. Diagnostics (Basel) 2023; 13:3235. [PMID: 37892056 PMCID: PMC10606229 DOI: 10.3390/diagnostics13203235] [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: 08/04/2023] [Revised: 10/06/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Background: CT-guided hook-wire localization is an essential step in the management of small pulmonary nodules. Few studies, however, have focused on reducing radiation exposure during the procedure. Purpose: This study aims to explore the feasibility of implementing a low-dose computed tomography (CT)-guided hook wire localization using tailored kVp based on patients' body size. Materials and Methods: A total of 151 patients with small pulmonary nodules were prospectively enrolled for CT-guided hook wire localization using individualized low-dose CT (LDCT) vs. standard-dose CT (SDCT) protocols. Radiation dose, image quality, characteristics of target nodules and procedure-related variables were compared. All variables were analyzed using Chi-Square and Student's t-test. Results: The mean CTDIvol was significantly reduced for LDCT (for BMI ≤ 21 kg/m2, 0.56 ± 0.00 mGy and for BMI > 21 kg/m2, 1.48 ± 0.00 mGy) when compared with SDCT (for BMI ≤ 21 kg/m2, 5.24 ± 0.95 mGy and for BMI > 21 kg/m2, 6.69 ± 1.47 mGy). Accordingly, the DLP of LDCT was significantly reduced as compared with that of SDCT (for BMI ≤ 21 kg/m2, 56.86 ± 4.73 vs. 533.58 ± 122.06 mGy.cm, and for BMI > 21 kg/m2, 167.02 ± 38.76 vs. 746.01 ± 230.91 mGy.cm). In comparison with SDCT, the effective dose (ED) of LDCT decreased by an average of 89.42% (for BMI ≤ 21 kg/m2) and 77.68% (for BMI > 21 kg/m2), respectively. Although the images acquired with the LDCT protocol yielded inferior quality to those acquired with the SDCT protocol, they were clinically acceptable for hook wire localization. Conclusions: LDCT-guided localization can provide safety and nodule detection performance comparable to SDCT-guided localization, benefiting radiation dose reduction dramatically, especially for patients with small body mass indexes.
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Affiliation(s)
| | | | | | | | | | | | | | - Yu-Jing Zhou
- Correspondence: (Y.-J.Z.); (Y.-J.L.); Tel.: +86-180-9887-7000 (Y.J.-L.)
| | - Yi-Jun Liu
- Correspondence: (Y.-J.Z.); (Y.-J.L.); Tel.: +86-180-9887-7000 (Y.J.-L.)
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Abuzaid M, Elshami W, Cavli B, Ozturk C, ALMisned G, Tekin HO. A closer look at the utilized radiation doses during computed tomography pulmonary angiography (CTPA) for COVID-19 patients. Radiat Phys Chem Oxf Engl 1993 2023; 211:111025. [PMID: 37250685 PMCID: PMC10210819 DOI: 10.1016/j.radphyschem.2023.111025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 05/31/2023]
Abstract
Introduction CTPA stands for computed tomography pulmonary angiography. CTPA is an X-ray imaging that combines X-rays and computer technology to create detailed images of the pulmonary arteries and veins in the lungs. This test diagnoses and monitors conditions like pulmonary embolism, arterial blockages, and hypertension. Coronavirus (COVID-19) has threatened world health over the last three years. The number of (CT) scans increased and played a vital role in diagnosing COVID-19 patients, including life-threatening pulmonary embolism (PE). This study aimed to assess the radiation dose resulted from CTPA for COVID-19 patients. Methods Data were collected retrospectively from CTPA examinations on a single scanner in 84 symptomatic patients. The data collected included the dose length product (DLP), volumetric computed tomography dose index (CTDIvol), and size-specific dose estimate (SSDE). The organ dose and effective dose were estimated using VirtualDose software. Results The study population included 84 patients, 52% male and 48% female, with an average age of 62. The average DLP, CTDIvol, and SSDE were 404.2 mGy cm, 13.5 mGy, and 11.6 mGy\, respectively. The mean effective doses (mSv) for males and females were 3.01 and 3.29, respectively. The maximum to minimum organ doses (mGy) between patients was 0.8 for the male bladder and 7.33 for the female lung. Conclusions The increase in CT scans during the COVID-19 pandemic required close dose monitoring and optimization. The protocol used during CTPA should guarantee a minimum radiation dose with maximum patient benefits.
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Affiliation(s)
- Mohamed Abuzaid
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Wiam Elshami
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | | | | | - Ghada ALMisned
- Department of Physics, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - H O Tekin
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Istinye University, Faculty of Engineering and Natural Sciences, Computer Engineering Department, Istanbul, 34396, Turkey
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De Monte F, Sapignoli S, Laura Cortinovis A, Di Maggio A, Nardin M, Pizzirani E, Scagliori E, Volpe A, Paiusco M, Roggio A. Effectiveness of body size stratification for patient exposure optimization in Computed Tomography. Eur J Radiol 2023; 163:110804. [PMID: 37043885 DOI: 10.1016/j.ejrad.2023.110804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/23/2023] [Accepted: 03/26/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE To establish size-dependent DRL and to estimate the effectiveness of the size-dependent DRLs over size-independent DRLs for a CT exposure optimization process. METHODS The study included 16,933 adult CT body examinations of the most common CT protocols. Acquisitions were included following an image quality assessment. Patients were grouped into five different classes by means of the water equivalent diameter (Dw): 21 ≤ Dw < 25, 25 ≤ Dw < 29, 29 ≤ Dw < 33,33 ≤ Dw < 37 (in cm). CTDIvol, DLP, DLPtot. and SSDE median values were provided both for the sample as a whole (size-independent approach) and for each Dw class (size-dependent approach). The performance of the two approaches in classifying sub-optimal examinations was evaluated through the confusion matrix and Matthews Correlation Coefficient (MCC) metric. The 75th percentile of the CTDIvol distribution was arbitrarily chosen as a threshold level above which the acquisitions are considered sub-optimal. RESULTS CTDIvol, DLP, DLPtot and SSDE typical values (median values) are statistically different across Dw groups. The confusion matrix analysis suggests that size-independent DRL could not mark potential suboptimal protocols for small and large patients. The agreement between the size-dependent and size-independent methods is strong only for the most populous classes (MCC > 0.7). For small and large patients size-independent approach fails to identify as sub-optimal around 20 % of the acquisition (MCC≪0.2). CONCLUSIONS It was proven by means of the confusion matrix and MCC metric that stratifying DRLs by patient size, size-dependent DRL can be a powerful strategy in order to improve the dose optimization process shown that a size-independent DRL fails to identify sub-optimal examinations for small and large patients.
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Norsuddin NM, Mei Sin JG, Ravintaran R, Arasaratnam S, Abdul Karim MK. Impact of age and breast thickness on mean glandular dose of standard digital mammography and digital breast tomosynthesis. Appl Radiat Isot 2023; 192:110525. [PMID: 36436228 DOI: 10.1016/j.apradiso.2022.110525] [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: 02/20/2022] [Revised: 09/28/2022] [Accepted: 10/18/2022] [Indexed: 01/04/2023]
Abstract
This study compares the mean glandular dose (MGD) across 2D, 3D projection and Contrast-Enhanced Digital Mammography (CEDM) mammographic techniques. The important metadata were extracted from the digital mammography console. 650 subjects were clustered based on projections, age and CBT. The MGD of 2D, 3D, and CEDM was positively correlated with CBT but inversely correlated with the age factor. This study indicate MGD of CEDM was 16% and 22% lower compared to 2D and 3D techniques, respectively.
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Affiliation(s)
- Norhashimah Mohd Norsuddin
- Department of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Justine Go Mei Sin
- Department of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Rathieswari Ravintaran
- Department of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Shantini Arasaratnam
- Department of Radiology, Hospital Kuala Lumpur, Jalan Pahang, Kuala Lumpur, 50586, Malaysia
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Sayed IS, Roslan NS, Syed WS. Entrance Skin Dose (ESD) and Bucky Table Induced Backscattered Dose (BTI-BSD) in Abdominal Radiography With nanoDot Optically Stimulated Luminescence Dosimeter (OSLD). Cureus 2023; 15:e34585. [PMID: 36891018 PMCID: PMC9986971 DOI: 10.7759/cureus.34585] [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: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
In radiography, inconsistencies in patients' measured entrance skin dose (ESD) exist. There is no published research on the bucky table induced backscattered radiation dose (BTI-BSD). Thus, we aimed to ascertain ESD, calculate the BTI-BSD in abdominal radiography with a nanoDot OSLD, and compare the ESD results with the published data. A Kyoto Kagaku PBU-50 phantom (Kyoto, Japan) in an antero-posterior supine position was exposed, selecting a protocol used for abdominal radiography. The central ray of x-ray beam was pointed at the surface of abdomen at the navel, where a nanoDot dosimeter was placed to measure ESD. For the BTI-BSD, exit dose (ED) was determined by placing a second dosimeter on the exact opposite side (backside) of the phantom from the dosimeter used to determine (ESD) with and without bucky table at identical exposure parameters. The BTI-BSD was calculated as the difference between ED with and without bucky table. The ESD, ED, and BTI-BSD were measured in milligray (mGy). ESD mean values with and without bucky table were 1.97 mGy and 1.84 mGy, whereas ED values were 0.062 mGy and 0.052 mGy, respectively. Results show 2-26% lower ESD values with nanoDot OSLD. The BTI-BSD mean value was found to be approximately 0.01 mGy. A local dose reference level (LDRL) can be established using ESD data to safeguard patients from unnecessary radiation. In addition, to minimize the risk of BTI-BSD in patients in radiography, the search for the use or fabrication of a new, lower atomic number material for the bucky table is suggested.
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Affiliation(s)
- Inayatullah Shah Sayed
- Department of Diagnostic Imaging and Radiotherapy, International Islamic University Malaysia, Kuantan Campus, Kuantan, MYS
| | - Nurul Shuhada Roslan
- Department of Diagnostic Imaging and Radiotherapy, International Islamic University Malaysia, Kuantan Campus, Kuantan, MYS
| | - Waliullah Shah Syed
- Department of Applied Sciences, Stanford International College, Mississauga, CAN
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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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11
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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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Bárdyová Z, Horváthová M, Gomola I, Neuschl V, Šimková J. PRECAUTION IN THE USE OF EFFECTIVE DOSE IN CORONARY CT ANGIOGRAPHY. RADIATION PROTECTION DOSIMETRY 2022; 198:547-553. [PMID: 36005971 DOI: 10.1093/rpd/ncac097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/11/2022] [Accepted: 02/22/2022] [Indexed: 06/15/2023]
Abstract
The effective dose is a quantity used in clinical practice for statistical evaluation of the radiation dose of patients undergoing different types of examinations. Coronary computed tomography angiography (CCTA) is a specific examination whose calculated effective dose may be subject to several biases. For this reason, it is important to consider factors (different examination techniques, heart rate and patient habitus) that may influence its resulting value. Another critical factor is the methodological procedure for calculating the effective dose and cardiac-specific coefficient used to estimate effective dose from the dose-length product in computed tomography. Because CCTA is increasingly used in cardiology, it is recommended that the chest coefficient be replaced with a new cardiac coefficient when calculating the effective dose.
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Affiliation(s)
- Zuzana Bárdyová
- Trnava University in Trnava, Faculty of Health Care and Social Work, Department of Laboratory Medicine, Univerzitné námestie 1, 918 43 Trnava, Slovak Republic
| | - Martina Horváthová
- Trnava University in Trnava, Faculty of Health Care and Social Work, Department of Laboratory Medicine, Univerzitné námestie 1, 918 43 Trnava, Slovak Republic
| | - Igor Gomola
- Slovak Medical University, Faculty of Public Health, Department of Radiation Hygiene, Limbová 12, 833 03 Bratislava, Slovak Republic
| | - Vladimír Neuschl
- MRI s. r. o., Institute of Imaging Diagnostics, Starohájska 2, 917 01 Trnava, Slovak Republic
| | - Jana Šimková
- MRI s. r. o., Institute of Imaging Diagnostics, Starohájska 2, 917 01 Trnava, Slovak Republic
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13
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Patient dose in CT angiography examinations: An institutional survey. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Kayun Z, Abdul Karim MK, Harun HH, Shaari AH, Mahmud R, Hamid HA, Sabarudin A, Chew MT. Radiation doses and size-specific dose estimate from CT brain examinations according to head sizes in a tertiary hospital in Malaysia. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2021.109694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Kayun Z, Karim M, Muhammad N, Aljewaw O, Chew M, Harun H. Implication of applying iterative reconstruction on Low Contrast Detectability in CT brain examination. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2021.109676] [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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Assessment of Radiation Dose in Medical Imaging and Interventional Radiology Procedures for Patient and Staff Safety. Diagnostics (Basel) 2021; 11:diagnostics11061116. [PMID: 34207322 PMCID: PMC8234165 DOI: 10.3390/diagnostics11061116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 02/05/2023] Open
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Evaluation of Organ Dose and Image Quality Metrics of Pediatric CT Chest-Abdomen-Pelvis (CAP) Examination: An Anthropomorphic Phantom Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11052047] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The aim of this study is to investigate the impact of CT acquisition parameter setting on organ dose and its influence on image quality metrics in pediatric phantom during CT examination. The study was performed on 64-slice multidetector CT scanner (MDCT) Siemens Definition AS (Siemens Sector Healthcare, Forchheim, Germany) using various CT CAP protocols (P1–P9). Tube potential for P1, P2, and P3 protocols were fixed at 100 kVp while P4, P5, and P6 were fixed at 80 kVp with used of various reference noise values. P7, P8, and P9 were the modification of P1 with changes on slice collimation, pitch factor, and tube current modulation (TCM), respectively. TLD-100 chips were inserted into the phantom slab number 7, 9, 10, 12, 13, and 14 to represent thyroid, lung, liver, stomach, gonads, and skin, respectively. The image quality metrics, signal to noise ratio (SNR) and contrast to noise ratio (CNR) values were obtained from the CT console. As a result, this study indicates a potential reduction in the absorbed dose up to 20% to 50% along with reducing tube voltage, tube current, and increasing the slice collimation. There is no significant difference (p > 0.05) observed between the protocols and image metrics.
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