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Qurashi A, Rainford L, Ajlan A, Khashoggi K, Ashkar L, Al-Raddadi M, Al-Ghamdi M, Al-Thobaiti M, Foley S. Optimal abdominal CT protocol for obese patients. Radiography (Lond) 2017; 24:e1-e12. [PMID: 29306386 DOI: 10.1016/j.radi.2017.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 08/03/2017] [Accepted: 08/07/2017] [Indexed: 01/15/2023]
Abstract
INTRODUCTION This study investigated the impact of different protocols on radiation dose and image quality for obese patients undergoing abdominal CT examinations. METHODS Five abdominal/pelvis CT protocols employed across three scanners from a single manufacturer in a single centre used a variety of parameters (kV: 100/120, reference mAs: 150/190/218/250/300, image reconstruction: filtered back projection (FBP)/iterative (IR)). The routine protocol employed 300 reference mAs and 120 kV. Data sets resulting from obese patient examinations (n = 42) were assessed for image quality using visual grading analysis by three experienced radiologists. Objective assessment (noise, signal/contrast-noise ratios) and radiation dose was compared to determine optimal protocols for prospective testing on a further sample of patients (n = 47) for scanners using FBP and IR techniques. RESULTS Compared to the routine protocol, mean radiation dose was reduced by 60% when using 100 kV and SAFIRE technique strength 3 (p = 0.001). Reduction of up to 30% in radiation dose was noted for the FBP protocol: 120 kV and 190 reference mAs (p = 0.008). Subjective and objective image quality for both protocols were comparable to that of the routine protocol (p > 0.05). An overall improvement in image quality with increasing strength of SAFIRE was noted. Upon clinical implementation of the optimal dose protocols, local radiology consensus deemed image quality to be acceptable for the participating obese patient cohort. CONCLUSION Radiation dose for obese patients can be optimised whilst maintaining image quality. Where iterative reconstruction is available relatively low kV and quality reference mAs are also viable for imaging obese patients at 30-60% lower radiation doses.
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Affiliation(s)
- A Qurashi
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland; Faculty of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia.
| | - L Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
| | - A Ajlan
- King Abdulaziz University, Jeddah, Saudi Arabia
| | - K Khashoggi
- King Abdulaziz University, Jeddah, Saudi Arabia
| | - L Ashkar
- King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - M Al-Ghamdi
- King Abdulaziz Hospital, Jeddah, Saudi Arabia
| | | | - S Foley
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
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Ajlan A, Al-Jedai A, Elsiesy H, Alkortas D, Al-Hamoudi W, Alarieh R, Al-Sebayel M, Broering D, Aba Alkhail F. Sofosbuvir-Based Therapy for Genotype 4 HCV Recurrence Post-Liver Transplant Treatment-Experienced Patients. Can J Gastroenterol Hepatol 2016; 2016:2872371. [PMID: 27446833 PMCID: PMC4904700 DOI: 10.1155/2016/2872371] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 11/10/2015] [Indexed: 12/20/2022] Open
Abstract
Background and Aim. This is an open label prospective cohort study conducted at a tertiary care hospital. The primary endpoint is SVR12 in patients treated with sofosbuvir-based therapy in post-liver transplant patients with genotype 4 HCV recurrence. Methodology. Thirty-six treatment-experienced liver transplant patients with HCV recurrence received sofosbuvir and ribavirin ± peginterferon. Results. We report here safety and efficacy data on 36 patients who completed the follow-up period. Mean age was 56 years, and the cohort included 24 males and one patient had cirrhosis. Mean baseline HCV RNA was 6.2 log10 IU/mL. The majority of patients had ≥ stage 2 fibrosis. Twenty-eight patients were treated with pegylated interferon plus ribavirin in addition to sofosbuvir for 12 weeks and the remaining were treated with sofosbuvir plus ribavirin only for 24 weeks. By week 4, only four (11.1%) patients had detectable HCV RNA. Of the 36 patients, 2 (5.5%) relapsed and one died (2.75%). Conclusion. Our results suggest that sofosbuvir + ribavirin ± pegylated interferon can be utilized successfully to treat liver transplant patients with HCV recurrence.
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Affiliation(s)
- A. Ajlan
- Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Centre, MBC-11, P.O. Box 3354, Riyadh 11211, Saudi Arabia
| | - A. Al-Jedai
- Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Centre, MBC-11, P.O. Box 3354, Riyadh 11211, Saudi Arabia
- Alfaisal University, College of Medicine, Riyadh, Saudi Arabia
| | - H. Elsiesy
- Alfaisal University, College of Medicine, Riyadh, Saudi Arabia
- Liver & Small Bowel Transplant and Hepatobiliary and Pancreatic Surgery-Organ Transplant Center, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - D. Alkortas
- Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Centre, MBC-11, P.O. Box 3354, Riyadh 11211, Saudi Arabia
| | - W. Al-Hamoudi
- Liver & Small Bowel Transplant and Hepatobiliary and Pancreatic Surgery-Organ Transplant Center, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
- King Saud University, College of Medicine, Riyadh, Saudi Arabia
| | - R. Alarieh
- Liver & Small Bowel Transplant and Hepatobiliary and Pancreatic Surgery-Organ Transplant Center, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - M. Al-Sebayel
- Liver & Small Bowel Transplant and Hepatobiliary and Pancreatic Surgery-Organ Transplant Center, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - D. Broering
- Liver & Small Bowel Transplant and Hepatobiliary and Pancreatic Surgery-Organ Transplant Center, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - F. Aba Alkhail
- Alfaisal University, College of Medicine, Riyadh, Saudi Arabia
- Liver & Small Bowel Transplant and Hepatobiliary and Pancreatic Surgery-Organ Transplant Center, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
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Fishman RA, Happ E, Stevens T, Kunschner L, Jaworski DM, Stradecki HM, Penar PL, Pendlebury WW, Pennington CJ, Edwards DR, Broaddus WC, Fillmore HL, Mukherjee J, Hawkins C, Guha A, Pioli PD, Milani S, Linskey ME, Zhou YH, Marchetti V, Barnett F, Wang M, Scheppke L, Sanchez-Cespedes J, De Rossi C, Nemerow G, Torbett B, Friedlander M, Goldlust SA, Singer S, DeAngelis LM, Lassman AB, Nolan CP, Yang SH, Lee SW, Chen ZP, Liu XM, Wojton JA, Chu Z, Qi X, Kaur B, Zhou YH, Hu Y, Pioli PD, Siegel E, Ro DI, Marlon S, Hsu N, Milani SN, Mohan S, Yu L, Hess KR, Linskey ME, Liu Y, Carson-Walter E, Walter K, Raghu H, Gondi CS, Gujrati M, Dinh DH, Rao JS, Narayana A, Kunnakkat SD, Medabalmi P, Golfinos J, Parker E, Knopp E, Zagzag D, Gruber D, Gruber ML, Burrell K, Jelveh S, Lindsey P, Hill R, Zadeh G, Ivkovic S, Beadle C, Massey SC, Swanson KR, Canoll P, Rosenfeld SS, McAllister S, Soroceanu L, Pakdel A, Limbad C, Adrados I, Desprez PY, Nakada M, Nambu E, Furuyama N, Yoshida Y, Kita D, Hayashi Y, Hayashi Y, Hamada JI, Seyed Sadr M, Maret D, Seyed Sadr E, Siu V, Alshami J, Denault JS, Faury D, Jabado N, Nantel A, Del Maestro R, Kunnakkat SD, Perretta D, Medabalmi P, Gruber ML, Gruber D, Golfinos J, Parker E, Narayana A, Pioli PD, Linskey ME, Zhou YH, Nagaiah G, Almubarak M, Torres-Trejo A, Newton, M, Willey P, Altaha R, Murphy SF, Banasiak M, Yee GT, Wotoczek-Obadia M, Tran Y, Prak A, Albright R, Mullan M, Paris D, Brem S, Yang YP, Ennis M, Tran N, Symons M, Najbauer J, Huszthy PC, Garcia E, Metz MZ, Gutova M, Frank RT, Miletic H, Glackin CA, Barish ME, Bjerkvig R, Aboody KS, Clump DA, Engh JA, Mintz AH, Cunnick J, Flynn DC, Clark AJ, Butowski NA, Chang SM, Prados MD, Clarke J, Polley MYC, Sughrue ME, McDermott MW, Parsa AT, Berger MS, Aghi MK, Megyesi JF, Costello P, Macdonald W, Dyer E, Macdonald D, Hammond R, Kalache Y, Easaw J, McIntyre J, Williams SC, Karajannis MA, Chiriboga L, von Deimling A, Zagzag D, Ajlan A, Husaine S, Petrecca K, Magnus N, Garnier D, Meehan B, Rak J. Angiogenesis and Invasion. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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