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Steiniger B, Fiebich M, Grimm MO, Malouhi A, Reichenbach JR, Scheithauer M, Teichgräber U, Franiel T. PAE planning: Radiation exposure and image quality of CT and CBCT. Eur J Radiol 2024; 172:111329. [PMID: 38278010 DOI: 10.1016/j.ejrad.2024.111329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 01/28/2024]
Abstract
PURPOSE To determine accurate organ doses, effective doses, and image quality of computed tomography (CT) compared with cone beam CT (CBCT) for correct identification of prostatic arteries. METHOD A dual-energy CT scanner and a flat-panel angiography system were used. Dose measurements (gallbladder (g), intestine (i), bladder (b), prostate (p), testes (t), active bone marrow of pelvis (bmp) and femura (bmf)) were performed using an anthropomorphic phantom with 65 thermoluminescent dosimeters in the pelvis and abdomen region. For the calculation of the contrast-to-noise ratio (CNR) of the pelvic arteries, a patient whose weight and height were almost identical to those of the phantom was selected for each examination type. RESULTS The effective dose of CT was 2.7 mSv and that of CBCT was 21.8 mSv. Phantom organ doses were lower for CT than for CBCT in all organs except the testes (g: 1.2 mGy vs. 3.3 mGy, i: 5.8 mGy vs. 23.9 mGy, b: 6.9 mGy vs. 19.4 mGy, p: 6.4 mGy vs. 13.2 mGy, t: 4.7 mGy vs. 2.4 mGy, bmp: 5.1 mGy vs. 18.2 mGy, bmf: 3.3 mGy vs. 6.6 mGy). For human pelvic arteries, the CNR of CT was better than that of CBCT, with the exception of one prostate artery that showed stenosis on CT. Evaluation by experienced radiologists also confirmed the better detectability of prostate arteries on CT examination. CONCLUSIONS In our study preprocedural CT had lower organ doses and better image quality comparedd with CBCT and should be considered for the correct identification of prostatic arteries.
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Affiliation(s)
- Beatrice Steiniger
- Department of Diagnostic and Interventional Radiology, University Hospital, Am Klinikum 1, 07747 Jena, Germany.
| | - Martin Fiebich
- Department LSE, Technische Hochschule Mittelhessen, Wiesenstraße 14, 35390 Gießen, Germany
| | - Marc-Oliver Grimm
- Clinic for Urology, University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Amer Malouhi
- Department of Diagnostic and Interventional Radiology, University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Department of Diagnostic and Interventional Radiology, University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Marcel Scheithauer
- Stabsstelle Strahlenschutz, University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Ulf Teichgräber
- Department of Diagnostic and Interventional Radiology, University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Tobias Franiel
- Department of Diagnostic and Interventional Radiology, University Hospital, Am Klinikum 1, 07747 Jena, Germany
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Fiebich M, Ammon J, Borowski M, de Las Heras Gala H, Loose R, Mentzel HJ, Poppe B. [Use of patient radiation shielding in diagnostic and interventional radiology]. Radiologie (Heidelb) 2023:10.1007/s00117-023-01157-0. [PMID: 37171543 DOI: 10.1007/s00117-023-01157-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 05/13/2023]
Abstract
The use of patient contact shielding provides an opportunity to reduce patient radiation exposure. Recently, the use has been the subject of controversy. The Radiation Protection Committee has published a recommendation on the use of patient radiation shields by considering the recent findings on dose savings but also the risks of incorrect use. In this article, a specification for the more frequently used types of X‑ray examination is given, which describes whether and which radiation contact shielding should be used. This is accompanied by a rationale for the use or non-use of patient radiation protection agents. Problems and possible errors are explained, as well as how to deal with special situations such as pregnant women and children.
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Affiliation(s)
- M Fiebich
- Institut für Medizinische Physik und Strahlenschutz, Technische Hochschule Mittelhessen, Wiesenstr. 14, 35390, Gießen, Deutschland.
| | - J Ammon
- Institut für Medizinische Physik, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | - M Borowski
- Institut für Röntgendiagnostik und Nuklearmedizin, Klinikum Braunschweig, Braunschweig, Deutschland
| | | | - R Loose
- Institut für Medizinische Physik, Klinikum Nürnberg Nord (i. R.), Nürnberg, Deutschland
| | - H-J Mentzel
- Sektion Kinderradiologie, Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Jena, Jena, Deutschland
| | - B Poppe
- Universitätsklinik für Medizinische Strahlenphysik, Medizinischer Campus Pius-Hospital, Department für Medizinische Physik und Akustik, Carl-von-Ossietzky-Universität Oldenburg, Oldenburg, Deutschland
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König AM, Verbe Zoum J, Fiebich M, Abissi PW, Mahnken AH. Comparison of the radiation protection effect of different radiation protection aprons made of different materials. Eur J Radiol 2023; 164:110862. [PMID: 37209465 DOI: 10.1016/j.ejrad.2023.110862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/13/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE The objective of this study is to examine the performance of new generation protection aprons as alternative to conventional lead aprons regarding their radiation protection effectiveness. METHOD AND MATERIALS Radiation protection aprons made of lead-containing and lead-free materials from a total of seven companies were compared. Furthermore, different lead equivalent values of 0.25, 0.35 and 0.5 mm were compared. For quantitative assessment, radiation attenuation was determined with increasing voltage in steps of 20 kV from 70 kV up to 130 kV. RESULTS New generation aprons and conventional protection lead aprons showed a similar shielding performance at lower tube voltages below 90 kVp. When tube voltage was increased above 90 kVp, significant (p < 0.05) differences between the three apron types were observed, with conventional lead material as best shielding performer over lead composite and lead-free aprons. CONCLUSION We observed a similar radiation protection performance between conventional lead aprons and new generation aprons at low intensity radiation workplaces, with lead aprons being dominant for all energies. Only new generation aprons of 0.5 mm thickness would adequately replace 0.25 and 0.35 mm conventional lead aprons. For healthy radiation protection, the possibility of using weight-reduced X-ray aprons is very limited.
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Affiliation(s)
- Alexander M König
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Marburg, Germany.
| | - Julius Verbe Zoum
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Marburg, Germany
| | - Martin Fiebich
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Marburg, Germany; University of Applied Sciences, Institute of Medical Physics and Radiation Protection, Giessen, Germany
| | - Pascaline-Wangechi Abissi
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Marburg, Germany; University of Applied Sciences, Institute of Medical Physics and Radiation Protection, Giessen, Germany
| | - Andreas H Mahnken
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Marburg, Germany
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Abissi P, Lymperopoulou G, Koutoulidis V, Grigoropoulos P, Papagiannis P, Seimenis I, Fiebich M, Agrokostas V. EVALUATION OF RADIATION BURDEN AND ASSOCIATED RISK IN SMOLDERING MULTIPLE MYELOMA PATIENTS MONITORED USING REPEATED CT IMAGING. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)03047-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Steiniger B, Klippel C, Teichgräber U, Reichenbach JR, Fiebich M. CAN THE SIZE-SPECIFIC DOSE ESTIMATE BE DERIVED FROM THE BODY MASS INDEX? A FEASIBILITY STUDY. Radiat Prot Dosimetry 2022; 198:325-333. [PMID: 35443046 PMCID: PMC9113340 DOI: 10.1093/rpd/ncac038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/10/2022] [Accepted: 03/03/2022] [Indexed: 06/14/2023]
Abstract
Size-specific dose estimate ($\mathbf{SSDE}$) index appears to be more suitable than the commonly used volume computed tomography dose index ($\mathbf{C}{\mathbf{TDI}}_{\mathbf{vol}}$) to estimate the dose delivered to the patient during a computed tomography (CT) scan. We evaluated whether an ${\mathbf{SSDE}}_{\mathbf{BMI}}$ can be determined from the patient's body mass index ($\mathbf{BMI}$) with sufficient reliability in the case that a $\mathbf{SSDE}$ is not given by the CT scanner. For each of the three most used examination types, CT examinations of 50 female and 50 male patients were analyzed. The $\mathbf{SSDE}$ values automatically provided by the scanner were compared with ${\mathbf{SSDE}}_{\mathbf{BMI}}$ determined from $\mathbf{C}{\mathbf{TDI}}_{\mathbf{vol}}$ and $\mathbf{BMI}$. A good accordance of ${\mathbf{SSDE}}_{\mathbf{BMI}}$ and $\mathbf{SSDE}$ was found for the chest and abdominal regions. A low correlation was observed for the head region. The presented method is a simple and practically useful surrogate approach for the chest and abdominal regions but not for the head.
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Affiliation(s)
| | - Chris Klippel
- Department of Diagnostic and Interventional Radiology, University Hospital Jena, Am Klinikum 1, Jena 07747, Germany
| | - Ulf Teichgräber
- Department of Diagnostic and Interventional Radiology, University Hospital Jena, Am Klinikum 1, Jena 07747, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Department of Diagnostic and Interventional Radiology, University Hospital Jena, Philosophenweg 3, Jena 07743, Germany
| | - Martin Fiebich
- Institute of Medical Physics and Radiation Protection, University of Applied Sciences Giessen, Wiesenstraße 14, Gießen 35390, Germany
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Koenig A, Akgöl A, Verbe J, Aigner R, Fiebich M, Thomas R, Mahnken A. Joint replacement increases radiation exposure to the staff in angiography: a phantom study. Eur J Radiol 2022; 151:110270. [DOI: 10.1016/j.ejrad.2022.110270] [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] [Received: 06/02/2021] [Revised: 03/09/2022] [Accepted: 03/16/2022] [Indexed: 11/28/2022]
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Steiniger B, Lechel U, Reichenbach JR, Fiebich M, Aschenbach R, Schegerer A, Waginger M, Bobeva A, Teichgräber U, Mentzel HJ. In vitro measurements of radiation exposure with different modalities (computed tomography, cone beam computed tomography) for imaging the petrous bone with a pediatric anthropomorphic phantom. Pediatr Radiol 2022; 52:1125-1133. [PMID: 35460347 PMCID: PMC9107409 DOI: 10.1007/s00247-022-05308-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 12/02/2021] [Accepted: 01/18/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Various imaging modalities, such as multi-detector computed tomography (CT) and cone beam CT are commonly used in infants for the diagnosis of hearing loss and surgical planning of implantation hearing aid devices, with differing results. OBJECTIVE We compared three different imaging modalities available in our institution, including a high-class CT scanner, a mid-class CT scanner and an angiography system with a cone beam CT option, for image quality and radiation exposure in a phantom study. MATERIALS AND METHODS While scanning an anthropomorphic phantom imitating a 1-year-old child with vendor-provided routine protocols, organ doses, surface doses and effective doses were determined for these three modalities with thermoluminescent dosimeters. The image quality was evaluated using the signal difference to noise ratio (SDNR) and the spatial resolution of a line-pair insert in the phantom head. The dose efficiency, defined as the ratio of SDNR and effective dose, was also compared. RESULTS The organ and surface doses were lowest with the high-class CT protocol, but the image quality was the worst. Image quality was best with the cone beam CT protocol, which, however, had the highest radiation exposure in this study, whereas the mid-class CT was in between. CONCLUSION Based on our results, high-end CT should be used for surgical planning because it has the lowest dose, while the image quality is still sufficient for this purpose. However, if highest image quality is needed and required, e.g., by ENT surgeons, the other modalities should be considered.
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Affiliation(s)
- Beatrice Steiniger
- Department of Diagnostic and Interventional Radiology, University Hospital, Am Klinikum 1, Jena, 07747, Germany.
| | - Ursula Lechel
- MB3 External and Internal Dosimetry and Biokinetics, Federal Office for Radiation Protection, Neuherberg, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Department of Diagnostic and Interventional Radiology, University Hospital, Jena, Germany
| | - Martin Fiebich
- Department LSE, Technische Hochschule Mittelhessen, Gießen, Germany
| | - Rene Aschenbach
- Department of Diagnostic and Interventional Radiology, University Hospital, Am Klinikum 1, Jena, 07747, Germany
| | - Alexander Schegerer
- MB3 External and Internal Dosimetry and Biokinetics, Federal Office for Radiation Protection, Neuherberg, Germany
| | - Matthias Waginger
- Section Pediatric Radiology, Department of Diagnostic and Interventional Radiology, University Hospital, Jena, Germany
| | - Anelyia Bobeva
- Department of Diagnostic and Interventional Radiology, University Hospital, Am Klinikum 1, Jena, 07747, Germany
| | - Ulf Teichgräber
- Department of Diagnostic and Interventional Radiology, University Hospital, Am Klinikum 1, Jena, 07747, Germany
| | - Hans-Joachim Mentzel
- Section Pediatric Radiology, Department of Diagnostic and Interventional Radiology, University Hospital, Jena, Germany
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Happel C, Borowski M, Kamp A, Rudolf F, Wicke JH, Gröner D, Grünwald F, Fiebich M. [Prenatal Radiation Exposure in Nuclear Medicine]. Nuklearmedizin 2021; 60:233-239. [PMID: 33572000 DOI: 10.1055/a-1365-7954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Radiation exposure from nuclear medicine procedures during pregnancy may cause uncertainty among patients and medical professionals. In 2019, the German Society of Medical Physics (DGMP) and the German Society of Radiology (DRG) published a fully revised version of the report "Prenatal Radiation Exposure Arising from Medical Indication, Dose Calculation, Conclusions for Physicians and Pregnant Women". This report offers a basis for dose calculation and determination of radiation exposure to the unborn. This review summarizes the most notable general adaptions made in the report's newest version and specifically points out the changes relevant to the field of nuclear medicine.The DGMP report provides physicians and medical physicists with means to estimate prenatal radiation exposure to the unborn conservatively, in a prompt and comprehensible approach. The rapidly evolving field of indications in nuclear medicine and radiology gave rise to the initiative of profoundly revising the previous version of the report from 2002. It now accounts for the extended range of devices, nuclear medicine hybrid imaging and radiotracers recently introduced. The most extensive change is a shift from the former 3-step-concept for the dose calculation to a 2-step-concept. In diagnostic nuclear medicine the first step comprises a conservative approximation of radiation exposure on the basis of current diagnostic reference levels (DRL). If exposure is assessed to be below 20 mSv, risk to the unborn child is sufficiently low, no further approaches are considered necessary. If calculated doses exceed 20 mSv, for diagnostic studies without existing DRL or in case of radionuclide therapies step 2 requires dose calculation based on administered activity and the stage of pregnancy.The DGMP report on prenatal radiation exposure offers valuable guidance for physicians and medical physicists in the field of nuclear medicine. The calculation concept provides an important basis to estimate radiation exposure to the unborn. Its extensive revision in 2019 accounts for recent scientific and technical developments and a reform of the stepwise approach to dose estimation.
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Affiliation(s)
- Christian Happel
- Universitätsklinikum Frankfurt am Main; Klinik für Nuklearmedizin
| | - Markus Borowski
- Städtisches Klinikum Braunschweig; Institut für Röntgendiagnostik und Nuklearmedizin
| | - Alexandra Kamp
- Bundesamt für Strahlenschutz, Abteilung medizinischer und beruflicher Strahlenschutz
| | - Frank Rudolf
- Medizinische Hochschule Hannover, Stabsstelle Strahlenschutz und Abteilung Medizinische Physik
| | - Jan Henryk Wicke
- Medizinische Hochschule Hannover, Stabsstelle Strahlenschutz und Abteilung Medizinische Physik
| | - Daniel Gröner
- Universitätsklinikum Frankfurt am Main; Klinik für Nuklearmedizin
| | - Frank Grünwald
- Universitätsklinikum Frankfurt am Main; Klinik für Nuklearmedizin
| | - Martin Fiebich
- Technische Hochschule Mittelhessen Gießen; Institut für Medizinische Physik und Strahlenschutz
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Happel C, Gröner D, Borowski M, Schulze B, Fiebich M, Grünwald F. Radiojodtherapie bei unbekannter Frühschwangerschaft: Abschätzung der Dosis des Ungeborenen bei einer Patientin mit Schilddrüsenkarzinom. Nuklearmedizin 2021; 60:110-112. [PMID: 33440436 DOI: 10.1055/a-1338-1414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Christian Happel
- Universitätsklinikum Frankfurt am Main, Klinik für Nuklearmedizin
| | - Daniel Gröner
- Universitätsklinikum Frankfurt am Main, Klinik für Nuklearmedizin
| | - Markus Borowski
- Städtisches Klinikum Braunschweig, Institut für Röntgendiagnostik und Nuklearmedizin
| | | | - Martin Fiebich
- Technische Hochschule Mittelhessen Gießen, Institut für Medizinische Physik und Strahlenschutz
| | - Frank Grünwald
- Universitätsklinikum Frankfurt am Main, Klinik für Nuklearmedizin
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Fiebich M, Block A, Borowski M, Geworski L, Happel C, Kamp A, Lenzen H, Mahnken AH, Müller WU, Östreicher G, Rudolf F, Stamm G, Starck P, Steiniger B, Wicke JH, Wolf U, Wucherer M, Zankl M, Zink K, Zweig C. Prenatal radiation exposure in diagnostic and interventional radiology. ROFO-FORTSCHR RONTG 2020; 193:778-786. [PMID: 33327031 DOI: 10.1055/a-1313-7527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The exposure of a pregnant woman to X-rays is an event that can cause uncertainty for all concerned. This review provides guidance on how to assess such a situation and how to determine the dose to the unborn child. In general, the use of X-rays in pregnant women in radiology should be avoided. If possible, alternatives should be used, or examinations postponed to a time after the pregnancy. This review gives a summary of the procedure for determining the radiation exposure of a pregnant woman. METHOD Based on the previous report of 2002 and the literature on prenatal radiation exposure published thereafter, the DGMP/DRG report on the procedure for the assessment of prenatal radiation exposure was adapted to the current state of science and technology. RESULTS Typically, only relatively low radiation exposures of less than 20 mSv occur for the unborn child in X-ray diagnostics in the vast majority of cases. At these dose level the additional risk of damage to the embryo or fetus caused by the radiation is low and therefore only a rough conservative estimate using tabulated values are made. Only in a few types of examination (CT and interventional radiology) higher doses values might occur in the uterus. Instead of dose estimates (step 1 in the two-step model) in these cases the calculation of dose (step 2) are required and further action by the physician may be necessary. CONCLUSIONS During the assessment, it is useful to initially use simple conservative estimation procedures to quickly determine whether a case falls into this large group less than 20 mSv, where there is a very low risk to the unborn child. If this is the case, the pregnant woman should be informed immediately by the doctor who performed the examination/treatment. This avoids a psychological burden on the patient. The DGMP/DRG report suggests a relatively simple, clearly structured procedure with advantages for all parties involved (physician, medical physics experts, MTRA and patient). KEY POINTS · The DGMP/DRG report on prenatal radiation exposure describes the procedure for calculating radiation exposures and the associated risks for the unborn child.. · Using the two-step model, only a simple assessment based on the first step is necessary for most prenatal radiation exposures.. · With the given tables it is possible to estimate individual risks for the unborn child taking into account the radiation exposure.. · Only in the rare case that the first estimate results in a uterine dose larger 20 mSv a more accurate calculation is necessary.. CITATION FORMAT · Fiebich M, Block A, Borowski M et al. Prenatal radiation exposure in diagnostic and interventional radiology. Fortschr Röntgenstr 2021; 193: 778 - 786.
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Affiliation(s)
- Martin Fiebich
- Institute of Medical Physics and Radiation Protection, University of Applied Sciences Giessen, Germany
| | - Andreas Block
- Institute for Medical Radiation Physics and Radiation Protection, Hospital of Dortmund gGmbH, Dortmund, Germany
| | - Markus Borowski
- Institute of Radiology and Nuclear Medicine, Municipal Hospital Braunschweig, Germany
| | - Lilli Geworski
- Department of medical physics and radiation protection, Hannover Medical School, Hannover, Germany
| | - Christian Happel
- Department of Nuclear Medicine, Goethe University Frankfurt; University Hospital, Frankfurt am Main, Germany
| | - Alexandra Kamp
- Department Medical and Occupational Radiation Protection, Federal Office for Radiation Protection Neuherberg, Germany
| | - Horst Lenzen
- Department of Clinical Radiology, University Hospital Münster, Germany
| | - Andreas H Mahnken
- Department of Diagnostic and Interventional Radiology, Phillips University Marburg; Marburg University Hospital, Marburg, Germany
| | | | - Gebhard Östreicher
- Medical Physics and Radiation Protection, University Hospital Augsburg, Germany
| | - Frank Rudolf
- Department of medical physics and radiation protection, Hannover Medical School, Hannover, Germany
| | - Georg Stamm
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - Peter Starck
- Institute of Diagnostic and Interventional Radiology, Medical Physics, Städtisches Klinikum Karlsruhe gGmbH, Karlsruhe, Germany
| | - Beatrice Steiniger
- Department of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - Jan-Henryk Wicke
- Department of medical physics and radiation protection, Hannover Medical School, Hannover, Germany
| | - Ulrich Wolf
- Department of Radiation Oncology, University Hospital Leipzig, Germany
| | - Michael Wucherer
- Institute of Medical Physics, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Maria Zankl
- Institute of Radiation Medicine, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
| | - Klemens Zink
- Institute of Medical Physics and Radiation Protection, University of Applied Sciences Giessen, Germany
| | - Claudia Zweig
- Clinic for Radiooncology and Radiotherapy; Department Medical Radiological Physics, Hospital Carl-Thiem-Klinikum Cottbus gGmbH, Cottbus, Germany
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Koenig AM, Maas J, Viniol S, Etzel R, Fiebich M, Thomas RP, Mahnken AH. Scatter radiation reduction with a radiation-absorbing pad in interventional radiology examinations. Eur J Radiol 2020; 132:109245. [PMID: 33011604 DOI: 10.1016/j.ejrad.2020.109245] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 02/18/2020] [Revised: 08/16/2020] [Accepted: 08/19/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Radiation-absorbing pads are an additional possibility to reduce scattered radiation at its source. The goal of this study is to investigate the efficacy of a new reusable radiation-absorbing pad at its origin in an experimental setup. MATERIAL AND METHODS All measurements were carried out using a clinical angiography system with a standardized fluoroscopy protocol, different C-arm angulations and an anthropomorphic torso phantom as a scattering body. An ionization chamber was used to measure the radiation exposure at five different heights of a simulated operator during a simulated transfemoral angiography intervention. Measurements were carried out with and without radiation-absorbing pads with lead equivalents of 0.25 and 0.5 mm placed onto the scattering body. For all measurements a mobile acrylic shield and an under-table lead curtain was used. RESULTS At all operator heights from 100 to 165 cm a significant radiation dose reduction of up to 80.6 % (p < 0.01) using the radiation-absorbing pad was measured, when compared to no radiation-absorbing pad. At the height of 165 cm the radiation-absorbing pad with a lead equivalence of 0.5 mm showed a significant radiation dose reduction (51.4 %, p < 0.01) in comparison to a lead equivalence of 0.25 mm. CONCLUSION The addition of a radiation-absorbing pad to the standard protection means results in a significant dose reduction for the operator, particularly for upper body parts.
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Affiliation(s)
- A M Koenig
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, University Hospital Marburg, Germany.
| | - J Maas
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, University Hospital Marburg, Germany
| | - S Viniol
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, University Hospital Marburg, Germany
| | - R Etzel
- Mittelhessen University of Applied Sciences, Institute of Medical Physics and Radiation Protection, Giessen, Germany
| | - M Fiebich
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, University Hospital Marburg, Germany; Mittelhessen University of Applied Sciences, Institute of Medical Physics and Radiation Protection, Giessen, Germany
| | - R P Thomas
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, University Hospital Marburg, Germany
| | - A H Mahnken
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, University Hospital Marburg, Germany
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Gehron J, Schuster M, Rindler F, Bongert M, Böning A, Krombach G, Fiebich M, Grieshaber P. Watershed phenomena during extracorporeal life support and their clinical impact: a systematic in vitro investigation. ESC Heart Fail 2020; 7:1850-1861. [PMID: 32530129 PMCID: PMC7373893 DOI: 10.1002/ehf2.12751] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/13/2020] [Accepted: 04/20/2020] [Indexed: 11/27/2022] Open
Abstract
Aims Extracorporeal life support (ECLS) during acute cardiac failure restores haemodynamic stability and provides life‐saving cardiopulmonary support. Unfortunately, all common cannulation strategies and remaining pulmonary blood flow increase left‐ventricular afterload and may favour pulmonary congestion. The resulting disturbed pulmonary gas exchange and a residual left‐ventricular action can contribute to an inhomogeneous distribution of oxygenated blood into end organs. These complex flow interactions between native and artificial circulation cannot be investigated at the bedside: only an in vitro simulation can reveal the underlying activities. Using an in vitro mock circulation loop, we systematically investigated the impact of heart failure, extracorporeal support, and cannulation routes on the formation of flow phenomena and flow distribution in the arterial tree. Methods and results The mock circulation loop consisted of two flexible life‐sized vascular models (aorta and vena cava) driven by two paracorporeal assist devices, resistance elements, and compliance reservoirs to mimic the circulatory system. Several large‐bore antegrade and retrograde access ports allowed connection to an ECLS system for extracorporeal support. With four degrees of extracorporeal support—that for cardiac failure, early recovery, late recovery, and weaning—we investigated aortic blood flow velocity, blood flow, and mixing zones using colour‐coded Doppler ultrasound in the aorta and its corresponding branches. Full retrograde extracorporeal support (3–4 L/min) perfused major portions of the aorta but did not reach the supra‐aortic branches and ascending aorta, resulting in an area in the thoracic aorta demonstrating nearly stagnant blood flow velocities during cardiogenic shock and early recovery (0 ± 4 cm/s; −10 ± 15 cm/s, respectively) confined by two watersheds at the aortic isthmus and renal artery origin. Even increased ECLS flow was unable to shift the watershed towards the aortic arch. Antegrade support resulted in homogeneous flow distribution during all stages of cardiac failure but created a markedly negative flow vector in the ascending aorta during cardiogenic shock and early recovery with increased afterload. Conclusions Our systematic fluid‐mechanical analysis confirms the clinical assumption that despite restoring haemodynamic stability, extracorporeal support generates an inhomogeneous distribution of oxygenated blood with an inadequate supply to end organs and increased left‐ventricular afterload with absent ventricular unloading. End‐organ supply may be monitored by near‐infrared spectroscopy, but an obviously non‐controllable watershed emphasizes the need for additional measures: pre‐pulmonary oxygenation with a veno‐arterial‐venous ECLS configuration can allow a transpulmonary passage of oxygenated blood, providing improved end‐organ supply.
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Affiliation(s)
- Johannes Gehron
- Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Rudolf-Buchheim-Str. 7, 35392, Giessen, Germany
| | - Maximilian Schuster
- Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Rudolf-Buchheim-Str. 7, 35392, Giessen, Germany
| | - Florian Rindler
- Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Rudolf-Buchheim-Str. 7, 35392, Giessen, Germany
| | - Markus Bongert
- Research Center for Biomedical Technology (BMT), University of Applied Sciences and Arts, Dortmund, Germany
| | - Andreas Böning
- Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Rudolf-Buchheim-Str. 7, 35392, Giessen, Germany
| | - Gabriele Krombach
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen, Giessen, Germany
| | - Martin Fiebich
- Division of Life Science Engineering, University of Applied Sciences, Giessen, Germany
| | - Philippe Grieshaber
- Department of Adult and Pediatric Cardiovascular Surgery, University Hospital Giessen, Rudolf-Buchheim-Str. 7, 35392, Giessen, Germany
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Schäfer SB, Papst S, Fiebich M, Rudolph C, de Laffolie J, Krombach GA. Modification of chest radiography exposure parameters using a neonatal chest phantom. Pediatr Radiol 2020; 50:28-37. [PMID: 31583441 DOI: 10.1007/s00247-019-04522-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 07/09/2019] [Accepted: 09/02/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The acquisition of chest radiographs in neonates is of critical importance in diagnostics because of the risk of respiratory distress syndrome and pneumothorax in preterm infants. OBJECTIVE To achieve a dose reduction while preserving a diagnostic image quality for chest radiographs of neonates. MATERIALS AND METHODS All radiographs, generated on a fully digital X-ray unit by using a neonatal chest phantom, were evaluated under variation of the tube voltage (40-70 kV) and mAs levels (1-10.2 mAs) with and without an additional 0.1-mm copper (Cu) filtration. Noise, contrast and contrast-to-noise ratio for bronchus, heart, lungs and vessels were determined. Visual assessment of the image quality was carried out by three radiologists using a Likert scale. To evaluate a maximally possible dose reduction, the dose of the radiographs with still acceptable image quality at a minimal dose was compared to the dose of the radiographs with the standard settings used in clinical routine. RESULTS The noise showed decreasing values with increasing dose, while the contrast values were increased. For the contrast-to-noise ratio, a digressive course of the values as a function of the tube voltage was found. The visual evaluation of image quality showed the best evaluation of the structures at the lowest possible dose in the settings (44 kV, 3.36 mAs) with copper filtration and in the settings (44 kV, 1.56 mAs) without copper filtration. A maximum dose reduction from 8.29 μSv to 2.21 μSv (about 73%) was obtained. CONCLUSION A dose reduction while preserving diagnostic image quality in a digital X-ray system is generally possible by reducing the tube voltage and simultaneous adaptation of the mAs settings.
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Affiliation(s)
- Stefan B Schäfer
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen, Justus-Liebig University, Klinikstrasse 33, 35392, Giessen, Germany.
| | - Sabine Papst
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen, Justus-Liebig University, Klinikstrasse 33, 35392, Giessen, Germany.,Department of Pediatric Radiology, University Hospital Giessen, Justus-Liebig University, 35392, Giessen, Germany
| | - Martin Fiebich
- Institute of Medical Physics and Radiation Protection, University of Applied Sciences, 35392, Giessen, Germany
| | - Claudia Rudolph
- Department of Pediatric Radiology, University Hospital Giessen, Justus-Liebig University, 35392, Giessen, Germany
| | - Jan de Laffolie
- Department of General Pediatrics and Neonatology, University Hospital Giessen, Justus-Liebig University, 35392, Giessen, Germany
| | - Gabriele A Krombach
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen, Justus-Liebig University, Klinikstrasse 33, 35392, Giessen, Germany.,Department of Pediatric Radiology, University Hospital Giessen, Justus-Liebig University, 35392, Giessen, Germany
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Schopphoven S, Cavael P, Bock K, Fiebich M, Mäder U. Breast phantoms for 2D digital mammography with realistic anatomical structures and attenuation characteristics based on clinical images using 3D printing. Phys Med Biol 2019; 64:215005. [PMID: 31469105 DOI: 10.1088/1361-6560/ab3f6a] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The aim of this work was to develop a production process for breast phantoms for 2D digital mammography (DM) with realistic anatomical structures and attenuation characteristics based on clinical images using 3D printing. The presented production process is based on PolyJet 3D printing technology using a polypropylene like printing material. First, an attenuation calibration function for this material and the achievable lateral resolution of the printing process of about 200 µm was determined. Subsequently, to generate the digital 3D model of the breast phantom, the pixel intensities of the unprocessed clinical image that are related to the attenuation along the z-axis of the breast, were converted to corresponding phantom heights using the calibration function. To validate the process, an image of the 3D printed breast phantom was acquired on the full field digital mammography (FFDM) system used for calibration and compared with the clinical image in terms of anatomical structures and associated attenuation characteristics. The exposure parameters and image impression of the phantom were evaluated using five other FFDM systems of different manufacturers and types. Results demonstrated that the anatomical structures in the images and the attenuation characteristics of a female breast and the derived phantom agreed on the FFDM system used for calibration. The automatic exposure control segmentation, the automatically selected exposure parameters and the image postprocessing of the clinical and phantom image indicated a high level of conformity. As shown, the phantom is also suitable for other FFDM systems. In conclusion, an approach to produce anthropomorphic breast phantoms for DM offering realistic anatomical structures and attenuation characteristics based on clinical images was successfully developed. As shown, the phantom realistically simulated the original female breast. Therefore, it is expected that such phantoms are promising to support bridging the gap between physical-technical and diagnostic image quality assessment. In addition, they enable a variety of practical and scientific applications for which present technical phantoms are not suitable.
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Affiliation(s)
- Stephan Schopphoven
- Referenzzentrum Mammographie Süd West, Reference Centre for Mammography Screening Southwest Germany, Bahnhofstrasse 7, 35037 Marburg, Germany. Author to whom any correspondence should be addressed
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Koenig AM, Etzel R, Greger W, Viniol S, Fiebich M, Thomas RP, Mahnken AH. Protective Efficacy of Different Ocular Radiation Protection Devices: A Phantom Study. Cardiovasc Intervent Radiol 2019; 43:127-134. [PMID: 31489475 DOI: 10.1007/s00270-019-02319-1] [Citation(s) in RCA: 8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 08/19/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of this study was to investigate the efficacy of different designs and types of ocular radiation protection devices depending on simulated varied body heights in a phantom-simulated thoracic intervention. MATERIALS AND METHODS A clinical angiography system with a standardized fluoroscopy protocol with an anthropomorphic chest phantom as a scattering object and optically stimulated luminescence dosimeters for measuring radiation dose were used. The dosimeters were placed at the position of eyes of an anthropomorphic head phantom simulating the examiner. The head phantom was placed on a height-adjustable stand simulating the height of the examiner from 160 to 200 cm with 10 cm increments. The dose values were then measured with no radiation protection, a weightless-like radiation protection garment, radiation protection glasses and visors. RESULTS The average dose reduction using radiation protection devices varied between 57.7 and 83.4% (p < 0.05) in comparison with no radiation protection. Some radiation protection glasses and visors showed a significant dose reduction for the eye lenses when the height of the examiner increased. The right eye was partially less protected, especially if the distances between the simulated examiner's head and the scatter object were small. CONCLUSION All the investigated protection devices showed a significant reduction in radiation exposure to the simulated examiner. For some devices, the radiation dose increased with decreasing distance to the scattering object, especially for the right eye lens.
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Affiliation(s)
- A M Koenig
- Clinic of Diagnostic and Interventional Radiology, Philipps-University of Marburg, Baldingerstrasse 1, 35043, Marburg, Germany.
| | - R Etzel
- Clinic of Diagnostic and Interventional Radiology, Philipps-University of Marburg, Baldingerstrasse 1, 35043, Marburg, Germany.,Institute of Medical Physics and Radiation Protection, Mittelhessen University of Applied Sciences, Giessen, Germany
| | - W Greger
- Institute of Medical Physics and Radiation Protection, Mittelhessen University of Applied Sciences, Giessen, Germany
| | - S Viniol
- Clinic of Diagnostic and Interventional Radiology, Philipps-University of Marburg, Baldingerstrasse 1, 35043, Marburg, Germany
| | - M Fiebich
- Institute of Medical Physics and Radiation Protection, Mittelhessen University of Applied Sciences, Giessen, Germany
| | - R P Thomas
- Clinic of Diagnostic and Interventional Radiology, Philipps-University of Marburg, Baldingerstrasse 1, 35043, Marburg, Germany
| | - A H Mahnken
- Clinic of Diagnostic and Interventional Radiology, Philipps-University of Marburg, Baldingerstrasse 1, 35043, Marburg, Germany
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Leonhäuser B, Happel C, Gröner D, Bockisch B, Fiebich M, Hellwig D, Grünwald F, Kranert WT. [Evaluation of intratherapeutic 177Lu-HA-DOTATATE treatment in neuroendocrine tumors: dosimetry with SPECT, whole-body imaging and gamma probe]. Nuklearmedizin 2019; 58:379-386. [PMID: 31461752 DOI: 10.1055/a-0987-9689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM Peptide receptor radionuclide therapy (PRRT) with 177Lu-HA-DOTATATE has evolved as a new path in the treatment of somatostatin-receptor-expressing neuroendocrine tumors. The kidneys are proven as organs at risk and should be evaluated dosimetrically. Overlap with other organs will make dosimetry based on planar scintigraphy inaccurate. Aim of this study was to approximate the contribution of the kidneys to conjugated planar views without the use of a SPECT/CT. MATERIAL AND METHOD An algorithm was developed to determine the kidney dose using an EXCEL (Microsoft) based program. Dosimetric data were drawn and merged from three modalities: an individually calibrated gamma probe, a whole-body scintigraphy (WBS) and SPECT-acquisitions. The method was evaluated for 85 kidneys. Kidney masses were obtained via CT volumetry. RESULTS The developed algorithm combines data from the three modalities. The ratio of the events within a kidney-VOI and the events from the summed coronary SPECT views (kidney ROI) represents the contribution of the kidney to the whole-body kidney ROI. This fraction was calculated to 49 % (17 % - 78 %) and 45 % (18 % - 75 %) for the left and the right kidney, respectively. Quantification of activity was deduced from equalizing the WBS count with the concurrent gamma probe measurement. Monoexponential curves were fitted to the obtained kidney activities, with resulting doses of 0,13 to 0,77 Gy/GBq (average 0,36 and 0,39 Gy/GBq for the left and the right kidney). CONCLUSION The presented method is suitable to perform kidney dosimetry by using a gamma probe and a gamma camera, without using SPECT/CT.
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Affiliation(s)
- Britta Leonhäuser
- CHARITÉ - Universitätsmedizin Berlin, Abteilung Medizinphysik-Experten sonstige Einrichtungen, Berlin
| | - Christian Happel
- Universitätsklinikum Frankfurt am Main, Klinik für Nuklearmedizin, Frankfurt
| | - Daniel Gröner
- Universitätsklinikum Frankfurt am Main, Klinik für Nuklearmedizin, Frankfurt
| | - Benjamin Bockisch
- Universitätsklinikum Frankfurt am Main, Klinik für Nuklearmedizin, Frankfurt
| | - Martin Fiebich
- Technische Hochschule Mittelhessen, Fachbereich Life Science Engineering, Gießen
| | - Dirk Hellwig
- Universitätsklinikum Regensburg, Klinik für Nuklearmedizin, Regensburg
| | - Frank Grünwald
- Universitätsklinikum Frankfurt am Main, Klinik für Nuklearmedizin, Frankfurt
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Grieshaber P, Roth P, Wiesmann T, Gehron J, Bongert M, Fiebich M, Böning A. Neuartige Doppellumenkanüle für extrakorporale Kreislaufunterstützungsverfahren. Z Herz- Thorax- Gefäßchir 2019. [DOI: 10.1007/s00398-019-0307-5] [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: 11/28/2022]
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Fiebich M, Wolf U. Die neue deutsche Strahlenschutzverordnung. Z Med Phys 2018; 28:259-263. [PMID: 30385004 DOI: 10.1016/j.zemedi.2018.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Etzel R, König AM, Keil B, Fiebich M, Mahnken AH. Effectiveness of a new radiation protection system in the interventional radiology setting. Eur J Radiol 2018; 106:56-61. [PMID: 30150051 DOI: 10.1016/j.ejrad.2018.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/30/2018] [Accepted: 07/07/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The goal of this study was to examine a new weightless-like radiation protection garment regarding its radiation protection efficacy and to compare it to a conventional two-piece apron suit plus thyroid collar and standard ancillary shields. MATERIAL AND METHODS All measurements were carried out using a clinical angiography system with a standardized fluoroscopy protocol for different C-arm angulations. An anthropomorphic torso phantom served as a scattering body. In addition, an ionization chamber was used to measure the radiation exposure on five different representative heights and at two different positions of an examiner during a typical fluoroscopic-guided intervention. RESULTS The new weightless-like radiation protection garment and the conventional protection concept showed a mean dose reduction of 98.1% (p < 0.01) and 90.1% (p < 0.01) when compared to no shielding, respectively. By adding ancillary shields to both systems, an average reduction of 99.0% (p < 0.01) and 98.2% (p < 0.01) was found. In addition, the efficacy of both systems varied depending on the height, the C-arm angulation and position of the examiner. CONCLUSION Combined with ancillary shields as an overall protection system, the recently introduced weightless-like radiation protection garment showed a significant better radiation protection efficacy when compared to conventional radiation protection measures.
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Affiliation(s)
- Robin Etzel
- Technische Hochschule Mittelhessen (THM) - University of Applied Sciences, Department of Life Science Engineering, Institute of Medical Physics and Radiation Protection, Wiesenstrasse 14, 35390 Giessen, Germany; Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Baldingerstrasse, 35043 Marburg, Germany.
| | - Alexander M König
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Baldingerstrasse, 35043 Marburg, Germany.
| | - Boris Keil
- Technische Hochschule Mittelhessen (THM) - University of Applied Sciences, Department of Life Science Engineering, Institute of Medical Physics and Radiation Protection, Wiesenstrasse 14, 35390 Giessen, Germany.
| | - Martin Fiebich
- Technische Hochschule Mittelhessen (THM) - University of Applied Sciences, Department of Life Science Engineering, Institute of Medical Physics and Radiation Protection, Wiesenstrasse 14, 35390 Giessen, Germany.
| | - Andreas H Mahnken
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Baldingerstrasse, 35043 Marburg, Germany.
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Bohrer E, Schäfer S, Mäder U, Noël PB, Krombach GA, Fiebich M. Optimizing radiation exposure for CT localizer radiographs. Z Med Phys 2017; 27:145-158. [DOI: 10.1016/j.zemedi.2016.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 09/16/2016] [Accepted: 09/16/2016] [Indexed: 10/20/2022]
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Abstract
BACKGROUND The use of radiation protection equipment can reduce the radiation exposure of patients. OBJECTIVES The aim was to show which patient shields should be used for the different types of examination. METHODS The results of multiple studies were compiled and analyzed and recommendations made for the use of patient shields. The absolute dose values and the protective effect were considered. RESULTS Radiological protection should be used in many investigations; particularly in the case of CT investigations, a reasonable dose reduction potential exists due to the higher radiation dose. CONCLUSIONS Based on these recommendations, workflow changes in some types of investigation are expected due to the use of additional patient shields.
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Affiliation(s)
- M Fiebich
- Institut für Medizinische Physik und Strahlenschutz, Technische Hochschule Mittelhessen, Wiesenstr. 14, 35390, Gießen, Deutschland.
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König A, Etzel R, Keil B, Fiebich M, Mahnken A. Effektivität der Kombination verschiedener Strahlenschutzmittel in der Interventionellen Radiologie. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A König
- Philipps-Universität Marburg, Diagnostische und Interventionelle Radiologie, Marburg
| | - R Etzel
- Technische Hochschule Mittelhessen, Institut für Medizinische Physik und Strahlenschutz, Gießen
| | - B Keil
- Technische Hochschule Mittelhessen, Institut für Medizinische Physik und Strahlenschutz, Gießen
| | - M Fiebich
- Technische Hochschule Mittelhessen, Institut für Medizinische Physik und Strahlenschutz, Gießen
| | - A Mahnken
- Philipps-Universität Marburg, Diagnostische und Interventionelle Radiologie, Marburg
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Gehron J, Rindler F, Schuster M, Andrick J, Bongert M, Krombach G, Fiebich M, Böning A, Grieshaber P. The Hemodynamic Burden of Femoral Extracorporeal Life Support for Severe Circulatory Failure: Investigating Competing Flow Phenomena with Color Doppler Sonography. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- J. Gehron
- Universitätsklinikum Gießen und Marburg GmbH Standort Gießen, Klinik für Herz-, Kinderherz- und Gefäßchirurgie, Gießen, Germany
| | - F. Rindler
- Universitätsklinikum Gießen und Marburg GmbH Standort Gießen, Klinik für Herz-, Kinderherz- und Gefäßchirurgie, Gießen, Germany
| | - M. Schuster
- Universitätsklinikum Gießen und Marburg GmbH Standort Gießen, Klinik für Herz-, Kinderherz- und Gefäßchirurgie, Gießen, Germany
| | - J. Andrick
- Universitätsklinikum Gießen und Marburg GmbH Standort Gießen, Klinik für Herz-, Kinderherz- und Gefäßchirurgie, Gießen, Germany
| | - M. Bongert
- Fachhochschule Dortmund, FB Maschinenbau, FSP Biomedizintechnik, Dortmund, Germany
| | - G. Krombach
- Universitätsklinikum Gießen und Marburg GmbH Standort Gießen, Diagnostische und Interventionelle Radiologie, Gießen, Germany
| | - M. Fiebich
- Technische Hochschule Mittelhessen, FB Life Science Engineering, Gießen, Germany
| | - A. Böning
- Universitätsklinikum Gießen und Marburg GmbH Standort Gießen, Klinik für Herz-, Kinderherz- und Gefäßchirurgie, Gießen, Germany
| | - P. Grieshaber
- Universitätsklinikum Gießen und Marburg GmbH Standort Gießen, Klinik für Herz-, Kinderherz- und Gefäßchirurgie, Gießen, Germany
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Etzel R, König AM, Keil B, Mahnken AH, Fiebich M. Session 16. Dosimetry, radiation protection and radiation biology II. BIOMED ENG-BIOMED TE 2017. [DOI: 10.1515/bmt-2017-5015] [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: 11/15/2022]
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Stamm G, Fiebich M. Session 28: CT-optimisation I. BIOMED ENG-BIOMED TE 2017. [DOI: 10.1515/bmt-2017-5049] [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: 11/15/2022]
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Neubauer J, Benndorf M, Reidelbach C, Krauß T, Lampert F, Zajonc H, Kotter E, Langer M, Fiebich M, Goerke SM. Comparison of Diagnostic Accuracy of Radiation Dose-Equivalent Radiography, Multidetector Computed Tomography and Cone Beam Computed Tomography for Fractures of Adult Cadaveric Wrists. PLoS One 2016; 11:e0164859. [PMID: 27788215 PMCID: PMC5082876 DOI: 10.1371/journal.pone.0164859] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 10/03/2016] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To compare the diagnostic accuracy of radiography, to radiography equivalent dose multidetector computed tomography (RED-MDCT) and to radiography equivalent dose cone beam computed tomography (RED-CBCT) for wrist fractures. METHODS As study subjects we obtained 10 cadaveric human hands from body donors. Distal radius, distal ulna and carpal bones (n = 100) were artificially fractured in random order in a controlled experimental setting. We performed radiation dose equivalent radiography (settings as in standard clinical care), RED-MDCT in a 320 row MDCT with single shot mode and RED-CBCT in a device dedicated to musculoskeletal imaging. Three raters independently evaluated the resulting images for fractures and the level of confidence for each finding. Gold standard was evaluated by consensus reading of a high-dose MDCT. RESULTS Pooled sensitivity was higher in RED-MDCT with 0.89 and RED-MDCT with 0.81 compared to radiography with 0.54 (P = < .004). No significant differences were detected concerning the modalities' specificities (with values between P = .98). Raters' confidence was higher in RED-MDCT and RED-CBCT compared to radiography (P < .001). CONCLUSION The diagnostic accuracy of RED-MDCT and RED-CBCT for wrist fractures proved to be similar and in some parts even higher compared to radiography. Readers are more confident in their reporting with the cross sectional modalities. Dose equivalent cross sectional computed tomography of the wrist could replace plain radiography for fracture diagnosis in the long run.
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Affiliation(s)
- Jakob Neubauer
- Department of Radiology, University Medical Center Freiburg, Freiburg, Germany
- * E-mail:
| | - Matthias Benndorf
- Department of Radiology, University Medical Center Freiburg, Freiburg, Germany
| | - Carolin Reidelbach
- Department of Radiology, University Medical Center Freiburg, Freiburg, Germany
| | - Tobias Krauß
- Department of Radiology, University Medical Center Freiburg, Freiburg, Germany
| | - Florian Lampert
- Department of Plastic and Hand Surgery, University Medical Center Freiburg, Freiburg, Germany
| | - Horst Zajonc
- Department of Plastic and Hand Surgery, University Medical Center Freiburg, Freiburg, Germany
| | - Elmar Kotter
- Department of Radiology, University Medical Center Freiburg, Freiburg, Germany
| | - Mathias Langer
- Department of Radiology, University Medical Center Freiburg, Freiburg, Germany
| | - Martin Fiebich
- Department of Medical Physics and Radiation Protection, University of Applied Sciences Gießen, Gießen, Germany
| | - Sebastian M. Goerke
- Department of Radiology, Ortenau Klinikum Offenburg-Gengenbach, Offenburg, Germany
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Fiebich M. Bildqualität und Strahlenexposition. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581598] [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: 10/22/2022]
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Fiebich M. BfS-Melderegister „Besondere Vorkommnisse“. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581796] [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: 10/22/2022]
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Walz M, Bender T, Madsack B, Kolodziej M, Fiebich M, Hermen J, Sohrabi K. Terminologie und automatisiertes Klassifikationssystem für radiologische Untersuchungsarten – Umsetzung im Rahmen des Dosis- und Qualitätsmanagementsystems IVEU. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581235] [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: 10/22/2022]
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Fiebich M. Patientenschutzmittel – Sinn und Unsinn, Empfehlungen der SSK. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581939] [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: 10/22/2022]
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Fiebich M. Strahlenexposition und Strahlenschutz. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581800] [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: 10/22/2022]
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Neubauer J, Neubauer C, Gerstmair A, Krauss T, Reising K, Zajonc H, Kotter E, Langer M, Fiebich M, Voigt J. Comparison of the Radiation Dose from Cone Beam Computed Tomography and Multidetector Computed Tomography in Examinations of the Hand. ROFO-FORTSCHR RONTG 2016; 188:488-93. [DOI: 10.1055/s-0042-101251] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- J. Neubauer
- Department of Radiology, University Medical Center Freiburg, Germany
| | - C. Neubauer
- Department of Radiology, University Medical Center Freiburg, Germany
| | - A. Gerstmair
- Department of Radiology, University Medical Center Freiburg, Germany
| | - T. Krauss
- Department of Radiology, University Medical Center Freiburg, Germany
| | - K. Reising
- Department of Orthopedics and Trauma Surgery, University Medical Center Freiburg, Germany
| | - H. Zajonc
- Department of Plastic and Hand Surgery, University Medical Center Freiburg, Germany
| | - E. Kotter
- Department of Radiology, University Medical Center Freiburg, Germany
| | - M. Langer
- Department of Radiology, University Medical Center Freiburg, Germany
| | - M. Fiebich
- Institut of Medical Physics and Radiation Protection, University of Applied Sciences, Giessen, Germany
| | - J. Voigt
- Institut of Medical Physics and Radiation Protection, University of Applied Sciences, Giessen, Germany
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Grieshaber P, Gehron J, Bongert M, Schäfer S, Fiebich M, Krombach G, Böning A. Exploration of the Mixing Phenomena during Interaction of Internal and External Circulations (EMPACs): Developing an in-vitro and in-silico Model of the Human Circulation. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571485] [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: 10/22/2022]
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Hermen J, Jahnen A, Kolodziej M, Bender T, Fiebich M, Borowski M, Bressel S, Madsack B, Walz M. IVEU: IT-based collection and reporting of radiological examination parameters. Radiat Prot Dosimetry 2015; 165:57-61. [PMID: 25802461 DOI: 10.1093/rpd/ncv028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In Germany, each site using ionising radiation in human medicine is assigned to a competent medical authority (CMA) for quality assurance. Duties of these CMAs are, e.g. the inspection of medical aspects of the use of X-rays and nuclear medicine at the sites as well as technical quality assurance of X-ray devices. The CMAs themselves have to report the collected exposure values to the ministries and the Federal Office for Radiation Protection. The IVEU (IT-gestütztes Verfahren zur Erfassung von Untersuchungsparametern) Software Framework assists CMAs and radiological departments in collecting and analysing data provided in DICOM headers.
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Affiliation(s)
- J Hermen
- Luxembourg Institute of Science and Technology (LIST), Luxembourg
| | - A Jahnen
- Luxembourg Institute of Science and Technology (LIST), Luxembourg
| | - M Kolodziej
- Technische Hochschule Mittelhessen, Institut für Medizinische Physik und Strahlenschutz, Gießen, Germany
| | - T Bender
- Technische Hochschule Mittelhessen, Institut für Medizinische Physik und Strahlenschutz, Gießen, Germany
| | - M Fiebich
- Technische Hochschule Mittelhessen, Institut für Medizinische Physik und Strahlenschutz, Gießen, Germany
| | - M Borowski
- Klinikum Braunschweig, Institut für Röntgendiagnostik und Nuklearmedizin, Braunschweig, Germany
| | - S Bressel
- Quomod-Teamworker.de, Rheinstetten, Germany
| | - B Madsack
- Ärztliche Stelle für Qualitätssicherung in der Radiologie, Nuklearmedizin und Strahlentherapie Hessen, TÜV SÜD Life Service GmbH, Frankfurt, Germany
| | - M Walz
- Ärztliche Stelle für Qualitätssicherung in der Radiologie, Nuklearmedizin und Strahlentherapie Hessen, TÜV SÜD Life Service GmbH, Frankfurt, Germany
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Penchev P, Mäder U, Fiebich M, Zink K. Design and evaluation of a Monte Carlo based model of an orthovoltage treatment system. Z Med Phys 2015; 25:341-352. [PMID: 26119861 DOI: 10.1016/j.zemedi.2015.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 10/23/2014] [Revised: 05/28/2015] [Accepted: 05/29/2015] [Indexed: 10/23/2022]
Abstract
The aim of this study was to develop a flexible framework of an orthovoltage treatment system capable of calculating and visualizing dose distributions in different phantoms and CT datasets. The framework provides a complete set of various filters, applicators and x-ray energies and therefore can be adapted to varying studies or be used for educational purposes. A dedicated user friendly graphical interface was developed allowing for easy setup of the simulation parameters and visualization of the results. For the Monte Carlo simulations the EGSnrc Monte Carlo code package was used. Building the geometry was accomplished with the help of the EGSnrc C++ class library. The deposited dose was calculated according to the KERMA approximation using the track-length estimator. The validation against measurements showed a good agreement within 4-5% deviation, down to depths of 20% of the depth dose maximum. Furthermore, to show its capabilities, the validated model was used to calculate the dose distribution on two CT datasets. Typical Monte Carlo calculation time for these simulations was about 10 minutes achieving an average statistical uncertainty of 2% on a standard PC. However, this calculation time depends strongly on the used CT dataset, tube potential, filter material/thickness and applicator size.
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Affiliation(s)
- Petar Penchev
- Institute of Medical Physics and Radiation Protection - IMPS University of Applied Sciences, Gießen, Germany.
| | - Ulf Mäder
- Institute of Medical Physics and Radiation Protection - IMPS University of Applied Sciences, Gießen, Germany
| | - Martin Fiebich
- Institute of Medical Physics and Radiation Protection - IMPS University of Applied Sciences, Gießen, Germany
| | - Klemens Zink
- Institute of Medical Physics and Radiation Protection - IMPS University of Applied Sciences, Gießen, Germany; University Hospital Marburg, Department of Radiotherapy and Radiation Oncology, Philipps-University, Marburg, Germany
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Nasirudin RA, Mei K, Penchev P, Fehringer A, Pfeiffer F, Rummeny EJ, Fiebich M, Noël PB. Correction: Reduction of Metal Artifact in Single Photon-Counting Computed Tomography by Spectral-Driven Iterative Reconstruction Technique. PLoS One 2015; 10:e0131500. [PMID: 26098956 PMCID: PMC4476832 DOI: 10.1371/journal.pone.0131500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Nasirudin RA, Mei K, Panchev P, Fehringer A, Pfeiffer F, Rummeny EJ, Fiebich M, Noël PB. Reduction of metal artifact in single photon-counting computed tomography by spectral-driven iterative reconstruction technique. PLoS One 2015; 10:e0124831. [PMID: 25955019 PMCID: PMC4425555 DOI: 10.1371/journal.pone.0124831] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 03/17/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose The exciting prospect of Spectral CT (SCT) using photon-counting detectors (PCD) will lead to new techniques in computed tomography (CT) that take advantage of the additional spectral information provided. We introduce a method to reduce metal artifact in X-ray tomography by incorporating knowledge obtained from SCT into a statistical iterative reconstruction scheme. We call our method Spectral-driven Iterative Reconstruction (SPIR). Method The proposed algorithm consists of two main components: material decomposition and penalized maximum likelihood iterative reconstruction. In this study, the spectral data acquisitions with an energy-resolving PCD were simulated using a Monte-Carlo simulator based on EGSnrc C++ class library. A jaw phantom with a dental implant made of gold was used as an object in this study. A total of three dental implant shapes were simulated separately to test the influence of prior knowledge on the overall performance of the algorithm. The generated projection data was first decomposed into three basis functions: photoelectric absorption, Compton scattering and attenuation of gold. A pseudo-monochromatic sinogram was calculated and used as input in the reconstruction, while the spatial information of the gold implant was used as a prior. The results from the algorithm were assessed and benchmarked with state-of-the-art reconstruction methods. Results Decomposition results illustrate that gold implant of any shape can be distinguished from other components of the phantom. Additionally, the result from the penalized maximum likelihood iterative reconstruction shows that artifacts are significantly reduced in SPIR reconstructed slices in comparison to other known techniques, while at the same time details around the implant are preserved. Quantitatively, the SPIR algorithm best reflects the true attenuation value in comparison to other algorithms. Conclusion It is demonstrated that the combination of the additional information from Spectral CT and statistical reconstruction can significantly improve image quality, especially streaking artifacts caused by the presence of materials with high atomic numbers.
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Affiliation(s)
- Radin A. Nasirudin
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany
- * E-mail:
| | - Kai Mei
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Petar Panchev
- Institut für Medizinische Physik und Strahlenschutz, Technische Hochschule Mittelhessen, Wiessenstrasse 14, 35390 Giessen, Germany
| | - Andreas Fehringer
- Chair for Biomedical Physics and Institute for Medical Engineering, Technische Universität München, James-Franck-Strasse 1, 85748 Garching, Germany
| | - Franz Pfeiffer
- Chair for Biomedical Physics and Institute for Medical Engineering, Technische Universität München, James-Franck-Strasse 1, 85748 Garching, Germany
| | - Ernst J. Rummeny
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Martin Fiebich
- Institut für Medizinische Physik und Strahlenschutz, Technische Hochschule Mittelhessen, Wiessenstrasse 14, 35390 Giessen, Germany
| | - Peter B. Noël
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany
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Walz M, Hermen J, Kolodziej M, Madsack B, Borowski M, Bressel S, Bender T, Simmler R, Fiebich M, Richter C, Kolder R, Hmaidat R, Weisser G. Ergebnisse des IVEU-Projektes: Auswertung von DICOM-Header-Daten bei einer Ärztlichen Stelle. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550831] [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: 10/23/2022]
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Neubauer J, Reidelbach C, Neubauer C, Leschka S, Soschynski M, Voigt J, Fiebich M, Langer M, Kotter E, Goerke S. Vergleich von dosisäquivalentem Röntgen, Multidetektor-CT und Flachdetektor-CT bei Mittelhandfrakturen: eine Phantomstudie. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551245] [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: 10/23/2022]
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Etzel R, Fiebich M. SU-D-18C-07: Framework for Time-Dependency Analysis of MRI Data to Visualize and Quantify Lung Ventilation by Using Oxygen as Contrast Media. Med Phys 2014. [DOI: 10.1118/1.4887915] [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: 11/07/2022] Open
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Walz M, Hermen J, Madsack B, Kolodziej M, Borowski M, Bressel S, Bender T, Simmler R, Fiebich M, Richter C, Kolder R, Weisser G. IVEU-Projekt: Erfassung und Auswertung von DICOM – Header – Daten, Strahlenexpositionen und Untersuchungsparametern bei Ärztlichen Stellen und Strahlenanwendern. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Fiebich M. Strahlenexposition und Strahlenschutz. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373393] [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: 10/25/2022]
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Pabst SE, Laffolie JD, Hamscho N, Stracke H, Fiebich M, Krombach GA. Dosisreduktion anhand der Modifikation der Belichtungsparameter am neonatalen Thoraxphantom. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373607] [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: 10/25/2022]
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Fiebich M, Voigt JM. Bildqualität und Strahlenexposition. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372735] [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: 10/25/2022]
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Schäfer S, Alejandre-Lafont E, Schmidt T, Gizewski E, Fiebich M, Krombach G. Dose Management for X-Ray and CT: Systematic Comparison of Exposition Values from Two Institutes to Diagnostic Reference Levels and Use of Results for Optimisation of Exposition. ROFO-FORTSCHR RONTG 2014; 186:785-94. [DOI: 10.1055/s-0033-1356425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | | | - T. Schmidt
- Neuroradiology, University Hospital Giessen
| | - E. Gizewski
- Neuroradiology, University Hospital Insbruck
| | - M. Fiebich
- Institute of Medical Physics and Radiation Protection, University of Applied Sciences, Giessen
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Bergmann T, Maeder U, Fiebich M, Dickob M, Nattkemper TW, Anselmetti D. Categorization of two-photon microscopy images of human cartilage into states of osteoarthritis. Osteoarthritis Cartilage 2013; 21:1074-82. [PMID: 23680876 DOI: 10.1016/j.joca.2013.04.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 03/30/2013] [Accepted: 04/27/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The degeneration of articular cartilage is part of the clinical syndrome of osteoarthritis (OA) and one of the most common causes of pain and disability in middle-aged and older people(1). However, the objective detection of an initial state of OA is still challenging. In order to categorize cartilage into states of OA, an algorithm is presented which offers objective categorization on the basis of two-photon laser-scanning microscopy (TPLSM) images. METHODS The algorithm is based on morphological characteristics of the images and results in a topographical visualization. This paper describes the algorithm and shows the result of a categorization of human cartilage samples. RESULTS The resulting map of the analysis of TPLSM images can be divided into areas which correspond to the grades of the Outerbridge-Categorization. The algorithm is able to differentiate the samples in coincidence with the macroscopic impression. CONCLUSION The method is promising for early OA detection and categorization. In order to achieve a higher benefit for the physician the method must be transferred to an endoscopic setup for an application in surgery.
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Affiliation(s)
- T Bergmann
- Institute of Bioprocess Engineering and Pharmaceutical Technology, Technische Hochschule Mittelhessen, Wiesenstraße 14, Giessen, Germany.
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Fiebich M, Schopphoven S. Bildqualität und Dosis in der Mammografie. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346537] [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: 10/26/2022]
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48
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Fiebich M. Strahlenexposition und Strahlenschutz. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1345847] [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: 10/26/2022]
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49
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Fiebich M, Voigt JM. Bildqualität und Strahlenexposition. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1345947] [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: 10/26/2022]
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50
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Beer S, Dobler D, Gross A, Ost M, Elseberg C, Maeder U, Schmidts TM, Keusgen M, Fiebich M, Runkel F. In line monitoring of the preparation of water-in-oil-in-water (W/O/W) type multiple emulsions via dielectric spectroscopy. Int J Pharm 2013; 441:643-7. [DOI: 10.1016/j.ijpharm.2012.10.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 10/19/2012] [Accepted: 10/23/2012] [Indexed: 11/28/2022]
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