scholarly journals Four-Year Cumulative Radiation Exposure in Patients Undergoing Computed Tomography Angiography for Suspected Pulmonary Embolism

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Edwin A. Takahashi ◽  
Hyo-Chun Yoon
Keyword(s):  
Pulmonary Embolism ◽  
Radiation Dose ◽  
Radiation Exposure ◽  
Ct Scans ◽  
Suspected Pulmonary Embolism ◽  
Effective Radiation Dose ◽  
Medical Radiation ◽  
Medical Radiation Exposure ◽  
Effective Radiation ◽  
Acute Pe

Purpose.The objective of this study was to determine the estimated effective radiation dose of pulmonary CT angiography (CTA) for suspected pulmonary embolism (PE) contributing to total medical radiation exposure over a 4-year period.Materials and Methods.This investigation retrospectively reviewed 300 patients who presented to the emergency department and received a pulmonary CTA scan for suspected PE. We evaluated these patients' electronic medical record to determine their estimated radiation exposure to CT scans during the following four years. Using DLP toEconversion coefficients, we calculated the cumulative effective radiation dose each subject received.Results.A total of 900 CT scans were reviewed in this study. Pulmonary CTA delivered an average effective radiation dose of 10.7 ± 2.5 mSv and accounted for approximately 65% of subjects' 4-year cumulative medical radiation dose. Only 6.3% of subjects had a positive acute PE according to their radiology report.Conclusion.Pulmonary CTA accounted for the majority of subjects’ medically related effective radiation dose over a 4-year period. With only a minority of subjects having positive findings for acute PE, increased efforts should be made to clinically assess pretest probability before the consideration of imaging.

scholarly journals Comparison of Dual- and Single-Source Dual-Energy CT for Diagnosis of Acute Pulmonary Artery Embolism

2020 ◽  
Author(s):  
Bernhard Petritsch ◽  
Pauline Pannenbecker ◽  
Andreas Max Weng ◽  
Simon Veldhoen ◽  
Jan-Peter Grunz ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Image Quality ◽  
Radiation Dose ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Suspected Pulmonary Embolism ◽  
Effective Radiation Dose ◽  
Distribution Maps ◽  
Filter Group ◽  
Effective Radiation

Purpose Comparison of dual-source dual-energy CT (DS-DECT) and split-filter dual-energy CT (SF-DECT) regarding image quality and radiation dose in patients with suspected pulmonary embolism. Materials and Methods We retrospectively analyzed pulmonary dual-energy CT angiography (CTPA) scans performed on two different CT scanners in 135 patients with suspected pulmonary embolism (PE). Scan parameters for DS-DECT were 90/Sn150 kV (n = 68 patients), and Au/Sn120 kV for SF-DECT (n = 67 patients). The iodine delivery rate was 1400 mg/s in the DS-DECT group vs. 1750 mg/s in the SF-DECT group. Color-coded iodine distribution maps were generated for both protocols. Objective (CT attenuation of pulmonary trunk [HU], signal-to-noise ratio [SNR], contrast-to-noise ratio [CNR]) and subjective image quality parameters (two readers [R], five-point Likert scale), as well as radiation dose parameters (effective radiation dose, size-specific dose estimations [SSDE]) were compared. Results All CTPA scans in both groups were of diagnostic image quality. Subjective CTPA image quality was rated as good or excellent in 80.9 %/82.4 % (R1 / R2) of DS-DECT scans, and in 77.6 %/76.1 % of SF-DECT scans. For both readers, the image quality of split-filter iodine distribution maps was significantly lower (p < 0.05) with good or excellent ratings in only 43.3 %/46.3 % (R1 / R2) vs. 83.8 %/88.2 % for maps from DS-DECT. The HU values of the pulmonary trunk did not differ between the two techniques (p = n. s.), while both the SNR and CNR were significantly higher in the split-filter group (p < 0.001; p = 0.003). Both effective radiation dose (2.70 ± 1.32 mSv vs. 2.89 ± 0.94 mSv) and SSDE (4.71 ± 1.63 mGy vs. 5.84 ± 1.11 mGy) were significantly higher in the split-filter group (p < 0.05). Conclusion The split-filter allows for dual-energy imaging of suspected pulmonary embolism but is associated with lower iodine distribution map quality and higher radiation dose. Key points:  Citation Format

Burden of Medical Radiation Exposure in Children with Sickle Cell Disease.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1525-1525 ◽  
Author(s):  
Courtney L. Wendel ◽  
Jon A. Anderson ◽  
Timothy J. Blackburn ◽  
Charles T. Quinn
Keyword(s):  
Nuclear Medicine ◽  
Sickle Cell Disease ◽  
Radiation Exposure ◽  
Sickle Cell ◽  
Ct Scans ◽  
Radiographic Study ◽  
Cell Disease ◽  
Medical Radiation ◽  
Medical Radiation Exposure

Abstract Abstract 1525 Poster Board I-548 BACKGROUND Children with sickle cell disease (SCD) present to medical attention repeatedly throughout childhood for medical complications. Chest radiographs are often obtained for fever and respiratory symptoms, and plain radiographs are often ordered because of bone pain. Computed tomography (CT) and nuclear medicine (NM) studies may also be obtained for other complications. Exposure to medical radiation may increase the risk of cancer, especially in children. Growing children are inherently radiosensitive because of their high proportion of dividing cells, and children have more remaining years of life than adults during which cancer can develop. Therefore, it is important to determine the magnitude of medical radiation exposure in children with SCD because they could be so frequently exposed. METHODS We reviewed the medical records for all members of the Dallas Newborn Cohort (Blood 2004;103:4023-7) to determine the number and type of radiographic studies each individual received from 1996 to the present. We recorded the type of radiographic study, body location, clinical indication, date of study, age at the time of study, and the number and types of views when applicable. We also recorded slice thickness and mode for CT scans as well as injection activity, radionuclide, and type of radiopharmaceutical for nuclear medicine studies. To account for different lengths of follow-up, we standardized the number of radiographic studies to yearly rates for each individual to determine the projected number of studies a SCD patient would receive by 18 years of age. RESULTS We studied 938 patients (52.8% male) with a mean follow-up of 9.4 years (median 9.2, range 0.1 – 20.6). 571 had sickle cell anemia (SS), 283 had sickle-hemoglobin C disease (SC), 63 had Sβ+-thalassemia (Sβ+), and 21 had Sβ0-thalassemia (Sβ0). We identified 9,246 radiographic studies, including 8,697 radiographs, 441 CT scans, and 108 NM studies. 711 (76%) patients had at least one radiographic study. Patients with SS or Sβ0 were more likely to have had at least one radiographic study than those with SC or Sβ+ (77% vs. 65%; P<0.0001). The mean number of studies per patient was 9.9 [95% confidence interval (C.I.) 8.9 – 10.9; range 0 – 115], corresponding to a mean rate of 1.5 per year (95% C.I. 1.3 – 1.6; range 0 – 27.3). We project that a patient with SCD will be exposed to the radiation from 26.7 (95% C.I. 24.1 – 29.3; range 0 – 492.1) radiographic studies by 18 years of age. Approximately 5% of patients with SCD will be exposed to 100 or more radiographic studies during childhood. CONCLUSIONS Children with SCD are frequently exposed to medical radiation. Some are exposed to over 100 radiographic studies. Radiographs of the painful part are frequently obtained but are infrequently indicated. Because growing children are more radiosensitive than adults and have more remaining years of life, medical radiation exposure could be clinically significant. We are now calculating the radiation effective doses for this cohort to quantify the risk of malignancy. It is prudent to limit the medical radiation exposure of this high-risk population. Disclosures No relevant conflicts of interest to declare.

Management of personnel of fire and rescue garrisons taking into account radiation exposure

2021 ◽  
Vol 92 ◽  
pp. 94-105
Author(s):  
A. G. Zavorotnyy ◽  
Keyword(s):  
Mathematical Model ◽  
Radiation Dose ◽  
Radiation Exposure ◽  
The State ◽  
Reference Points ◽  
Effective Radiation Dose ◽  
Risk Of Death ◽  
Radiation Accidents ◽  
Stochastic Effect ◽  
Effective Radiation

Introduction. At present, despite the efforts made by the state, the state of radiation protection does not reach the level at which there is no unacceptable risk of harm to the life or health of people, the environment, the property of individuals and legal entities, state and municipal property on the territory of the Russian Federation in the event of implementation of radiation treats. The readiness of management bodies, forces and means of fire and rescue garrisons to eliminate the consequences of radiation accidents is a very urgent problem. Goals and objectives. The aim of the work is to improve the management of the personnel of fire and rescue garrisons, taking into account the radiation exposure in preparation for liquidation and during the elimination of radiation accidents. Tasks include the creation and justification of a model that allows you to convert the exit risks of the deterministic effects into the risks of stochastic effects. Methods. To create a model for the management of fire and rescue garrisons’ personnel, taking into account the radiation exposure, we used the literature experimental data and used the probabilistic-statistical method and the method of least squares. Results and discussion. The calculated model of management of the fire and rescue garrisons’ personnel, taking into account radiation exposure in preparation for liquidation and in the course of liquidation of radiation accidents, is developed. The probabilistic mathematical model allows us to estimate the exit of stochastic and deterministic effects depending on the effective radiation dose. The excellent convergence of the predicted (calculated) value EAR1 = 0,000607 and the statistical value EAR0 = 0,000724 is due to the fact that the reference points LD10 = 2 Gy , LD50/60 = 4 Gy , LD90 = 6 Gy are based on repeatedly verified statistical data on radiation accidents and deaths of more than 1000 people in radiation accidents [1]. This indicates that the mathematical model adequately reflects the exit of stochastic and deterministic effects observed during the operation of nuclear facilities both in normal mode and in radiation accidents. Conclusions. The probability of exit of stochastic and deterministic effects depending on the radiation dose received by the personnel of fire and rescue garrisons is presented. The threshold of the stochastic effect for humans is in the vicinity of the equivalent dose of 10 mSv for radiation with low linear energy transfer. At the same time, the probability of a stochastic effect is 3 · 10-6 on average after 15 years. This model of radiation exposure management for the personnel of fire and rescue garrisons could be a good tool for the emergency response manager (fire extinguishing manager) during preparation for the elimination and during the elimination of radiation accidents. Keywords: management, personnel, fire and rescue garrison, radiation exposure, effective radiation dose, risk of death

Low-dose and standard-dose unenhanced helical computed tomography for the assessment of acute renal colic: prospective comparative study

2005 ◽  
Vol 46 (7) ◽  
pp. 756-763 ◽  
Author(s):  
Bong Soo Kim ◽  
Im Kyung Hwang ◽  
Yo Won Choi ◽  
Sook Namkung ◽  
Heung Cheol Kim ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Low Dose ◽  
Standard Dose ◽  
Helical Ct ◽  
Ct Scans ◽  
Ureteral Stones ◽  
Effective Radiation Dose ◽  
Low Dose Ct ◽  
Ureter Stones ◽  
Effective Radiation

Purpose: To compare the efficacy of low-dose and standard-dose computed tomography (CT) for the diagnosis of ureteral stones. Material and Methods: Unenhanced helical CT was performed with both a standard dose (260 mAs, pitch 1.5) and a low dose (50 mAs, pitch 1.5) in 121 patients suspected of having acute renal colic. The two studies were prospectively and independently interpreted for the presence and location of ureteral stones, abnormalities unrelated to stone disease, identification of secondary signs, i.e. hydronephrosis and perinephric stranding, and tissue rim sign. The standard-dose CT images were interpreted by one reviewer and the low-dose CT images independently by two reviewers unaware of the standard-dose CT findings. The findings of the standard and low-dose CT scans were compared with the exact McNemar test. Interobserver agreements were assessed with kappa analysis. The effective radiation doses resulting from two different protocols were calculated by means of commercially available software to which the Monte-Carlo phantom model was given. Results: The sensitivity, specificity, and accuracy of standard-dose CT for detecting ureteral stones were 99%, 93%, and 98%, respectively, whereas for the two reviewers the sensitivity of low-dose CT was 93% and 95%, specificity 86%, and accuracy 92% and 94%. We found no significant differences between standard-dose and low-dose CT in the sensitivity and specificity for diagnosing ureter stones ( P>0.05 for both). However, the sensitivity of low-dose CT for detection of 19 stones less than or equal to 2 mm in diameter was 79% and 68%, respectively, for the two reviewers. Low-dose CT was comparable to standard-dose CT in visualizing hydronephrosis and the tissue rim sign. Perinephric stranding was far less clear on low-dose CT. Low-dose CT had the same diagnostic performance as standard-dose CT in diagnosing alternative diseases. Interobserver agreement between the two low-dose CT reviewers in the diagnosis of ureter stones and alternative diseases, the identification of secondary signs, and tissue rim sign were high, with kappa values ranging from 0.769 to 0.968. On standard-dose CT scans, the calculated mean effective radiation dose was 7.30 mSv for males and 10.00 mSv for females. On low-dose CT scans, the calculated mean effective radiation dose was 1.40 mSv for males and 1.97 mSv for females. Conclusion: Compared with standard scans using 260 mAs, low-dose unenhanced helical CT using a reduced tube current of 50 mAs results in a concomitant decrease in the radiation dose of 81%. Although low-dose CT was limited in its ability to depict small-sized calculi less than or equal to 2 mm, it is still comparable to standard-dose CT for the diagnosis of ureter stones and alternative disease.

Reproductive Effects of Low-to-Moderate Medical Radiation Exposure

2012 ◽  
Vol 19 (36) ◽  
pp. 6171-6177 ◽  
Author(s):  
G. Latini ◽  
L. Dipaola ◽  
A. Mantovani ◽  
E. Picano
Keyword(s):  
Radiation Exposure ◽  
Reproductive Effects ◽  
Medical Radiation ◽  
Medical Radiation Exposure

Effective Radiation Dose in a Skeletal Survey Performed for Suspected Child Abuse

2016 ◽  
Vol 171 ◽  
pp. 310-312 ◽  
Author(s):  
Rachel P. Berger ◽  
Ashok Panigrahy ◽  
Shawn Gottschalk ◽  
Michael Sheetz
Keyword(s):  
Child Abuse ◽  
Radiation Dose ◽  
Skeletal Survey ◽  
Effective Radiation Dose ◽  
Effective Radiation

scholarly journals Simulated Radiation Dose Reduction in Whole-Body CT on a 3rd Generation Dual-Source Scanner: An Intraindividual Comparison

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 118
Author(s):  
Andreas S. Brendlin ◽  
Moritz T. Winkelmann ◽  
Phuong Linh Do ◽  
Vincent Schwarze ◽  
Felix Peisen ◽  
...  
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Dose Reduction ◽  
Whole Body ◽  
Reference Standard ◽  
Diagnostic Confidence ◽  
Effective Radiation Dose ◽  
Intraindividual Comparison ◽  
Dual Source ◽  
Effective Radiation

To evaluate the effect of radiation dose reduction on image quality and diagnostic confidence in contrast-enhanced whole-body computed tomography (WBCT) staging. We randomly selected March 2016 for retrospective inclusion of 18 consecutive patients (14 female, 60 ± 15 years) with clinically indicated WBCT staging on the same 3rd generation dual-source CT. Using low-dose simulations, we created data sets with 100, 80, 60, 40, and 20% of the original radiation dose. Each set was reconstructed using filtered back projection (FBP) and Advanced Modeled Iterative Reconstruction (ADMIRE®, Siemens Healthineers, Forchheim, Germany) strength 1–5, resulting in 540 datasets total. ADMIRE 2 was the reference standard for intraindividual comparison. The effective radiation dose was calculated using commercially available software. For comparison of objective image quality, noise assessments of subcutaneous adipose tissue regions were performed automatically using the software. Three radiologists blinded to the study evaluated image quality and diagnostic confidence independently on an equidistant 5-point Likert scale (1 = poor to 5 = excellent). At 100%, the effective radiation dose in our population was 13.3 ± 9.1 mSv. At 20% radiation dose, it was possible to obtain comparably low noise levels when using ADMIRE 5 (p = 1.000, r = 0.29). We identified ADMIRE 3 at 40% radiation dose (5.3 ± 3.6 mSv) as the lowest achievable radiation dose with image quality and diagnostic confidence equal to our reference standard (p = 1.000, r > 0.4). The inter-rater agreement for this result was almost perfect (ICC ≥ 0.958, 95% CI 0.909–0.983). On a 3rd generation scanner, it is feasible to maintain good subjective image quality, diagnostic confidence, and image noise in single-energy WBCT staging at dose levels as low as 40% of the original dose (5.3 ± 3.6 mSv), when using ADMIRE 3.

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