scholarly journals Universal Sinus Computed Tomography Protocol for Diagnostic Imaging and Intraoperative Navigation

2015 ◽  
Vol 6 (3) ◽  
pp. ar.2015.6.0134 ◽  
Author(s):  
Joseph M. Hoxworth ◽  
Devyani Lal
Keyword(s):  
Computed Tomography ◽  
Diagnostic Imaging ◽  
Radiation Exposure ◽  
Intraoperative Navigation ◽  
Sinus Surgery ◽  
Successful Implementation ◽  
Potential Cost ◽  
Imaging Protocol ◽  
Imaging Guidance ◽  
Ct Protocol

Background Sinus computed tomography (CT) is performed for the diagnosis of paranasal sinus disease and to assess response to medical therapy. In addition, sinus CT is used for intraoperative imaging guidance. Multiple CTs increase cost and radiation exposure. Objective To determine potential cost savings and radiation dose reduction that result from the use of a single universal sinus CT protocol for diagnostic imaging and intraoperative navigation. Materials and Methods For sinus CT at the authors' institution, a single imaging protocol was begun and deemed acceptable by neuroradiologists and surgeons for diagnostic imaging and intraoperative guidance. The electronic medical record was queried over a 4-year period to determine the number of sinus CTs performed, dose-length products, referring providers' specialties, percentage of CTs used for intraoperative navigation, and the elapsed time between CT and surgery. Results A total of 6187 sinus CTs were performed by using a 64-detector scanner during the study period (2759 women and 3428 men; 53.6 ± 16.7 years [mean ± SD]), and 596 endoscopic sinus surgery cases used imaging guidance, for which all the CTs were deemed technically adequate. The mean dose-length product for the CTs was 338.4 ± 31.9 mGy-cm (mean ± SD). Of the 3702 sinus CTs ordered by nonotolaryngology providers, 167 surgeries with intraoperative navigation (4.5%) were performed. A higher percentage of CT referrals from sinus surgeons (23.9%) and other otolaryngology providers (11.4%) was used for imaging guidance (p < 0.0001). The time interval between sinus CT and surgery was greatest for nonotolaryngology providers (63.1 days, p < 0.01). Based on Medicare reimbursement, the total estimated saving was $147,628. Conclusions Adopting a single universal sinus CT protocol for diagnostic imaging and intraoperative navigation can be an effective means of decreasing cost and radiation exposure. However, successful implementation must take into account multiple practice-based considerations.

Can a CT be Omitted in Pediatric Minor Head Trauma?

2017 ◽  
Vol 16 (01) ◽  
pp. 001-007
Author(s):  
Maria Sinzig ◽  
Eveline Achatz ◽  
Günter Fasching ◽  
Christoph Arneitz
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Head Trauma ◽  
Neurological Status ◽  
Ct Scans ◽  
Minor Head Trauma ◽  
Pediatric Ct ◽  
Ct Protocol ◽  
In Infants And Children

AbstractThis study aimed to evaluate the need for radiation exposure in pediatric minor head trauma. Symptomatic patients after minor head trauma were observed for at least 24 hours in a 13-month period. A computed tomography (CT) scan was performed on children with a depressed neurological status. Two hundred fourteen patients with a mean age of 9.3 years were included. An intracranial hemorrhage (ICH) was diagnosed in three (1.4%) patients. The overall CT rate was 10.7%. The study concluded that neuro-observation without initial CT scans is safe in infants and children following minor head trauma. Special pediatric CT protocol can limit radiation exposure.

Assessment of imaging protocol and patient radiation exposure in pediatric computed tomography angiography

2020 ◽  
Vol 172 ◽  
pp. 108807
Author(s):  
Ali Aamry ◽  
Mohammed Alsufayan ◽  
Hassan Aldossari ◽  
Batil Alonazi ◽  
Abdelmoneim Sulieman
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Computed Tomography Angiography ◽  
Imaging Protocol ◽  
Patient Radiation Exposure

Multimodality Imaging Guidance in Interventional Pain Management

2016 ◽  
Keyword(s):  
Computed Tomography ◽  
Pain Management ◽  
Soft Tissue ◽  
Radiation Exposure ◽  
Multimodality Imaging ◽  
Standard Of Care ◽  
Ultrasound Guided ◽  
Ct Guided ◽  
Imaging Guidance ◽  
Interventional Pain Management

Multimodality Imaging Guidance for Interventional Pain Management is a comprehensive resource covering fluoroscopy-guided procedures, ultrasound interventions, and computed tomography (CT)-guided procedures used in interventional pain management. Fluoroscopy-guided procedures have been the standard of care for many years and are widely available and affordable. Due to the lack of radiation exposure and the ability to see various soft tissue structures, ultrasound-guided interventions are more precise and safer. The benefits, disadvantages, and basic techniques of CT-guided procedures, primarily performed by radiologists, are also included in the volume. By covering all imaging modalities, Multimodality Imaging Guidance for Interventional Pain Management allows for an efficient comparison of the capabilities of each modality.

Sinus Computed Tomography Imaging in Pediatric Cystic Fibrosis

2016 ◽  
Vol 155 (1) ◽  
pp. 160-165 ◽  
Author(s):  
Ozgul Gergin ◽  
Kosuke Kawai ◽  
Robert D. MacDougall ◽  
Caroline D. Robson ◽  
Ethan Moritz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cystic Fibrosis ◽  
Radiation Exposure ◽  
Preoperative Evaluation ◽  
Tertiary Care ◽  
Case Series ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Study Objective ◽  
Significant Difference

Study Objective To evaluate the prevalence of computed tomography (CT) sinus imaging in a pediatric cystic fibrosis (CF) population, determine changes in Lund Mackay (LM) scores over time, and estimate radiation exposure. Study Design Case series with chart review. Setting Tertiary care children’s hospital. Subjects and Methods In total, 202 pediatric patients with CF who underwent endoscopic sinus surgery (ESS) were included. The total number of CT scans was calculated for each patient, with specific focus on the indications for and subsequent outcomes of the sinus CT scan subgroup. Results Patients underwent a total of 1718 CT scans, 832 of which were sinus CT scans (mean of 4.2 sinus scans per patient). Disease evaluation (54%) and preoperative planning (35%) were the most common indications. Otolaryngologists were more likely to order imaging for preoperative evaluation, and those scans were more likely to result in surgery compared with those requested by other physicians ( P < .001). Ninety CT scans (10.8%) led to no change in management. There was no significant difference in LM scores between patients admitted to the hospital or prescribed antibiotics and those who were not. There was also no significant change in LM score following ESS after adjusting for age and sex ( P = .23). Conclusion Based on LM scores, all sinus CT scans in patients with CF reveal moderate to severe sinus disease. Effort should be made to minimize radiation exposure in patients with CF by limiting sinus CT scans to the preoperative context or for evaluation of potential sinusitis complications.

scholarly journals Direct measurement of radiation exposure dose to individual organs during diagnostic computed tomography examination

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazuta Yamashita ◽  
Kosaku Higashino ◽  
Hiroaki Hayashi ◽  
Kazuki Takegami ◽  
Fumio Hayashi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Ct Scanning ◽  
Exposure Dose ◽  
Whole Body ◽  
Organ Doses ◽  
Abdomen Ct ◽  
Clinical Methods ◽  
Ct Protocol ◽  
Tube Current

AbstractIonizing radiation from Computed tomography (CT) examinations and the associated health risks are growing concerns. The purpose of this study was to directly measure individual organ doses during routine clinical CT scanning protocols and to evaluate how these measurements vary with scanning conditions. Optically stimulated luminescence (OSL) dosimeters were surgically implanted into individual organs of fresh non-embalmed whole-body cadavers. Whole-body, head, chest, and abdomen CT scans were taken of 6 cadavers by simulating common clinical methods. The dosimeters were extracted and the radiation exposure doses for each organ were calculated. Average values were used for analysis. Measured individual organ doses for whole-body routine CT protocol were less than 20 mGy for all organs. The measured doses of surface/shallow organs were higher than those of deep organs under the same irradiation conditions. At the same tube voltage and tube current, all internal organ doses were significantly higher for whole-body scans compared with abdominal scans. This study could provide valuable information on individual organ doses and their trends under various scanning conditions. These data could be referenced and used when considering CT examination in daily clinical situations.

Imaging dose of megavoltage computed tomography (MVCT) for treatment verification in the tomotherapy of breast cancer

2017 ◽  
Vol 17 (2) ◽  
pp. 244-252
Author(s):  
K. W. Cheung ◽  
K. K. Sang ◽  
H. I. Lam ◽  
W. M. Chan ◽  
P. M. Wu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Absorbed Dose ◽  
Left Breast ◽  
Acquisition Time ◽  
Organ Doses ◽  
Imaging Protocol ◽  
Normal Tissues ◽  
Significant Difference ◽  
Megavoltage Computed Tomography

AbstractAimThe purpose of this study was to investigate whether significant difference exists on radiation dose delivered to organs at risks in megavoltage computed tomography (MVCT) verification using three predefined scanning modes, namely fine (2 mm), normal (4 mm) and coarse (6 mm). This will provide information for the imaging protocol of tomotherapy for the left breast.Materials and methodsOrgan doses were measured using thermoluminescent dosimeters (TLD-100) placed within a female Rando phantom for MVCT imaging. Kruskal–Wallis test was conducted with p<0·05 to evaluate the significant difference between the three MVCT scanning modes.ResultsStatistically significant difference existed in organ absorbed dose between different scan mode selections (p<0·001). Relative to the normal scan selection (4 mm), the absorbed dose to the organs of interests can be scaled down by 0·7 and scaled up by 2·1 for coarse (6 mm) and fine scans (2 mm) respectively.ConclusionsOptimisation of imaging protocols is of paramount importance to keep the radiation exposure ‘as low as reasonably achievable’. The recommendation of undergoing daily coarse mode for MVCT verification in breast tomotherapy not only mitigates the radiation exposure to normal tissues, but also trims the scan-acquisition time.

scholarly journals Radiation exposure of computed tomography imaging for the assessment of acute stroke

2020 ◽  
Author(s):  
Sebastian Zensen ◽  
Nika Guberina ◽  
Marcel Opitz ◽  
Martin Köhrmann ◽  
Cornelius Deuschl ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Stroke ◽  
Radiation Exposure ◽  
Ct Perfusion ◽  
Dose Length Product ◽  
Ct Dose ◽  
Dose Monitoring ◽  
Ct Protocol ◽  
Ct Dose Index ◽  
Contrast Ct

Abstract Purpose To assess suspected acute stroke, the computed tomography (CT) protocol contains a non-contrast CT (NCCT), a CT angiography (CTA), and a CT perfusion (CTP). Due to assumably high radiation doses of the complete protocol, the aim of this study is to examine radiation exposure and to establish diagnostic reference levels (DRLs). Methods In this retrospective study, dose data of 921 patients with initial CT imaging for suspected acute stroke and dose monitoring with a DICOM header–based tracking and monitoring software were analyzed. Between June 2017 and January 2020, 1655 CT scans were included, which were performed on three different modern multi-slice CT scanners, including 921 NCCT, 465 CTA, and 269 CTP scans. Radiation exposure was reported for CT dose index (CTDIvol) and dose-length product (DLP). DRLs were set at the 75th percentile of dose distribution. Results DRLs were assessed for each step (CTDIvol/DLP): NCCT 33.9 mGy/527.8 mGy cm and CTA 13.7 mGy/478.3 mGy cm. Radiation exposure of CTP was invariable and depended on CT device and its protocol settings with CTDIvol 124.9–258.2 mGy and DLP 1852.6–3044.3 mGy cm. Conclusion Performing complementary CT techniques such as CTA and CTP for the assessment of acute stroke increases total radiation exposure. Hence, the revised DRLs for the complete protocol are required, where our local DRLs may help as benchmarks.

Stellenwert der Navigation

2017 ◽  
Vol 01 (04) ◽  
pp. 317-334
Author(s):  
Jan-Sven Jarvers ◽  
Ulrich Spiegl ◽  
Stefan Glasmacher ◽  
Christoph Heyde ◽  
Christoph Josten
Keyword(s):  
Patient Safety ◽  
Radiation Exposure ◽  
Pedicle Screw ◽  
Spinal Surgery ◽  
Intraoperative Imaging ◽  
Intraoperative Navigation ◽  
Advantages And Disadvantages ◽  
Tumor Diseases ◽  
Intraoperative Control ◽  
Improved Technology

Abstract Importance of Navigation Navigation and intraoperative imaging have undergone an enormous development in recent years. By using intraoperative navigation, the precision of pedicle screw implantation can be increased in the sense of patient safety. Especially in the case of complex defects or tumor diseases, navigation is a decisive aid. As a result of the constantly improved technology, the requirements for reduced radiation exposure and intraoperative control can also be met. The high costs of the devices can be amortized, for example by a reduced number of revisions. This overview presents the principles of navigation in spinal surgery and the advantages and disadvantages of the different navigation procedures.

Requesting physicians’ knowledge of X-radiation exposure from computed tomography scan examinations: A case study of two Nigerian tertiary hospitals

2020 ◽  
Vol 3 ◽  
pp. 36-39
Author(s):  
Samson O. Paulinus ◽  
Benjamin E. Udoh ◽  
Bassey E. Archibong ◽  
Akpama E. Egong ◽  
Akwa E. Erim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ionizing Radiation ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Work Experience ◽  
Radiation Risk ◽  
Radiological Protection ◽  
X Ray ◽  
Tertiary Hospitals ◽  
Medical Exposure

Objective: Physicians who often request for computed tomography (CT) scan examinations are expected to have sound knowledge of radiation exposure (risks) to patients in line with the basic radiation protection principles according to the International Commission on Radiological Protection (ICRP), the Protection of Persons Undergoing Medical Exposure or Treatment (POPUMET), and the Ionizing Radiation (Medical Exposure) Regulations (IR(ME)R). The aim is to assess the level of requesting physicians’ knowledge of ionizing radiation from CT scan examinations in two Nigerian tertiary hospitals. Materials and Methods: An 18-item-based questionnaire was distributed to 141 practicing medical doctors, excluding radiologists with work experience from 0 to >16 years in two major teaching hospitals in Nigeria with a return rate of 69%, using a voluntary sampling technique. Results: The results showed that 25% of the respondents identified CT thorax, abdomen, and pelvis examination as having the highest radiation risk, while 22% said that it was a conventional chest X-ray. Furthermore, 14% concluded that CT head had the highest risk while 9% gave their answer to be conventional abdominal X-ray. In addition, 17% inferred that magnetic resonance imaging had the highest radiation risk while 11% had no idea. Furthermore, 25.5% of the respondents have had training on ionizing radiation from CT scan examinations while 74.5% had no training. Majority (90%) of the respondents were not aware of the ICRP guidelines for requesting investigations with very little (<3%) or no knowledge (0%) on the POPUMET and the IR(ME)R respectively. Conclusion: There is low level of knowledge of ionizing radiation from CT scan examinations among requesting physicians in the study locations.

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