scholarly journals Association of Radiation Doses and Cancer Risks from CT Pulmonary Angiography Examinations in Relation to Body Diameter

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 681
Author(s):  
Hanif Haspi Harun ◽  
Muhammad Khalis Abdul Karim ◽  
Zulkifly Abbas ◽  
Mohd Amir Abdul Rahman ◽  
Akmal Sabarudin ◽  
...  
Keyword(s):  
Pulmonary Angiography ◽  
Mean Value ◽  
The Body ◽  
Effective Diameter ◽  
Ct Pulmonary Angiography ◽  
Ct Dose ◽  
Body Diameter ◽  
Ct Dose Index ◽  
Probability Of Cancer ◽  
Risk Of Cancer

In this study, we aimed to estimate the probability of cancer risk induced by CT pulmonary angiography (CTPA) examinations concerning effective body diameter. One hundred patients who underwent CTPA examinations were recruited as subjects from a single institution in Kuala Lumpur. Subjects were categorized based on their effective diameter size, where 19–25, 25–28, and >28 cm categorized as Groups 1, 2, and 3, respectively. The mean value of the body diameter of the subjects was 26.82 ± 3.12 cm, with no significant differences found between male and female subjects. The risk of cancer in breast, lung, and liver organs was 0.009%, 0.007%, and 0.005% respectively. The volume-weighted CT dose index (CTDIvol) was underestimated, whereas the size-specific dose estimates (SSDEs) provided a more accurate description of the radiation dose and the risk of cancer. CTPA examinations are considered safe but it is essential to implement a protocol optimized following the As Low as Reasonably Achievable (ALARA) principle.

scholarly journals Can Patient’s Body Weight Represent Body Diameter for Pediatric Size-Specific Dose Estimate in Thoracic and Abdominal Computed Tomography?

2019 ◽  
Vol 9 ◽  
pp. 24 ◽  
Author(s):  
Supika Kritsaneepaiboon ◽  
Suwadee Eng-chuan ◽  
Saowapark Yoykaew
Keyword(s):  
Computed Tomography ◽  
Body Weight ◽  
Statistical Significance ◽  
Correlation Coefficients ◽  
Effective Diameter ◽  
Dose Estimate ◽  
Ct Dose ◽  
Body Diameter ◽  
Ct Dose Index ◽  
Dose Index

Objective: The objective of the study was to determine whether body weight (BW) can be substituted for body diameters to calculate size-specific dose estimate (SSDE) in the children. Materials and Methods: A total of 196 torso computed tomography (CT) studies were retrospectively reviewed. Anteroposterior diameter (DAP) and lateral diameter (Dlat) were measured, and DAP+Dlat, effective diameter, SSDE diameter and SSDEBW were calculated. Correlation coefficients among body diameters, all SSDE types and percentage changes between CT dose index volumes and SSDEs were analyzed by BW and age subgroups. Results: Overall BW was more strongly correlated with body diameter (r = 0.919–0.960, P < 0.001) than was overall age (r = 0.852–0.898, P < 0.001). The relationship between CT dose index volume and each of the SSDE types (r = 0.934–0.953, P < 0.001), between SSDEBW and all SSDE diameters (r = 0.934–0.953, P < 0.001), and among SSDE diameters (r = 0.950–0.989, P < 0.001) overall had strong correlations with statistical significance. The lowest magnitude difference was SSDEBW−SSDEeff. Conclusion: BW can be used instead of body diameter to calculate all SSDE types, with our suggested best accuracy for SSDEeff and the least variation in age < four years and BW < 20 kg. Key Messages: Size-specific dose estimate (SSDE) is a new and accurate dose-estimating parameter for the individual patient which is based on the actual size or body diameter of the patient. BW can be an important alternative for all body diameters to estimate size-specific dose or calculate SSDE in children.

scholarly journals Doses from cervical spine computed tomography (CT) examinations in the UK

2018 ◽  
Vol 91 (1085) ◽  
pp. 20170834 ◽  
Author(s):  
John R Holroyd ◽  
Sue Edyvean
Keyword(s):  
Cervical Spine ◽  
Mean Value ◽  
Patient Dose ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Ct Dose ◽  
Spine Ct ◽  
Ct Dose Index ◽  
The Uk ◽  
Dose Index

Objective: To review doses to patients undergoing cervical spine CT examinations in the UK. Methods: A data collection form was developed and distributed to medical physicists and radiographers via e-mail distribution lists. The form requested details of CT scanners, exposure protocols and patient dose index information. Results: Data were received for 73 scanners. It was seen that 97% of scanners used automatic exposure control, and 60% of scanners used an iterative reconstruction technique for cervical spine examinations. The majority of scans were taken at 120 kV. The average patient dose indicators in terms of CT dose index (CTDIvol) ranged from 3.5 to 39.7 mGy (mean value 16.7 mGy), and for the DLP, ranged from 87 to 1030 mGy cm (mean value 379 mGy cm) as quoted for the standard 32 cm phantom. Conclusion: The rounded third quartile value of the mean dose distributions from this study were a CT dose index (CTDIvol) of 20 mGy and a dose–length product of 440 mGy cm as quoted for a 32 cm body phantom. These are significantly higher than those in the 2011 Public Health England CT dose survey when adjusted for phantom size. It is suggested that the existing national diagnostic reference levels for cervical spine CT should be amended, both with the new values and also to quote according to the 32 cm phantom. Advances in knowledge: Proposed new national diagnostic reference levels are presented for cervical spine CT examinations.

Reduced Kilovoltage in Computed Tomography–Guided Intervention in a Community Hospital: Effect on the Radiation Dose

2014 ◽  
Vol 65 (4) ◽  
pp. 345-351 ◽  
Author(s):  
Saman Rezazadeh ◽  
Steven J. Co ◽  
Simon Bicknell
Keyword(s):  
Low Dose ◽  
Effective Diameter ◽  
Tube Voltage ◽  
Dose Length Product ◽  
Ct Guided ◽  
Ct Dose ◽  
Patient Size ◽  
Ct Dose Index ◽  
Volume Ct ◽  
Dose Index

Purpose The purpose of this study was to determine whether low-kilovoltage (80 or 100 kV) computed tomography (CT)-guided interventions performed in a community-based hospital are feasible and to compare radiation exposure incurred with conventional 120 kV potential. Materials and Methods Effective doses (ED) received by patients who underwent CT-guided intervention were analysed before and after a low-dose kilovoltage protocol was instituted in our department. We performed CT-guided procedures of 93 consecutive patients by using conventional 120-kV tube voltage (50 patients) and a low voltage of 80 or 100 kV for the remainder of this cohort. Automatic tube current modulation was enabled to obtain the best image quality. Procedure details were prospectively recorded and included examination site and type, slice width, tube voltage and current, dose length product, volume CT dose index, and size-specific dose estimate. Dose length product was converted to ED to account for radiosensitivity of specific organs. Statistical comparisons with test differences in the ED, volume CT dose index, size-specific dose estimate, and effective diameter (patient size) were made by using the Student t test. Results All but 6 of the procedures performed at 80 kV were successful, for a success rate of 86%. At lower voltages, the ED was significantly ( P < .01) reduced, on average, by 57%, 73%, and 65% for the pelvic, chest, and abdomen procedures, respectively. Conclusion A low-dose radiation technique by using 80 or 100 kV results in a high technical success rate for pelvic, chest, and abdomen CT-guided interventional procedures, although dramatically decreasing radiation exposure. There was no significant difference in effective diameter (patient size) between the conventional and the low-dose groups, which would suggest that dose reduction was indeed a result of kVp change and not patient size.

A Systematic Review of Double Low-dose CT Pulmonary Angiography in Pulmonary Embolism

2019 ◽  
Vol 15 (5) ◽  
pp. 453-460 ◽  
Author(s):  
Sultan Aldosari ◽  
Zhonghua Sun
Keyword(s):  
Systematic Review ◽  
Pulmonary Embolism ◽  
Image Quality ◽  
Radiation Dose ◽  
Contrast Medium ◽  
Low Dose ◽  
Pulmonary Angiography ◽  
Ct Pulmonary Angiography ◽  
Low Contrast ◽  
Low Contrast Medium

Background: The aim of this study is to perform a systematic review of the feasibility and clinical application of double low-dose CT pulmonary angiography (CTPA) in the diagnosis of patients with suspected pulmonary embolism. Discussion: A total of 13 studies were found to meet selection criteria reporting both low radiation dose (70 or 80 kVp versus 100 or 120 kVp) and low contrast medium dose CTPA protocols. Lowdose CTPA resulted in radiation dose reduction from 29.6% to 87.5% in 12 studies (range: 0.4 to 23.5 mSv), while in one study, radiation dose was increased in the dual-energy CT group when compared to the standard 120 kVp group. CTPA with use of low contrast medium volume (range: 20 to 75 ml) was compared to standard CTPA (range: 50 to 101 ml) in 12 studies with reduction between 25 and 67%, while in the remaining study, low iodine concentration was used with 23% dose reduction achieved. Quantitative assessment of image quality (in terms of signal-to-noise ratio and contrast-to-noise ratio) showed that low-dose CTPA was associated with higher, lower and no change in image quality in 3, 3 and 6 studies, respectively when compared to the standard CTPA protocol. The subjective assessment indicated similar image quality in 11 studies between low-dose and standard CTPA groups, and improved image quality in 1 study with low-dose CTPA. Conclusion: This review shows that double low-dose CTPA is feasible in the diagnosis of pulmonary embolism with significant reductions in both radiation and contrast medium doses, without compromising diagnostic image quality.

scholarly journals Whole Body Low Dose Computed Tomography Using Third-Generation Dual-Source Multidetector With Spectral Shaping: Protocol Optimization and Literature Review

Dose-Response ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 155932582097313
Author(s):  
Dario Baldi ◽  
Liberatore Tramontano ◽  
Vincenzo Alfano ◽  
Bruna Punzo ◽  
Carlo Cavaliere ◽  
...  
Keyword(s):  
Effective Dose ◽  
Low Dose ◽  
Whole Body ◽  
Dose Length Product ◽  
Osteolytic Lesions ◽  
Subjective Image Quality ◽  
Ct Dose ◽  
Dual Source ◽  
Ct Dose Index ◽  
Low Dose Computed Tomography

For decades, the main imaging tool for multiple myeloma (MM) patient’s management has been the conventional skeleton survey. In 2014 international myeloma working group defined the advantages of the whole-body low dose computed tomography (WBLDCT) as a gold standard, among imaging modalities, for bone disease assessment and subsequently implemented this technique in the MM diagnostic workflow. The aim of this study is to investigate, in a group of 30 patients with a new diagnosis of MM, the radiation dose (CT dose index, dose-length product, effective dose), the subjective image quality score and osseous/extra-osseous findings rate with a modified WBLDCT protocol. Spectral shaping and third-generation dual-source multidetector CT scanner was used for the assessment of osteolytic lesions due to MM, and the dose exposure was compared with the literature findings reported until 2020. Mean radiation dose parameters were reported as follows: CT dose index 0.3 ± 0.1 mGy, Dose-Length Product 52.0 ± 22.5 mGy*cm, effective dose 0.44 ± 0.19 mSv. Subjective image quality was good/excellent in all subjects. 11/30 patients showed osteolytic lesions, with a percentage of extra-osseous findings detected in 9/30 patients. Our data confirmed the advantages of WBLDCT in the diagnosis of patients with MM, reporting an effective dose for our protocol as the lowest among previous literature findings.

scholarly journals COVID-19-induced vascular angiopathy: CTPA signs in critically ill patients other than acute pulmonary embolism and high-lung opacity scores

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Mohamed Hossameldin khalifa ◽  
Ahmed Samir ◽  
Ayman Ibrahim Baess ◽  
Sara Samy Hendawi
Keyword(s):  
Artificial Intelligence ◽  
Pulmonary Embolism ◽  
Lung Volume ◽  
Acute Pulmonary Embolism ◽  
Pulmonary Angiography ◽  
Vascular Tree ◽  
Ct Pulmonary Angiography ◽  
Artificial Intelligence System ◽  
Intelligence System ◽  
Severity Scores

Abstract Background Vascular angiopathy is suggested to be the major cause of silent hypoxia among COVID-19 patients without severe parenchymal involvement. However, pulmonologists and clinicians in intensive care units become confused when they encounter acute respiratory deterioration with neither severe parenchymal lung involvement nor acute pulmonary embolism. Other radiological vascular signs might solve this confusion. This study investigated other indirect vascular angiopathy signs on CT pulmonary angiography (CTPA) and involved a novel statistical analysis that was performed to determine the significance of associations between these signs and the CT opacity score of the pathological lung volume, which is calculated by an artificial intelligence system. Results The study was conducted retrospectively, during September and October 2020, on 73 patients with critical COVID-19 who were admitted to the ICU with progressive dyspnea and low O2 saturation on room air (PaO2 < 93%). They included 53 males and 20 females (73%:27%), and their age ranged from 18 to 88 years (mean ± SD=53.3 ± 13.5). CT-pulmonary angiography was performed for all patients, and an artificial intelligence system was utilized to quantitatively assess the diseased lung volume. The radiological data were analyzed by three expert consultant radiologists to reach consensus. A low CT opacity score (≤10) was found in 18 patients (24.7%), while a high CT opacity score (>10) was found in 55 patients (75.3%). Pulmonary embolism was found in 24 patients (32.9%); three of them had low CT opacity scores. Four other indirect vasculopathy CTPA signs were identified: (1) pulmonary vascular enlargement (57 patients—78.1%), (2) pulmonary hypertension (14 patients—19.2%), (3) vascular tree-in-bud pattern (10 patients—13.7%), and (4) pulmonary infarction (three patients—4.1%). There were no significant associations between these signs and the CT opacity score (0.3205–0.7551, all >0.05). Furthermore, both pulmonary vascular enlargement and the vascular tree-in-bud sign were found in patients without pulmonary embolism and low CT-severity scores (13/15–86.7% and 2/15–13.3%, respectively). Conclusion Pulmonary vascular enlargement or, less commonly, vascular tree-in-bud pattern are both indirect vascular angiopathy signs on CTPA that can explain the respiratory deterioration which complicates COVID-19 in the absence of severe parenchymal involvement or acute pulmonary embolism.

scholarly journals CT pulmonary angiography in COVID-19 pneumonia: relationship between pulmonary embolism and disease severity

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Aya Yassin ◽  
Maryam Ali Abdelkader ◽  
Rehab M. Mohammed ◽  
Ahmed M. Osman
Keyword(s):  
Pulmonary Embolism ◽  
Disease Severity ◽  
Laboratory Data ◽  
Pulmonary Angiography ◽  
Significant Relation ◽  
Ct Pulmonary Angiography ◽  
Laboratory Results ◽  
Severity Of The Disease ◽  
The Relationship ◽  
D Dimer

Abstract Background Pulmonary embolism (PE) is one of the known sequels of COVID-19 infection. We aimed to assess the incidence of PE in patients with COVID-19 infection and to evaluate the relationship between the CT severity of the disease and the laboratory indicators. This was a retrospective study conducted on 96 patients with COVID-19 infection proved by positive PCR who underwent CT pulmonary angiography (CTPA) with a calculation of the CT severity of COVID-19 infection. Available patients’ complaint and laboratory data at the time of CTPA were correlated with PE presence and disease severity. Results Forty patients (41.7%) showed positive PE with the median time for the incidence of PE which was 12 days after onset of the disease. No significant correlation was found between the incidence of PE and the patients’ age, sex, laboratory results, and the CT severity of COVID-19. A statistically significant relation was found between the incidence of PE and the patients’ desaturation, hemoptysis, and chest pain. A highly significant correlation was found between the incidence of PE and the rising in the D-dimer level as well as the progressive CT findings when compared to the previous one. Conclusion CT progression and the rising in D-dimer level are considered the most important parameters suggesting underlying PE in patients with positive COVID-19 infection which is commonly seen during the second week of infection and alert the use of CT pulmonary angiography to exclude or confirm PE. This is may help in improving the management of COVID-19 infection.

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