scholarly journals Radiation Exposure in Patients with Isolated Limb Trauma: Acceptable or Are We Imaging Too Much?

2020 ◽  
Vol 9 (11) ◽  
pp. 3609
Author(s):  
James A. Wheeler ◽  
Natasha Weaver ◽  
Zsolt J. Balogh ◽  
Herwig Drobetz ◽  
Andrew Kovendy ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Effective Dose ◽  
Radiation Risk ◽  
Plain Film ◽  
Study Cohort ◽  
X Ray ◽  
Cumulative Effective Dose ◽  
Orthopaedic Patients ◽  
Extremity Trauma ◽  
The Mean

The aim of our study was to investigate the cumulative effective dose of radiation resulting from medical imaging in orthopaedic patients with isolated extremity trauma. Deidentified radiology records of consecutive patients without age restriction with isolated extremity trauma requiring operative treatment at a regional hospital were reviewed retrospectively over a 1-year period, and the effective dose per patient for each study type of plain film X-ray, computed tomography, and operative fluoroscopy was used to calculate cumulative effective dose. Values were summarised as mean, ± standard deviation, maximum, and proportion with overdose (>20 mSv). The study cohort included 428 patients (193 male and 235 female) with an average age of 44 years (±28). There were 447 procedures performed, i.e., all involved operative fluoroscopy, 116 involved computed tomography, and 397 involved X-ray. The mean cumulative effective dose per patient was 1.96 mSv (±4.98, 45.12). The mean cumulative effective dose for operative fluoroscopy was 0.32 mSv (±0.73, 5.91), for X-ray was 1.12 mSv (±3.6, 39.23) and for computed tomography was 2.22 mSv (±4.13, 20.14). The mean cumulative effective dose of 1.96 mSv falls below the recommended maximum annual exposure of 20 mSv. This study can serve as a guide for informing clinicians and patients of the acceptable radiation risk in the context of isolated extremity trauma.

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.

Using 100- instead of 120-kVp computed tomography to diagnose pulmonary embolism almost halves the radiation dose with preserved diagnostic quality

2010 ◽  
Vol 51 (3) ◽  
pp. 260-270 ◽  
Author(s):  
Peter Björkdahl ◽  
Ulf Nyman
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Image Quality ◽  
Radiation Dose ◽  
Effective Dose ◽  
Ct Number ◽  
Subjective Image Quality ◽  
Diagnostic Quality ◽  
X Ray ◽  
Tube Potential

Background: Concern has been raised regarding the mounting collective radiation doses from computed tomography (CT), increasing the risk of radiation-induced cancers in exposed populations. Purpose: To compare radiation dose and image quality in a chest phantom and in patients for the diagnosis of pulmonary embolism (PE) at 100 and 120 peak kilovoltage (kVp) using 16-multichannel detector computed tomography (MDCT). Material and Methods: A 20-ml syringe containing 12 mg I/ml was scanned in a chest phantom at 100/120 kVp and 25 milliampere seconds (mAs). Consecutive patients underwent 100 kVp ( n = 50) and 120 kVp ( n = 50) 16-MDCT using a “quality reference” effective mAs of 100, 300 mg I/kg, and a 12-s injection duration. Attenuation (CT number), image noise (1 standard deviation), and contrast-to-noise ratio (CNR; fresh clot = 70 HU) of the contrast medium syringe and pulmonary arteries were evaluated on 3-mm-thick slices. Subjective image quality was assessed. Computed tomography dose index (CTDIvol) and dose–length product (DLP) were presented by the CT software, and effective dose was estimated. Results: Mean values in the chest phantom and patients changed as follows when X-ray tube potential decreased from 120 to 100 kVp: attenuation +23% and +40%, noise +38% and +48%, CNR −6% and 0%, and CTDIvol −38% and −40%, respectively. Mean DLP and effective dose in the patients decreased by 42% and 45%, respectively. Subjective image quality was excellent or adequate in 49/48 patients at 100/120 kVp. No patient with a negative CT had any thromboembolism diagnosed during 3-month follow-up. Conclusion: By reducing X-ray tube potential from 120 to 100 kVp, while keeping all other scanning parameters unchanged, the radiation dose to the patient may be almost halved without deterioration of diagnostic quality, which may be of particular benefit in young individuals.

320-multidetector cardiac computed tomography in the evaluation of conotruncal anomalies

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Elnagar ◽  
U Ghieda ◽  
A Ibrahim ◽  
M Dawoud
Keyword(s):  
Computed Tomography ◽  
Effective Dose ◽  
Predictive Value ◽  
Cardiac Computed Tomography ◽  
Preoperative Evaluation ◽  
Mdct Angiography ◽  
Complex Anatomy ◽  
Conotruncal Anomalies ◽  
The Mean ◽  
Sensitivity Specificity

Abstract Background Multi-detector computed tomography (MDCT) has become an effective tool in the assessment of congenital heart disease in infants and children. Purpose To evaluate the role of 320-row MDCT in the assessment of conotruncal anomalies and compare it with echocardiography (echo) considering the operative and/or catheter findings as the gold standard. Methods The studied group included 50 patients having conotruncal anomalies. All patients were evaluated with 320-row MDCT angiography. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of MDCT and echo were calculated. The patient effective dose was reported. Results The overall sensitivity, specificity, accuracy, PPV and NPV for MDCT angiography in assessment of various abnormalities in patients with conotruncal anomalies were 98.97%, 100%, 99.75%, 100% and 99.67% for MDCT angiography. Sensitivity, specificity, PPV and NPV of MDCT angiography were 97.87%, 100%, 100% and 99.04% and 99.49%, 100%, 100% &99.86% for the detection of intracardiac defects and extracardiac vascular anomalies respectively. The mean absorbed radiation dose was 63.63 mGy-Cm per scan and the mean effective dose was 1.56±0.47 mSv. Conclusion 320-MDCT angiography offers an excellent diagnostic procedure in the preoperative evaluation of the complex anatomy of the conotruncal anomalies. Funding Acknowledgement Type of funding source: None

scholarly journals Cumulative Effective Dose from Medical Imaging in Inflammatory Bowel Disease

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2387
Author(s):  
Agata Łukawska ◽  
Dominika Ślósarz ◽  
Aneta Zimoch ◽  
Karol Serafin ◽  
Elżbieta Poniewierka ◽  
...  
Keyword(s):  
Medical Imaging ◽  
Effective Dose ◽  
Factors Associated ◽  
Cumulative Effective Dose ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
The Mean ◽  
High Doses ◽  
To Receive ◽  
Length Of Hospitalization

Inflammatory bowel diseases (IBD) are chronic and relapsing disorders usually requiring numerous medical imaging. IBD patients might be exposed to a large dose of radiation. As a cumulative effective dose (CED) ≥ 50 mSv is considered significant for stochastic risks of cancer, it is important to monitor the radiation exposure of IBD patients. In the present work, we aimed to quantify the mean CED in IBD patients and identify factors associated with exposure to high doses of diagnostic radiation. A retrospective chart view of patients with IBD hospitalized between 2015 and 2019 was performed. A total of 65 patients with Crohn’s disease (CD) and 98 patients with ulcerative colitis (UC) were selected. Of all imaging studies performed, 73% were with doses of ionizing radiation. Mean CED (SD) amounted to 19.20 (15.64) millisieverts (mSv) and 6.66 (12.39) mSv, respectively, in patients with CD and UC (p < 0.00001). Only 1.84% of the patients received CED ≥ 50 mSv. We identified three factors associated with CED in the IBD patients: number of surgical procedures, and number and length of hospitalization. CD patients with strictures or penetrating disease and UC patients with extensive colitis were more likely to receive higher radiation doses.

Intra-operative skull X-ray for misdirection of the cochlear implant array into the vestibular labyrinth

2015 ◽  
Vol 129 (9) ◽  
pp. 923-927 ◽  
Author(s):  
A M Hassan ◽  
R Patel ◽  
M Redleaf
Keyword(s):  
Computed Tomography ◽  
Cochlear Implant ◽  
Case Series ◽  
Electrode Array ◽  
Plain Film ◽  
Neural Response ◽  
Reliable Indicator ◽  
X Ray ◽  
Vestibular Labyrinth ◽  
Neural Response Telemetry

AbstractObjectives:This paper reports five cases of aberrant cochlear implant electrode array insertion into the vestibular labyrinth. A review of the literature was conducted in order to clarify reasonable preventive and detection strategies and endorse the routine use of intra-operative plain skull X-ray.Methods:The study entailed a clinical case series and literature review. The setting was a tertiary academic referral centre. The following data were evaluated: pre-operative temporal bone computed tomography, operative reports, intra-operative imaging, neural response telemetry/imaging and post-operative imaging.Results:There were no consistent pre-operative risk factors found on computed tomography scans and no reliable intra-operative signs of electrode array misdirection. All misdirections in our case series, and those in the literature, were easily detectable on intra-operative plain film X-ray.Conclusion:These reported cases demonstrate implant misdirection without the surgeon's awareness. Aberrant insertion cannot be anticipated, and neural response telemetry/imaging is not a reliable indicator of misdirection. Routine intra-operative anteroposterior plain X-ray of the head is a reliable indicator of misdirection, and is fast and relatively inexpensive.

scholarly journals Assessment of radiation dose to pediatric patients during routine digital chest X-ray procedure in a government medical centre in Asaba, Nigeria

2021 ◽  
Vol 8 (3) ◽  
pp. 155-160
Author(s):  
Asogwa Chijioke Obiora ◽  
Hyacienth Uche Chiegwu ◽  
Akintayo Daniel Omojola ◽  
Ebube Mmeli Onwughalu
Keyword(s):  
Radiation Dose ◽  
Effective Dose ◽  
Pediatric Patients ◽  
Age Groups ◽  
Absorbed Dose ◽  
Field Size ◽  
X Ray ◽  
Chest X Ray ◽  
The Mean ◽  
Risk Of Cancer

Objective: Radiation dose to pediatric patients have been widely reported, it is however necessary that imaging expert keep doses as low as possible to forestall stall long term cancer risk. This study is aimed at determining pediatric entrance surface dose (ESD), 75th percentile ESD, absorbed dose (D) and effective dose (E) for 0-15 years. Material and Methods: The study used a digital radiography (DR) unit with a grid system for each chest X-ray. The thermoluminescent dosimeter (TLD) used was encapsulated in transparent nylon, it was then attached to the patient skin (chest wall) and the second was placed directly at the posterior end of it. Results: The mean ESDs for the 4 age groups were as follows: 0- < 1 (1.54±0.74mGy), 1- < 5 (1.53±0.83mGy), 5- < 10 (0.55±0.39mGy) and 10- ≤15 (1.30±0.57mGy), with an overall mean of 1.23mGy. The 75th percentile ESD for each age group above 10 patients (excluding 5- < 10yrs) was 2.18, 2.19 and 1.75mGy respectively. The absorbed dose (D) ranged from 0.03-2.39mGy. The mean effective dose (E) for the 4 age groups was 0.18±0.03mSv. There was a good correlation between ESD and D (P = 0.001). A One-Way ANOVA shows that the field size and focus to film distance (FFD) affected the ESD and D (P < 0.001) respectively. The risk of childhood cancer from a single radiograph was of the order of (1.54-23.4) ×10-6. Conclusion: The 75th percentile ESD, E and childhood risk of cancer was higher than most studies it was compared with. The study reveals that machine parameters such as the field size and FFD played a major role in dose increase. Protocol optimization is currently needed for pediatric patients in the studied facility.

scholarly journals Hybrid (2D/3D) Dosimetry of Radiolabeled Gold Nanoparticles for Sentinel Lymph Node Detection in Patients with Breast Cancer

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Gerardo Ramírez-Nava ◽  
Clara Santos-Cuevas ◽  
Guillermina Ferro-Flores ◽  
Blanca Ocampo-García ◽  
Isaac Chairez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Gold Nanoparticles ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Effective Dose ◽  
Residence Time ◽  
Sentinel Lymph Node Detection ◽  
3D Dosimetry ◽  
The Mean

Previously, we reported the preparation and preclinical studies of 99mTc-labeled gold nanoparticles-mannose (99mTc-AuNP-mannose) with potential for sentinel lymph node (SLN) detection by using nuclear medicine procedures. This study aimed to evaluate the biokinetics and hybrid (2D/3D) dosimetry of 99mTc-AuNP-mannose in five patients with breast cancer under a sentinel lymph node detection protocol. Anterior and posterior whole-body planar images (2D, at 0.5, 2, 6, and 24 h) and single-photon emission computed tomography (3D at 6.5 h)/computed tomography (SPECT/CT) images were acquired after 99mTc-AuNP-mannose administration (37 MBq). Through a hybrid quantification method, activity in tissues of interest at the different acquisition times was determined and integrated over time to obtain the total nuclear transformations (N), as well as the mean residence time, in each tissue. N values and the OLINDA code were used for estimating the internal radiation absorbed doses. Results demonstrated that 99mTc-AuNP-mannose successfully accumulates and remains up to 24 h in the sentinel lymph node without detectable migration to other lymph nodes and no side effects on patients. Negligible absorption of the radiolabeled nanoparticles into the circulatory system was observed, from which the radio-nanosystem is rapidly eliminated by kidneys. Hybrid (2D/3D) dosimetry evaluations showed equivalent doses to SLN, breast, and kidneys of 172.34, 5.32, and 0.08 mSv/37 MBq, respectively, with an effective dose of 2.05E − 03 mSv/MBq. The mean effective residence time in SLN was 0.92 h. This preliminary study indicates that the use of 99mTc-AuNP-mannose for successful SLN detection in patients is safe, producing an effective dose at the level recommended for diagnostic studies (<10 mSv).

Optimization of computed tomography urography protocol, 1997 to 2008: Effects on radiation dose

2009 ◽  
Vol 50 (4) ◽  
pp. 446-454 ◽  
Author(s):  
P. Dahlman ◽  
L. Jangland ◽  
M. Segelsjö ◽  
A. Magnusson
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Effective Dose ◽  
Excretory Urography ◽  
Ct Urography ◽  
Tube Current Modulation ◽  
Current Modulation ◽  
Tube Current ◽  
The Mean ◽  
The Impact

Background: Since computed tomography (CT) urography began to replace excretory urography as the primary imaging technique in uroradiology, the collective radiation dose to the patients has increased. Purpose: To examine the changes in the CT urography protocol for investigating suspected urinary tract malignancy between the years 1997 and 2008, and how these changes have influenced the mean effective dose. Material and Methods: The study was based on 102 patients (mean age 66.1±14.8 years, range 31–89 years; 30 female, 72 male) divided into five groups (groups A–E) corresponding to the time points at which changes were made to the CT urography protocol. The mean effective doses were estimated using the ImPACT CT Patient Dosimetry Calculator. Results: The number of scan phases at CT urography was reduced from four to three in 1999, resulting in a reduction of the mean effective dose from 29.9/22.5 (female [F]/male [M]) mSv (group A) to 26.1/18.9 (F/M) mSv (group B). In 2001, mAs settings were adapted to patient size, and the mean effective dose was reduced to 16.8/12.0 (F/M) mSv (group C). In 2005, scans were performed with a multidetector-row CT equipped with automatic tube current modulation in the x- and y-axis (CARE Dose). The effective mAs was also lowered in the unenhanced and excretory phase, yet the mean effective dose increased to 18.2/13.1 (F/M) mSv (group D), since the effective mAs had to be increased in the corticomedullary phase to maintain image quality. In 2008, as tube current modulation in the x-, y-, and z-axis was introduced (CARE Dose4D), the mean effective dose was reduced to 11.7/8.8 (F/M) mSv (group E). Conclusion: This study shows that the individual mean effective dose to patients undergoing CT urography has decreased by 60%, from 29.9/22.5 (F/M) mSv in 1997 to 11.7/8.8 (F/M) mSv in 2008.

scholarly journals Entrance Skin Dose (Radiation) Measurement and Evaluation (for all age groups) at the State Specialist Hospital, Okitipupa, Nigeria

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Abiola Olawale Ilori ◽  
Gilbert Ibitola ◽  
Olanrewaju Ajanaku ◽  
Reuben Dapo Utomewore
Keyword(s):  
Health Workers ◽  
Radiation Risk ◽  
Age Groups ◽  
The State ◽  
Skin Dose ◽  
Radiation Measurement ◽  
X Ray ◽  
Entrance Skin Dose ◽  
The Mean ◽  
Measurement And Evaluation

This study was carried out on entrance skin dose (ESD) (Radiation) measurement and evaluation (for all age groups) at the State Specialist Hospital, Okitipupa, Ondo State, Nigeria. Entrance skin doses for randomly selected patients between 0-4 years, 5-9 years, 10-17 years and above 18 years old undergoing X-ray chest (Poster Anterior) examinations were measured and evaluation of the source-to-skin distance (SSD) records for the patients during the x-ray chest examinations were carried out. The mean ESD reported for chest PA projections were 66.43 µGy, 105.10 µGy, 215.76 µGy and 291.81 µGy respectively for age range 0 - 4 years, 5 - 9 years, 10 - 17 years and above 18 years. The ESD values reported in this present study were same with the NRPB recommendations of year 2000 of 50 µGy for newborn to 1-year-old, 70 µGy for 5 years and 120 µGy for 10 years old children. The values reported for age 1 to 4 years were lower than 0.1 mGy recommended and the mean ESD for age 5 to 9 years for chest PA examination was 0.11 mGy which is lower than the recommended 0.12 mGy. However, other values reported in this present study were compared with the guidance levels set by the International regulation bodies and were found to be within safe limits and they do not pose any significant health risk to the patients of all age ranges or the health workers. The effective radiation doses (ERDs) for all the age groups were computed, and by comparisons, it was found that the radiation risk factors (RRFs) are relatively low.

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