Aim: The aim of this study was to compare objective image quality data for patient pulmonary embolism between a conventional pulmonary CTA protocol with respect to a novel acquisition protocol performed with optimize radiation dose and less amount of iodinated contrast medium injected to the patients during PE scanning. Materials and Methods: Sixty- four patients with Pulmonary Embolism (PE) possibility, were examined using angio-CT protocol. Patients were randomly assigned to two groups: A (16 women and 16 men, with age ranging from 19-89 years) mean age, 62 years with standard deviation 16; range, 19-89 years) - injected contrast agent: 35-40 ml. B (16 women and 16 men, with age ranging from 28-86 years) - injected contrast agent: 70-80 ml. Other scanning parameters were kept constant. Pulmonary vessel enhancement and image noise were quantified; signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Subjective vessel contrast was assessed by two radiologists in consensus. Result: A total of 14 cases of PE (22 %) were found in the evaluated of subjects (nine in group A, and five in group B). All PE cases were detected by the two readers. There was no significant difference in the size or location of the PEs between the two groups, the average image noise was 14 HU for group A and 19 HU for group B. The difference was not statistically significant (p = 0.09). Overall, the SNR and CNR were slightly higher on group B (24.4 and 22.5 respectively) compared with group A (19.4 and 16.4 respectively), but those differences were not statistically significant (p = 0.71 and p = 0.35, respectively). Conclusion and Discussion: Both groups that had been evaluated by pulmonary CTA protocol allow similar image quality to be achieved as compared with each other’s, with optimize care dose for both protocol and contrast volume were reduced by 50 % in new protocol comparing to the conventional protocol.
IntroductionMultidetector computed tomography is the reference standard for the diagnosis of peripheral arterial disease (PAD). The aim of this study is to optimise the image quality of computed tomography (CT) scanning for the diagnosis of PAD with the lowest possible radiation and contrast volume.Material and methodsSeventy-two patients were referred for evaluation of suspected PAD with CT angiography. Patients were randomly assigned to an optimise care dose of kVp – group A, n = 36; 18 men, 18 women; mean age, 63 years with standard deviation 15; range, 20-88 years (contrast volume 80-85 ml was injected automatically with bolus tracking, and group B, n = 36; 18 men, 18 women; mean age, 61 years with standard deviation 16; range, 26-88 years (contrast volume 120-140 ml was injected automatically with bolus tracking). Other scanning parameters were kept constant. Lower extremities vessel enhancement and image noise were quantified, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Subjective vessel contrast was assessed by two radiologists in consensus.ResultA total of 16 cases of PAD (22.2%) were found in the evaluated of subjects (10 in group A, and six in group B). All PAD cases were detected by the two readers. There was no significant difference in the size or location of the PAD between the two groups; the average image noise was 19 HU for group A and 16 HU for group B. The difference was not statistically significant (p = 0.183). Overall, the SNR and CNR were slightly higher in group B (25.5 and 24.1, respectively) compared with group A (20 and 17.4, respectively), but those differences were not statistically significant (p = 061 and p = 0.38, respectively).ConclusionsAll patients were evaluated by lower extremities CTA protocol allowing similar image quality to be achieved in both groups, with optimised care dose for both protocols, and contrast volume was reduced by 40% in the new protocol group compared to the conventional protocol group.
Reduction of the patient’s received radiation dose to as low as reasonably achievable (ALARA) is based on recommendations of radiation protection organizations such as the International Commission on Radiological Protection (ICRP) and the National Radiological Protection Board (NRPB). The aim of this study was to explore the frequency and characteristics of rejected / repeated radiographic films in governmental and private centers in Jenin city. The radiological centers were chosen based on their high volume of radiographic studies. The evaluation was carried out over a period of four months. The collected data were compiled at the end of each week and entered into a computer for analysis at the end of study. Overall 5000 films (images) were performed in four months, The average repeat rate of radiographic images was 10% (500 films). Repetition rate was the same for both thoracic and abdominal images (42%). The main reason for repeating imaging was inadequate imaging quality (58.2%) and poor film processing (38%). Human error was the most likely reason necessitating the repetition of the radiographs (48 %). Infant and children groups comprised 85% of the patient population that required repetition of the radiographic studies. In conclusion, we have a higher repetition rate of imaging studies compared to the international standards (10% vs. 4-6%, respectively). This is especially noticeable in infants and children, and mainly attributed to human error in obtaining and processing images. This is an important issue that needs to be addressed on a national level due to the ill effects associated with excessive exposure to radiation especially in children, and to reduce cost of the care delivered.
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