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

Abstract

<jats:sec><jats:title>Objective:</jats:title><jats:p> To review doses to patients undergoing cervical spine CT examinations in the UK. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> 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. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> 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 (CTDI<jats:sub>vol</jats:sub>) 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. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> The rounded third quartile value of the mean dose distributions from this study were a CT dose index (CTDI<jats:sub>vol</jats:sub>) 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. </jats:p></jats:sec><jats:sec><jats:title>Advances in knowledge:</jats:title><jats:p> Proposed new national diagnostic reference levels are presented for cervical spine CT examinations. </jats:p></jats:sec>

IPEM topical report: the first UK survey of dose indices from radiotherapy treatment planning computed tomography scans for adult patients

“…A Microsoft Excel TM (Washington, USA) data collection form was developed based on previous national dose audits for SPECT CT and PET CT (Iball et al 2017), and C-spine CT (Holroyd and Edyvean 2018). For each examination type the form required information on the CT scanner make, model and age.…”

Is It Possible to Replace Conventional Radiography (CR) with a Dose Neutral Computed Tomography (CT) of the Cervical Spine in Emergency Radiology—An Experimental Cadaver Study

“…Data published by Niiniviita et al in 2018 show that the mean radiation dose of CT of the cervical spine in adult and pediatric patients of a Finnish emergency department was at an astonishing high 18.3 mGy over a 2-year period according to dose-monitoring software [ 27 ]. Data from reviewing doses to patients undergoing cervical spine CT examinations in the UK published in 2018 indicate a rounded average dose of 20 mGy for c-spine CT [ 28 ]. The mean radiation dose of our standard protocol—a protocol identical to the routine protocol in the clinical setting for c-spine trauma imaging at our department—was 12.44 ± 4.56 mGy.…”

Feasibility analysis of high pitch cervical spine CT in uncooperative patients with acute cervical spine trauma: An initial experience

“…According to the survey conducted in the UK in 2018, [35] the average radiation dose was CTDIvol of 20 mGy/DLP of 440 mGy·cm (the third quartile, as shown below) when standard cervical CT (tube voltage 120 kV, automatic exposure control) was mostly adopted, and it was higher than the national diagnostic reference level in 2011 (correspondingly, CTDIvol of 15 mGy/DLP of 324 mGy·cm). In the present study, the radiation dose in both HP-CT and SD-CT groups was lower than that reported by J.R. Holroyd et al [35] The radiation dose in the SD-CT (correspondingly, CTDIvol of 16 mGy/DLP of 292 mGy·cm) was close to the national diagnostic reference level in 2011, while that in the HP-CT was lower when the same or sub-optimal images were obtained. In previous studies, the repeated scan caused by various reasons and the deviation of protocol settings in cervical CT may have resulted in a higher radiation dose.…”

“…[32] However, excessive radiological examinations on cervical spines would undoubtedly increase the risk of radiation exposure, thereby dramatically raising the patient's risk of thyroid cancer. [33,34] According to the survey conducted in the UK in 2018, [35] the average radiation dose was CTDIvol of 20 mGy/DLP of 440 mGy•cm (the third quartile, as shown below) when standard cervical CT (tube voltage 120 kV, automatic exposure control) was mostly adopted, and it was higher than the national diagnostic reference level in 2011 (correspondingly, CTDIvol of 15 mGy/ DLP of 324 mGy•cm). In the present study, the radiation dose in both HP-CT and SD-CT groups was lower than that reported by J.R. Holroyd et al [35] The radiation dose in the SD-CT (correspondingly, CTDIvol of 16 mGy/DLP of 292 mGy•cm) was close to the national diagnostic reference level in 2011, while that in the HP-CT was lower when the same or sub-optimal images were obtained.…”