Establishment of institutional diagnostic reference level for computed tomography with automated dose-tracking software

Liang, Chong Ri; Chen, Priscilla X. H.; Kapur, Jeevesh; Ong, Michael; Quek, Swee Tian; Kapur, Subhash C

doi:10.1002/jmrs.210

Cited by 25 publications

(9 citation statements)

References 11 publications

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“…There are considerable DRLs and benchmarks available internationally for our comparison. (Table 2) [8,9,12,20,[22][23][24][25][26][27][28][29][30]. Our institutional median values, also known as, our FRL are considerably lower than all other countries and well below our NDRL.…”

Section: Discussionmentioning

confidence: 86%

Establishment of facility reference level in computed tomography in selective examinations in a single institution in South Australia: A preliminary study

Chau¹

2019

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to 26 June 2017. Examinations were separated as contrast and non-contrast studies, and single phasic for single acquisition or multiphasic for more than one acquisition. The common CT examinations, including chest, chest abdomen/pelvis, and abdomen/pelvis were reported. Examinations such as CT colonoscopy, CT pulmonary angiogram, CT gating angiography, CT chest and abdomen/pelvis non-contrast, CT high resolution lung and CT renal colic were excluded from the study. This is mostly due to a low number of examinations and the use of different exposure factors and/or techniques. The median mean (50 th percentile), and 75 th percentile for the dose spread were calculated according to the examination. Results: There was a total of 1571 CT examinations performed between 26 December 2016 and 26 June 2017 using the Toshiba scanner in our institution. 262 examinations met the inclusion and exclusion criteria. The examinations and our institutional DRLs for our Toshiba scanner (established as median value of CTDIvol and DLP), were distributed as CT chest contrast (n=67, 25.6%, 6mGy, 219.1mGy.cm), CT chest non-contrast (n=41, 15.6%, 5.7mGy, 190.6 mGy), CT abdomen/pelvis contrast (single phase) (n=49, 18.7%, 6.5 mGy, 330.5 mGy.cm), CT abdomen/pelvis contrast (multi-phase) (n=33, 12.6%, 8.93 mGy, 1037.5 mGy.cm), CT abdomen/pelvis non-contrast (n=12, 4.6%, 10.1 mGy, 289.9 mGy.cm) and CT chest and abdomen/pelvis (n=60, 22.9%, 7.15 mGy, 619.4mGy.cm). Conclusions: The preliminary data provided information that our own institution and others can use for quality improvement activities. Future research is required to allow for further analysis to include more CT examinations in various scanners.

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Section: Discussionmentioning

confidence: 86%

Establishment of facility reference level in computed tomography in selective examinations in a single institution in South Australia: A preliminary study

Chau¹

2019

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“…Most developed nations has adopted regular audit to ensure optimization of ionizing radiations in the CT examinations, but on the contrary, it has infrequently been performed in developing countries like Nigeria. 11 This may have significant negative impact on the radiation doses received by patients undergoing CT investigations especially with the increasing numbers of CT scanners in our country. Hence, this study was designed to carry out an audit of CT examinations at two selected diagnostic centers in South-South region of Nigeria.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of novel PCR-CTPP for simultaneous detection of Mycobacterium tuberculosis complex and identification of RpoB H526D point mutation

Intorasoot¹,

Butr-Indr²,

Phunpae³

et al. 2023

JAMS

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Background: Despite the fact that the number of CT exams is small among all radiography investigations, a high amount of medical radiation exposure comes from CT application. Most developed nations have adopted regular audits to ensure optimization of ionizing radiations in the CT examinations, but on the contrary, it has infrequently been performed in developing countries like Nigeria. Objectives: This study was designed to carry out an audit of CT examinations at two selected diagnostic centers in the South-South region of Nigeria. Materials and methods: This study was a retrospective cross-sectional study conducted in two radiological facilities, which involved 210 tomographs of the chest, head, and abdomen, selected using a convenient method. The CT examinations were done using the departmental protocols and the generated data were analyzed statistically using descriptive statistics. Results: Head examination was the most commonly performed CT examination (56.7%), followed by abdominal 28.6 % and the least 14.8% was chest. The most common indication was a road traffic accident (RTA) 11.4%. The distribution of the type of CT machine that was used for the study showed that the Toshiba machine was used for most of the subjects 132 (62.9%) followed by Optima CT660 78 (37.1%). It was seen that 48.6% of the study used 0.75s, 40.5% used 0.5s, 10.5% used 0.35s and only 0.5% used 1s scan time. The effective doses were adult head (2.31±0.14), chest (4.65±0.21), abdominal (7.70±0.17), pediatric head (2.81±0.21), and pediatric chest (9.96±0.12). Conclusion: The carrying out of clinical audits is imperative to ensure both safeties of patients and diagnostic accuracy.

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“…Standard spiral CT acquisition with 5mm cuts was used without contrast media where possible in most patients based on our institution's CT chest protocol. 5 Patients undergoing surgery for aortic dissection repairs were excluded as all these patients had complete CT of the whole aorta. The study was approved by the National University Health System ethics review board (2018/00147).…”

Section: Methodsmentioning

confidence: 99%

Routine Preoperative Screening Computed Tomography of the Thorax for Cardiac Surgery

Sule

et al. 2021

Preprint

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Purpose: This study aims to evaluate the role of screening computed tomography (CT) thorax in cardiac surgery by analysing presence of CT aortic calcifications in association with change of operative strategy and postoperative stroke, as well as CT features of emphysema with development of pneumonia.Methods: All patients who underwent cardiac surgery from January 2013 to October 2017 by a single surgeon were retrospectively studied. Patients who underwent screening CT thorax prior to cardiac surgery (CT group) were compared with those who did not (no CT group). Multivariate subgroup analyses were performed to determine significant association with postoperative outcomes.Results: 392 patients were included, of which 156 patients underwent preoperative screening CT thorax. Patients in the CT group were older (63.9 vs 59.0 years, p=0.001), had fewer recent myocardial infarction preoperatively (41 vs 56.4%, p=0.003) and better ejection fraction >30% (p=0.02). Operative strategy was changed in 4.3% of patients, and 4.9% suffered stroke postoperatively. Presence of CT aortic calcifications was significantly associated with change in operative strategy (OR 1.54, p=0.016) but not associated with postoperative stroke (OR 0.53, p=0.33). Age was an independent risk factor for change in operative strategy among patients with CT thorax (p=0.02). Multivariate age-adjusted analysis showed only palpable plaque to be significantly associated with change in operative strategy (p<0.001). None of the patients with CT emphysema features developed pneumonia.Conclusion: The results do not support routine use of preoperative screening CT thorax. It should only be recommended in older patients.

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Establishment of institutional diagnostic reference level for computed tomography with automated dose-tracking software

Cited by 25 publications

References 11 publications

Establishment of facility reference level in computed tomography in selective examinations in a single institution in South Australia: A preliminary study

Establishment of facility reference level in computed tomography in selective examinations in a single institution in South Australia: A preliminary study

Evaluation of novel PCR-CTPP for simultaneous detection of Mycobacterium tuberculosis complex and identification of RpoB H526D point mutation

Routine Preoperative Screening Computed Tomography of the Thorax for Cardiac Surgery

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