Geschlechtsspezifische Bestimmung der effektiven Dosis am Beispiel von CT-Thoraxuntersuchungen

Boetticher, Heiner von; Lachmund, Jörn; Hoffmann, Wolfgang

doi:10.1078/0939-3889-00152

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…Although these endpoints are very much gender dependent, the weighing factors are given as an average for both genders (ICRP 1977). It is clear that in this case of thoracic exposure, female patients will incur a higher radiation dose due to the presence of more breast tissue (von Boetticher et al 2003). This averaging and the weighing factors' age-independence, among others, has lead to some criticism of the concept of effective dose (Martin 2007).…”

Section: Study Limitations and Future Perspectivesmentioning

confidence: 99%

Effective dose analysis of three-dimensional rotational angiography during catheter ablation procedures

Wielandts¹,

Smans²,

Ector³

et al. 2010

Phys. Med. Biol.

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There is increasing use of three-dimensional rotational angiography (3DRA) during cardiac ablation procedures. As compared with 2D angiography, a large series of images are acquired, creating the potential for high radiation doses. The aim of the present study was to quantify patient-specific effective doses. In this study, we developed a computer model to accurately calculate organ doses and the effective dose incurred during 3DRA image acquisition. The computer model simulates the exposure geometry and uses the actual exposure parameters, including the variation in tube voltage and current that is realized through the automatic exposure control (AEC). We performed 3DRA dose calculations in 42 patients referred for ablation on the Siemens Axiom Artis DynaCT system (Erlangen, Germany). Organ doses and effective dose were calculated separately for all projections in the course of the C-arm rotation. The influence of patient body mass index (BMI), dose-area product (DAP), collimation and dose per frame (DPF) rate setting on the calculated doses was also analysed. The effective dose was found to be 5.5 +/- 1.4 mSv according to ICRP 60 and 6.6 +/- 1.8 mSv according to ICRP 103. Effective dose showed an inversely proportional relationship to BMI, while DAP was nearly BMI independent. No simple conversion coefficient between DAP and effective dose could be derived. DPF reduction did not result in a proportional effective dose decrease. These paradoxical findings were explained by the settings of the AEC and the limitations of the x-ray tube. Collimation reduced the effective dose by more than 20%. Three-dimensional rotational angiography is associated with a definite but acceptable radiation dose that can be calculated for all patients separately. Their BMI is a predictor of the effective dose. The dose reduction achieved with collimation suggests that its use is imperative during the 3DRA procedure.

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Section: Study Limitations and Future Perspectivesmentioning

confidence: 99%

Effective dose analysis of three-dimensional rotational angiography during catheter ablation procedures

Wielandts¹,

Smans²,

Ector³

et al. 2010

Phys. Med. Biol.

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“…Therefore, anthropomorphic phantoms as we used are necessary to notice scattered radiation. The female phantoms received a slightly higher radiation dose compared to the male ones which is due to the breast tissue and its high conversion factor [10,15,16].…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Rotational Angiography in Congenital Heart Disease: Estimation of Radiation Exposure

Reinke¹,

Halbfass²,

Dittrich³

et al. 2013

OJRad

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Objectives: There is an increasing use of three-dimensional rotational angiography (3D-RA) during catheterization of congenital heart disease. Dose-area-product (DAP) measured by the angiography system and computed-tomography dose index (CTDI) do not appear practical for dose assessment. Hence, we performed real dose measurements in anthropomorphic phantoms. Methods: Three different anthropomorphic phantoms (10 kg, 19 kg and 73 kg bodyweight) equipped with thermoluminescent dosimeters (TLD) were used. We used a typical standard diagnostic program and a low-dose program. The effective dose (ED) was calculated according to the International Commission on Radiological Protection (ICRP) 103. The 3D distribution of radiation in the body was assessed. Results: ED for the male 10 kg phantom was 0.192 mSv in the diagnostic program and 0.050 mSv (male) in the low-dose program. The 19 kg phantom received an ED of 0.205 mSv (male) in the diagnostic program. In the low-dose program the ED reached 0.058 mSv (male). The male adult 73 kg phantom was exposed with an ED of 0.730 mSv in the diagnostic program and 0.282 mSv in the low-dose program. ED for the female phantoms was slightly higher for both acquisition-programs. Dose distribution was inhomogeneous with a dose maximum in the esophageal region behind the heart, whereas in the brain, intestine and gonads we found nearly no radiation. Conclusions: 3D-RA imaging in the interventional catheter laboratory is possible with an effective dose lower than 1 mSv. With its potential to reduce fluoroscopic time and the number of control angiographies in catheterization and intervention in complex anatomy, it can decrease the radiation dose.

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Three-dimensional cardiac rotational angiography: effective radiation dose and image quality implications

Wielandts¹,

Buck²,

Ector³

et al. 2009

Europace

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AimsThree-dimensional rotational angiography (3DRA) is a promising new online tool for 3D imaging during cardiac ablation procedures. No precise data exist concerning its associated radiation dose. The current study evaluated the effective dose (ED) of cardiac rotational angiography and its relation to patient properties, imaging system input settings, and quality of reconstructed 3D images. Methods and resultsWe performed Monte Carlo simulation-based radiation dose calculations in 42 patients referred for ablation of cardiac arrhythmias. Detailed tube setting information from the 3DRA system (Siemens Axiom Artis dBC with Syngo DynaCT Cardiac software) was used to provide an accurate input for dose calculations in all 248 frames used during image acquisition. Our calculations yielded an overall mean ED of 6.6 + 1.8 mSv (based on ICRP 103 weighing factors). Manual collimation of the radiation beam can reduce ED by more than 20%. Image quality did not significantly relate to patient body mass index (BMI), dose per frame setting, or dose-area product (DAP), but was rather explained by contrast filling, cardiac motion reduction, and absence of image reconstruction artefacts. In the system evaluated, DAP values are nearly independent from BMI (R 2 ¼ 0.30), due to its technical specifications.Therefore, patient BMI showed an unexpected strong inverse relation to ED. ConclusionThree-dimensional rotational angiography can be performed with acceptable patient radiation dose, comparable to cardiac CT. With the 3DRA system studied (Siemens Axiom), slender patients may currently receive unnecessarily high radiation doses when compared with obese patients, so that further dose reduction seems feasible for many patients. Adequate collimation is imperative to limit patient exposure.--

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Geschlechtsspezifische Bestimmung der effektiven Dosis am Beispiel von CT-Thoraxuntersuchungen

Cited by 3 publications

References 4 publications

Effective dose analysis of three-dimensional rotational angiography during catheter ablation procedures

Effective dose analysis of three-dimensional rotational angiography during catheter ablation procedures

Three-Dimensional Rotational Angiography in Congenital Heart Disease: Estimation of Radiation Exposure

Three-dimensional cardiac rotational angiography: effective radiation dose and image quality implications

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