Notifications and alerts in patient dose values for computed tomography and fluoroscopy-guided interventional procedures

Vañó, Eliseo; Loose, R.; Frija, G.; Paulo, Graciano; Efstathopoulos, Efstathios; Granata, Claudio; Corridori, Riccardo; Torresin, A.; Andersson, Jonas; Tsapaki, Virginia; Ammon, Josefin; Hoeschen, Christoph

doi:10.1007/s00330-022-08675-w

Cited by 7 publications

(3 citation statements)

References 19 publications

(25 reference statements)

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“…In this study, the effective radiation dose for patients using 80kV/Sn140kV was reduced by 63% compared with the 120kV group, resulting in a lower radiation dose. In addition, the alert value recommended by the American Association of Medical Physicists for trunk CT scan was 50 CTDI vol (mGy) [26], and the CTDI vol values in all groups in this study were significantly lower than the recommended level, the B, C, and D groups showing even lower values compared to group A, This offers a safer CTPA examination mode for patients.…”

Section: Comparison Of Radiation Doses Under Different Tube Voltagesmentioning

confidence: 51%

Assessment of Pulmonary Arterial Vessels With Newer Ct Examination Protocols With the Aim of Achieving a Ct-x-ray Dose and Cm-dosage Reduction

Sun,

Jin,

Luo

et al. 2024

Preprint

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We compared the effect of varying iodine contrast medium (CM) dosage on image quality and radiation dose in low-tube voltage dual source computed tomography (DSCT) pulmonary artery imaging was compared by sinogram affirmed iterative reconstruction (SAFIRE) combined with non linear blending (NLB), and optimization of pulmonary artery imaging protocol. A total of 166 patients were divided into groups A, B, C, and D based on the amount of CM used and tube voltage. The voltage of group A tube was 120kV, and CM dosage was 50ml, filtered back projection combined with linear blending post-treatment technology was adopted, In contrast, the voltage of group B, C and D tubes was 80kV/Sn140kV, the dosage of CM was 20ml, 30ml, 50ml, respectively, and SAFIRE combined with NLB was adopted. The CT values were highest in group D and lowest in group A, with groups C and D exhibiting values significantly greater than those in groups A and B (P<0.05). The background noise of groups A and B were significantly higher than groups C and D (P<0.05). contrast to noise ratio and signal to noise ratio of pulmonary arteries at all levels in group C and D were higher than those in group A and group B (P<0.05). pulmonary arteries and their branches in the groups A, B, C and D showed well, and the pulmonary artery emboli could be clearly displayed, with good inter observer consistency. The CT dose index volume, dose length product, and effective dose of group A were significantly higher than those of groups B, C, and D (P<0.05). This application of SAFIRE combined with NLB in DSCT enhances image quality while concurrently reducing contrast medium (iodine) dosage and radiation exposure.

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Section: Comparison Of Radiation Doses Under Different Tube Voltagesmentioning

confidence: 51%

Assessment of Pulmonary Arterial Vessels With Newer Ct Examination Protocols With the Aim of Achieving a Ct-x-ray Dose and Cm-dosage Reduction

Sun,

Jin,

Luo

et al. 2024

Preprint

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“…In addition, they eliminate the risk of making a mistake when manually writing down the doses from each test [ 8 , 9 ]. They also allow alerts to be set up to let users know when the dose has been exceeded for a given study, allowing optimization of test protocols [ 10 ]. Unfortunately, most of the DTS are not free ( Table 1 ), but the benefits of implementing this software mean that it might be cost-effective in the case of large heath care providers as well as for small facilities.…”

Section: Discussionmentioning

confidence: 99%

“…Alert values for computed tomography examinations recommended by the American Association of Physicists in Medicine[10] …”

mentioning

confidence: 99%

Summary of radiation dose management and optimization: comparison of radiation protection measures between Poland and other countries

Jasieniak¹,

Kuchcińska²,

Podgórska³

et al. 2023

Pol J Radiol

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The purpose of this study is to show the actual recommendations for dose management and provide an overview of the available options for dose tracking and dose optimization. The legal institutions that supervise the radiological exposure of patients and their most important directives are presented. A literature review of existing diagnostic reference levels for computed tomography (CT), interventional radiology, radiography, paediatric radiography, mammography, and fluoroscopy in Europe and Poland was carried out. It has been shown that, in Poland, it is necessary to verify and determine the new diagnostic reference levels (DRLs) for each imaging modality because the existing ones are adapted from other countries and are not determined on the basis of data from Polish hospitals. They have not been updated for 11-17 years, although it is recommended to update them every 3-5 years. Many countries in Europe have already determined DRLs based on the analysis of their own dosage data (e.g. Austria and Germany). Analysing the existing DRLs for CT in Poland, it was noticed that they concern only a single anatomical region. It is necessary to determine the DRLs for multi-region CT (i.e. chest-abdomen-pelvis and neck-chest-abdomen-pelvis) examinations because these examinations account for about 60% of all oncological CT examinations-based on data collected from The Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw.

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Large variation in radiation dose for routine abdomen CT: reasons for excess and easy tips for reduction

Smith-Bindman,

Kang,

Chu

et al. 2023

Eur Radiol

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Objective To characterize the use and impact of radiation dose reduction techniques in actual practice for routine abdomen CT. Methods We retrospectively analyzed consecutive routine abdomen CT scans in adults from a large dose registry, contributed by 95 hospitals and imaging facilities. Grouping exams into deciles by, first, patient size, and second, size-adjusted dose length product (DLP), we summarized dose and technical parameters and estimated which parameters contributed most to between-protocols dose variation. Lastly, we modeled the total population dose if all protocols with mean size-adjusted DLP above 433 or 645 mGy-cm were reduced to these thresholds. Results A total of 748,846 CTs were performed using 1033 unique protocols. When sorted by patient size, patients with larger abdominal diameters had increased dose and effective mAs (milliampere seconds), even after adjusting for patient size. When sorted by size-adjusted dose, patients in the highest versus the lowest decile in size-adjusted DLP received 6.4 times the average dose (1680 vs 265 mGy-cm) even though diameter was no different (312 vs 309 mm). Effective mAs was 2.1-fold higher, unadjusted CTDIvol 2.9-fold, and phase 2.5-fold for patients in the highest versus lowest size-adjusted DLP decile. There was virtually no change in kV (kilovolt). Automatic exposure control was widely used to modulate mAs, whereas kV modulation was rare. Phase was the strongest driver of between-protocols variation. Broad adoption of optimized protocols could result in total population dose reductions of 18.6–40%. Conclusion There are large variations in radiation doses for routine abdomen CT unrelated to patient size. Modification of kV and single-phase scanning could result in substantial dose reduction. Clinical relevance Radiation dose-optimization techniques for routine abdomen CT are routinely under-utilized leading to higher doses than needed. Greater modification of technical parameters and number of phases could result in substantial reduction in radiation exposure to patients. Key Points • Based on an analysis of 748,846 routine abdomen CT scans in adults, radiation doses varied tremendously across patients of the same size and optimization techniques were routinely under-utilized. • The difference in observed dose was due to variation in technical parameters and phase count. Automatic exposure control was commonly used to modify effective mAs, whereas kV was rarely adjusted for patient size. Routine abdomen CT should be performed using a single phase, yet multi-phase was common. • kV modulation by patient size and restriction to a single phase for routine abdomen indications could result in substantial reduction in radiation doses using well-established dose optimization approaches.

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Notifications and alerts in patient dose values for computed tomography and fluoroscopy-guided interventional procedures

Cited by 7 publications

References 19 publications

Assessment of Pulmonary Arterial Vessels With Newer Ct Examination Protocols With the Aim of Achieving a Ct-x-ray Dose and Cm-dosage Reduction

Assessment of Pulmonary Arterial Vessels With Newer Ct Examination Protocols With the Aim of Achieving a Ct-x-ray Dose and Cm-dosage Reduction

Summary of radiation dose management and optimization: comparison of radiation protection measures between Poland and other countries

Large variation in radiation dose for routine abdomen CT: reasons for excess and easy tips for reduction

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