Optimizing radiation exposure for CT localizer radiographs

Bohrer, Evelyn; Schäfer, Stefan; Mäder, Ulf; Noël, Peter B.; Krombach, Gabriele A.; Fiebich, Martin

doi:10.1016/j.zemedi.2016.09.004

Cited by 9 publications

(3 citation statements)

References 32 publications

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“…The technique could spark concerns regarding radiation exposure, since the absorbed doses during a scout scan for the selected patients were in the range 0.06-0.15 mGy, which is still higher than the typical dose associated with a routine DXA lumbar spine exam (0.037 mGy for a standard protocol at our institution). In particular, estimated effective doses for AP abdominal scout scans with the standard tube parameters used in this study (around 0.25 mSv) are still consequently higher than the effective dose of a DXA scan of the spine (around 0.013 mSv) [22,30]. Nevertheless, the scout scan is always acquired in CT examinations and therefore, obtaining BMD measurements based on the scout image does not only represent an increase in radiation exposure, but above all a better, more meaningful utilization of the dose associated with scout procedures and CT procedures in general.…”

Section: Discussionmentioning

confidence: 64%

“…This study showed a substantial agreement with DXA and suggested that SDXA could provide DXA-equivalent BMD measurements. Considering that the scout scan is a mandatory part of each CT examination, and is obtained before a potential IV contrast injection, the application of this method invivo could be beneficial and enable a truly opportunistic osteoporosis screening, as well as enabling a better utilization of the radiation dose associated with scout scans [21][22][23].…”

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confidence: 99%

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Spectral-detector based x-ray absorptiometry (SDXA): in-vivo bone mineral density measurements in patients with and without osteoporotic fractures

Laugerette

Baum

Gersing

et al. 2020

Biomed. Phys. Eng. Express

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Objectives: To study whether a dual-layer spectral CT scout scan-based areal BMD estimation method, called Spectral-detector based x-ray absorptiometry (SDXA), can differentiate patients with versus without osteoporotic fractures. Methods: The ability of the method to differentiate patients with osteoporosis was evaluated by assessing the areal BMD at the spine (L1 to L4) in a group of 19 patients presenting at least one fracture and comparing these results to the areal BMD of age- and gender-matched controls (57 patients). Finally, the reproducibility of SDXA was evaluated in-vivo through the calculation of coefficients of variation (CV), using three repeated analyses performed on each patient. Results: The average areal BMD of patients presenting fractures, measured with the scout scan-based method (0.86 ± 0.17 g cm−2), was found to be significantly lower than the average BMD of the control group (1.00 ± 0.17 g cm−2, p = 0.043). The reproducibility of the method in-vivo was found to be reasonable, with CVs ranging between 3.1 and 6.9%. Conclusions: The results illustrate that the SDXA method for DXA-equivalent areal BMD estimation -delivers the ability to distinguish patients presenting osteoporotic fractures. Considering the total number of CT examinations worldwide, SDXA could develop to be a useful tool for truly opportunistic osteoporosis screening for a future clinical day-to-day routine.

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Section: Discussionmentioning

confidence: 64%

mentioning

confidence: 99%

Spectral-detector based x-ray absorptiometry (SDXA): in-vivo bone mineral density measurements in patients with and without osteoporotic fractures

Laugerette

Baum

Gersing

et al. 2020

Biomed. Phys. Eng. Express

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“…These issues may be less frequent when CT scanner and dose-tracking Furthermore, dose delivered with the CT scout acquisition is included in DLP tot , which justifies differences between DLP and DLP tot in monophasic protocols. Patients can be highly exposed to radiation doses in the CT scout acquisition, whose exposure levels are equivalent to about 10 chest x-rays, contributing considerably to the integral dose of a full examination; relevant diagnostic information cannot be inferred from imaging data from scout acquisition, which show a wide variability in dose used, so an optimization of this one would be highly beneficial (Patel et al 2010;Bohrer et al 2017;Long et al 2017).…”

Section: Discussionmentioning

confidence: 99%

Dose-Tracking Software: A Retrospective Analysis of Dosimetric Data in CT Procedures

Buono

Capussela²,

Loffredo

et al. 2022

Health Physics

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The increasing use of ionizing radiation in healthcare is causing growing alarm about radiation protection of patients and the doses they receive during procedures. Radiation dose assessment for patients in radiodiagnostic procedures is the subject of interest in view of the recent Italian D.Lgs 31 July 2020, n. 101 (Decreto Legislativo 31 luglio 2020, n. 101) and one of its most important focuses is the prescription to provide patient exposure information as an integral part of the examination report. Dose monitoring systems are therefore essential for the collection of the dosimetric data. In order to analyse potential and critical issues of these software, different systems, adopted at the Antonio Cardarelli Hospital in Naples, were employed. Data extracted from the DoseWatch software (GE Healthcare) and Gray Detector (EL.CO. S.r.l. Healthcare Solutions, Italy) and relating to several protocols adopted for computed tomography (CT), were retrospectively analysed for the purpose of identifying critical issues in the data acquisition and recording phase, comparing with Italian nationwide diagnostic reference levels (DRLs), as provided for in regulatory provisions for radiation safety. Multiphase examinations were also included in this study. Once the distributions of volumetric CT Dose Index (CTDI vol ) and dose-length product (DLP) were determined for each acquisition phase and total DLP (DLP tot ) for each examination, the 25 th , 50 th and 75 th percentiles were calculated for each distribution and then compared with the relevant Italian nationwide DRLs. In addition, to improve protocol optimization and dose reduction the magnitude of the CT acquisition settings chosen in each procedure was evaluated. In conclusion, these systems allow accurate analysis of radiation dose according to equipment and protocol over time. For the application of optimization measures, a constant use of the dose tracking software is required, which can be translated into actions on scan parameters and prospective data analysis. Health Phys. 122(4):548-555; 2022

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DXA-equivalent quantification of bone mineral density using dual-layer spectral CT scout scans

et al. 2019

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Optimizing radiation exposure for CT localizer radiographs

Cited by 9 publications

References 32 publications

Spectral-detector based x-ray absorptiometry (SDXA): in-vivo bone mineral density measurements in patients with and without osteoporotic fractures

Spectral-detector based x-ray absorptiometry (SDXA): in-vivo bone mineral density measurements in patients with and without osteoporotic fractures

Dose-Tracking Software: A Retrospective Analysis of Dosimetric Data in CT Procedures

DXA-equivalent quantification of bone mineral density using dual-layer spectral CT scout scans

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