Patient doses using multidetector computed tomography scanners in Kenya

Korir, Geoffrey K; Wambani, Jeska S.; Korir, Ian K.

doi:10.1093/rpd/ncr484

Cited by 8 publications

(11 citation statements)

References 5 publications

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“…2 and comparison of these values with those from other countries is presented in Table 3. All adult findings from Turkey were consistent with the studies published in other countries (17)(18)(19)(20)(21)(22). Pediatric patient findings were also consistent with similar published studies (19)(20)(21)(23)(24)(25)(26), except for DLP values, which were higher in Turkey.…”

Section: Main Pointssupporting

confidence: 90%

Patient doses from CT examinations in Turkey

Ataç

Parmaksız²,

İnal³

et al. 2015

Diagn Interv Radiol

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M agnetic resonance imaging (MRI) is a widely used diagnostic tool for breast imaging in daily practice, with its high sensitivity to detect primary, recurrent, and residual breast cancer. Breast MRI serves as a reliable problem-solving tool in case of inconclusive mammography and ultrasonography (US) findings. It can be used to monitor the results of neoadjuvant chemotherapy and it may also contribute to preoperative evaluation of known lesions. With increasing use of MRI, number of breast lesions visible only on MRI and need for MRI-guided breast biopsy have increased (1). Second-look US can also be used for re-evaluation of these lesions; because US-guided biopsy is an easier, cheaper, and faster method if these lesions are visible on second-look US. According to a recently published meta-analysis, lesion detection rates with second-look US are variable in the literature (22.6%-82.1%). Mass lesions and malignant lesions were more likely to be detected at second-look US; average detection rates were 66% for masses, 29% for non-mass-like enhancement (NME) (2, 3). However, focal or NME lesions, which are less detectable than masses on second-look US, require MRI-guided biopsy in the majority of cases. According to the MRI-guided biopsy series in the literature, approximately 25%-35% of these lesions are diagnosed as malignant (4-9).Within this context, the aim of the present study is to assess the effectiveness of MRI-guided 10 Gauge (G) vacuum-assisted breast biopsies (VABB) performed at our institution and to examine the relationship between lesion characteristics and histopathologic results. B R E A S T I MAG I N G O R I G I N A L A R T I C L E PURPOSEWe aimed to assess the effectiveness of magnetic resonance imaging (MRI)-guided vacuum-assisted breast biopsy (VABB), evaluate and compare the characteristics and histopathologic findings of lesions, and overview the follow-up results of benign lesions. METHODSMRI findings and histopathologic results of breast lesions biopsied by MRI-guided VABB between 2013 and 2016 were retrospectively analyzed. MRI findings closely related with malignancy were investigated in particular. Follow-up results of benign lesions were evaluated. RESULTSMRI-guided VABB was applied to 116 lesions of 112 women. Of the lesions, 75 (65%) were benign, while 41 (35%) were malignant. Segmental (94%), clustered (89%), and clustered ring (67%) nonmass-like enhancement patterns were found to be more related with malignancy. False-negative rate of MRI-guided VABB was 12%, underestimation rate was 21%. One of the 54 followed-up benign lesions had a malignant result. CONCLUSION MRI-guided VABB is a reliable method for the diagnosis of breast lesions that are positive only on MRI. Follow-up results show that cancer detection rate is low for radio-pathologically concordant lesions. Further multicenter studies with larger patient population are needed to elucidate these results.You may cite this article as: Taşkın F, Soyder A, Tanyeri A, Öztürk VS, Ünsal A. Lesion characteristics, histopathologic r...

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Section: Main Pointssupporting

confidence: 90%

Patient doses from CT examinations in Turkey

Ataç

Parmaksız²,

İnal³

et al. 2015

Diagn Interv Radiol

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“…The mean effective dose per examination type was used to calculate the collective effective dose in CT. The annual collective effective dose (S) from the CT scanning examination patient population was determined for each age group as a product of mean effective dose and the total patient population per examination type (9) . As a guideline for good practice, the third quartile patient dose values for each age group examination procedure irrespective of the hospital or CT scanner model were determined and proposed as the initial national diagnostic reference levels (NDRLs) for each CT procedure.…”

Section: Reference Level For Ct Examinationsmentioning

confidence: 99%

“…In Kenya, the number of CT scanners in direct medical use increased by over 80 % in the past decade (8) . Previous studies have shown that CT examinations were performed using manufacturer-prescribed protocols, resulting in multiphase protocols and inadequate professional effort geared towards developing local optimal conditions commensurate to specific patient needs and indication (9) . Because the country does not have wellestablished national radiation dose management strategies, the radiation exposure to patients is not adequately managed, creating a need for optimisation and patient dose monitoring, record keeping, analysis as well as tracking of the exposed individuals.…”

Section: Introductionmentioning

confidence: 99%

National Diagnostic Reference Level Initiative for Computed Tomography Examinations in Kenya

Korir

Wambani

Korir³

et al. 2015

Radiat Prot Dosimetry

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The purpose of this study was to estimate the computed tomography (CT) examination frequency, patient radiation exposure, effective doses and national diagnostic reference levels (NDRLs) associated with CT examinations in clinical practice. A structured questionnaire-type form was developed for recording examination frequency, scanning protocols and patient radiation exposure during CT procedures in fully equipped medical facilities across the country. The national annual number of CT examinations per 1000 people was estimated to be 3 procedures. The volume-weighted CT dose index, dose length product, effective dose and NDRLs were determined for 20 types of adult and paediatric CT examinations. Additionally, the CT annual collective effective dose and effective dose per capita were approximated. The radiation exposure during CT examinations was broadly distributed between the facilities that took part in the study. This calls for a need to develop and implement diagnostic reference levels as a standardisation and optimisation tool for the radiological protection of patients at all the CT facilities nationwide.

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“…The cumulative KAP values for IPs were used with effective dose conversion factors to obtain effective dose for full examinations (Korir 2013;Hart and Wall 2002;Damilakis et al 2006;Schultz et al 1999). Effective dose for computed tomography examinations was estimated from the Dose length product (DLP) values and region-specific normalized effective dose coefficient (E DLP ) values in mSv mGy j1 cm j1 (Korir et al 2012;Hyun 2012;Huda et al 2011;Wambani et al 2010). …”

Section: Estimation Of Effective Dosementioning

confidence: 99%

“…The national annual number of CT examinations increased by 60% (from 44,500 to 112,000) from 2007 to 2011, which demonstrated the impact of Multi Detector Computed Tomography (MDCT) introduced into the country (Korir et al 2012). There may be unnecessary imaging referrals for payments to the referring clinician, and hence an increase in prescription.…”

Section: Ct Examination Frequencymentioning

confidence: 99%

Frequency and Collective Dose of Medical Procedures in Kenya

Korir¹,

Wambani²,

Korir³

et al. 2013

Health Physics

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The first comprehensive national survey on frequency and radiation dose imparted to the population from radiological procedures was carried out in Kenya and reported here. This survey involved assessment of frequency, typical patient radiation exposure, and collective effective dose from general radiography, fluoroscopy, interventional procedures (IPs), mammography, and computed tomography. About 300 x-ray facilities across the country were invited to participate in the survey, and a 31% response was recorded. The individual and collective radiation burdens of more than 62 types of pediatric and adult radiological examinations were quantified using effective and collective dose. The average effective dose for each radiological examination was assessed from the x-ray efficiency performance tests and patient data from over 30 representative radiological facilities. The results found indicated that over 3 million x-ray procedures were performed in 2011, resulting in an annual collective effective dose of 2,157 person-Sv and an annual effective dose per capita of 0.05 mSv. The most frequent examinations were general radiography (94%), computed tomography (3.3%), and fluoroscopy (2.5%). Although the contribution of computed tomography was small in terms of frequency, this procedure accounted for 36% of the effective dose per capita. General radiography was the most frequent type of examination with a contribution of 55% of the effective dose per capita.

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Patient doses using multidetector computed tomography scanners in Kenya

Cited by 8 publications

References 5 publications

Patient doses from CT examinations in Turkey

Patient doses from CT examinations in Turkey

National Diagnostic Reference Level Initiative for Computed Tomography Examinations in Kenya

Frequency and Collective Dose of Medical Procedures in Kenya

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