Quality Criteria Development within the Fourth Framework Research Programme: Computed Tomography

Jessen, K.; Bongartz, G.; Geleijns, Jacob; Golding, Stephen J.; Jurik, Anne Grethe; Leonardi, M.C.; Meerten, Els van Persijn van L.; Panzer, W.; Shrimpton, Paul; Tosi, Giovanni

doi:10.1093/oxfordjournals.rpd.a033147

Cited by 21 publications

(37 citation statements)

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“…Studies of occupational exposure to radiation have provided some direct estimates of the risk at lower doses for adults. Undergoing 2 to 3 abdominal CTs over a person's lifetime can increase the possibilities to develop cancer [10][11][12][13][14].Relatively fewer data describe how much radiation is received through the most common types of CT examinations for abdomen-pelvic area when applied in clinical practice, as most published studies focused on phantom studies.…”

Section: Issn: 2320-5407mentioning

confidence: 99%

“…In scanner B; they were 60 (±14.5), 120(±0)and 1(±0). The median effective dose for patients between multiphase abdomen-pelvic scan of both MDCT, a significant difference (P<0.05) was observed.Multiphase abdomen -pelvic scan of clinical study shows significant variation of effective dose with reference level of phantom studies (8)(9)(10)(11)(12)(13)(14) and it is highly depend on type of vendors.…”

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confidence: 99%

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Radiation Dose and Associated Exposure Parameters in Selected MDCT Scanners in Multiphase Scan of Abdomen- Pelvic Region: A Clinical Study.

Sathyathas¹,

Herath²,

Amalraj³

et al. 2017

IJAR

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We sought to estimate the radiation dose and associated exposure parameters in the multiphase abdomen -pelvic scan of Multidetector Computed Tomography (MDCT) studies in clinical practice. This was a retrospective cross sectional study describing radiation dose associated with main exposure parameters in diagnostic multiphase abdomen -pelvic scans performed on 152 consecutive patients by two different sixteen (16) slice CT scanners. Patient information, exposure parameters of CTDI (volume) , DLP, kVp, mAs and pitch were recorded for every phases of abdomen-pelvic study from dose report of MDCT scanners. Patient age range from 18 to 87 years. Overall CTDI (volume) median was 63.8 (±10.4)mGy for multiphase abdominal-pelvic scan with scanner A while it was 35.4 (±15.6)mGy for scanner B. Effective dose for patients in multiphase abdomen -pelvic CT scan range from 8.2 mSv to 58 mSv. Median effective dose for patients, who underwent multiphase abdomen-pelvic scan with scanner A and B were 38.5 (± 8.2) mSv and 21.3 (± 8.6) mSv respectively. Median value of exposure parameters of mAs, kVp and pitch were 150 (±29.7), 130 (±15.3) and 1.3 (±0

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Section: Issn: 2320-5407mentioning

confidence: 99%

mentioning

confidence: 99%

Radiation Dose and Associated Exposure Parameters in Selected MDCT Scanners in Multiphase Scan of Abdomen- Pelvic Region: A Clinical Study.

Sathyathas¹,

Herath²,

Amalraj³

et al. 2017

IJAR

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“…It is measured from one axial CT scan (one rotation of the x-ray tube) [21][22][23][24] , and is calculated by dividing the integrated absorbed dose by the nominal total beam collimation. The CTDI is always measured in the axial scan mode for a single rotation of the x-ray source, and theoretically estimates the average dose within the central region of a scan volume consisting of multiple, contiguous CT scans [Multiple Scan Average Dose (MSAD)] for the case where the scan length is sufficient for the central dose to approach its asymptotic upper limit 22,23,25 .…”

Section: Computed Tomography Dose Index (Ctdi)mentioning

confidence: 99%

Radiation exposure in patients with subarachnoid hemorrhage: a quality improvement target

Wong

Lin³

et al. 2013

JNS

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Object The care of patients with subarachnoid hemorrhage (SAH) has improved dramatically over the last decades. These gains are the result of improved microsurgical, endovascular, and medical management techniques. This intensive management subjects patients to multiple radiographic studies and thus increased radiation exposure. As greater understanding of the risks of radiation exposure develops, physicians must be better equipped to balance the need for optimal SAH management with the minimization of patient exposure to radiation from imaging studies. The goal in the current study was to determine if there is an opportunity for a reduction in radiation dose without a change in the quality of treatment in patients with SAH. Methods A retrospective chart review of all patients hospitalized for SAH at the Brigham and Women's Hospital in the period from January 1, 2009, to August 31, 2010, was performed. The authors calculated cumulative and imaging study–specific radiation doses, determined the time of day that imaging studies were performed, and surveyed neurosurgeons regarding issues surrounding imaging-related radiation exposure. Results The data for 77 patients were analyzed. The mean cumulative radiation dose during hospitalization was 2.76 Gy per patient (range 0.46–8.32 Gy). The mean radiation exposure from each CT, CT angiography (CTA), and angiography study was 0.08, 0.29, and 0.77 Gy (ranges 0.02–0.40, 0.15–0.99, and 0.11–4.36 Gy, respectively). Subgroup analysis of the top quartile of patients in terms of total radiation dose revealed a mean cumulative radiation dose of 4.78 Gy (range 3.42–8.32 Gy), mean cumulative number of CT and CTA scans of 14, and mean CT or CTA scan per day of 0.5 (maximum 0.8). Seventeen percent of the noncontrast head CT studies were performed just prior to morning rounds, more than double the 8% expected rate at random. Thirty-four percent of the repeat noncontrast head CTs did not show any change between scans, as documented on radiology reports. When surveyed, a majority of neurosurgeons incorrectly estimated the radiation dose typically received from CT, CTA, and angiography studies, and 65% asserted that radiation exposure is “not important” or only “somewhat important” when considering whether to order an imaging study. Conclusions Study findings suggested that patients with SAH have significant imaging-related exposure to radiation. The authors believe it is possible to continue the current improved outcomes in SAH with a significant reduction in radiation exposure from imaging studies. This analysis highlights the significance of accurate assessment of radiation exposure as a quality improvement target.

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“…Currently, radiological studies represent one of the main sources of exposure to ionizing radiation of artificial origin (1) . In such a context, computed tomography (CT) is highlighted as one of the most important radiological techniques for medical applications, whose utilization has significantly increased in the past decades (2) .…”

Section: Introductionmentioning

confidence: 99%

“…In such a context, computed tomography (CT) is highlighted as one of the most important radiological techniques for medical applications, whose utilization has significantly increased in the past decades (2) . As a consequence of the dissemination of such technique in the medical practice, a significant increase has been observed in the radiation dose to which patients who require diagnostic exams are exposed (1) .…”

Section: Introductionmentioning

confidence: 99%

When the non-contrast-enhanced phase is unnecessary in abdominal computed tomography scans? A retrospective analysis of 244 cases

et al. 2013

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Objective: To evaluate the necessity of the non contrast-enhanced phase in abdominal computed tomography scans. Materials and Methods: A retrospective, cross-sectional, observational study was developed, evaluating 244 consecutive abdominal computed tomography scans both with and without contrast injection. Initially, the contrast-enhanced images were analyzed (first analysis). Subsequently, the observers had access to the non-contrast-enhanced images for a second analysis. The primary and secondary diagnoses were established as a function of the clinical indications for each study (such as tumor staging, acute abdomen, investigation for abdominal collection and hepatocellular carcinoma, among others). Finally, the changes in the diagnoses resulting from the addition of the non-contrast-enhanced phase were evaluated. Results: Only one (0.4%; p > 0.999; non-statistically significant) out of the 244 reviewed cases had the diagnosis changed after the reading of non-contrast-enhanced images. As the secondary diagnoses are considered, 35 (14%) cases presented changes after the second analysis, as follows: nephrolithiasis (10%), steatosis (3%), adrenal nodule (0.7%) and cholelithiasis (0.3%). Conclusion: For the clinical indications of tumor staging, acute abdomen, investigation of abdominal collections and hepatocellular carcinoma, the non-contrast-enhanced phase can be excluded from abdominal computed tomography studies with no significant impact on the diagnosis. Keywords: Computed tomography; Ionizing radiation; Abdomen; Contrast media.Objetivo: Avaliar a necessidade da fase sem contraste nos exames de tomografia computadorizada de abdome. Materiais e Métodos: Foi realizado estudo retrospectivo, transversal e observacional, no qual foram avaliados 244 exames consecutivos de tomografia computadorizada de abdome realizados sem e com a injeção do meio de contraste. Procurou-se estabelecer, mediante análise das fases com o uso do meio de contraste (primeira análise), e posteriormente com o acréscimo da avaliação da fase sem meio de contraste (segunda análise), o diagnóstico principal e os secundá-rios em função da indicação clínica do exame (estadiamento tumoral, abdome agudo, pesquisa de coleção abdominal e hepatocarcinoma, entre outros). Foram medidas as mudanças nos diagnósticos principais e secundários, decorrentes do acréscimo da fase sem meio de contraste. Resultados: Dos 244 casos avaliados, apenas um (0,4%; p > 0,999; não significante) teve o seu diagnóstico modificado após a leitura da fase sem meio de contraste. Com relação aos diagnósticos secundários, 35 exames (14%) foram modificados após a segunda análise, sendo: nefrolitíase (10%), esteatose (3%), nódulo de adrenal (0,7%) e colelitíase (0,3%). Conclusão: Para as indicações clínicas de estadiamento tumoral, abdome agudo, pesquisa de coleção abdominal e carcinoma hepatocelular, a supressão da fase sem meio de contraste não apresentou impacto diagnóstico expressivo. Unitermos: Tomografia computadorizada; Radiação ionizante; Abdome; Meio de contraste.

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Quality Criteria Development within the Fourth Framework Research Programme: Computed Tomography

Cited by 21 publications

References 0 publications

Radiation Dose and Associated Exposure Parameters in Selected MDCT Scanners in Multiphase Scan of Abdomen- Pelvic Region: A Clinical Study.

Radiation Dose and Associated Exposure Parameters in Selected MDCT Scanners in Multiphase Scan of Abdomen- Pelvic Region: A Clinical Study.

Radiation exposure in patients with subarachnoid hemorrhage: a quality improvement target

When the non-contrast-enhanced phase is unnecessary in abdominal computed tomography scans? A retrospective analysis of 244 cases

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