Radiation Dose Estimations to the Thorax Using Organ-Based Dose Modulation

Lungren, Matthew P.; Yoshizumi, Terry T.; Brady, Samuel M.; Toncheva, Greta; Anderson-Evans, Colin; Lowry, Carolyn; Zhou, Xiaoliang; Frush, Donald P.; Hurwitz, Lynne M.

doi:10.2214/ajr.11.7798

Cited by 39 publications

(50 citation statements)

References 22 publications

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“…33 We found that maternal breast dose is generally higher for CTPA than for VQ, but organ-based tube current modulation has been shown to reduce this. 35 Further opportunities to reduce CTPA radiation doses include the use of statistical and model-based iterative reconstruction techniques, 36 reducing the tube voltage, as we have already performed from 120 to 100 kVp, 37 increasing the pitch to above 1 and decreasing the scan volume. Lowering the peak kilovoltage has the additional advantage of increasing the contrast attenuation within the pulmonary arteries, as the average X-ray energy approaches the k-edge of iodine (33 keV).…”

Section: Dosimetrymentioning

confidence: 99%

Diagnosing venous thromboembolism in pregnancy

Grüning

Mingo

Gosling

et al. 2016

BJR

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Objective: We report the imaging outcomes of all pregnant patients referred for suspected thromboembolism over a 43-month period. Methods: We identified 168 patients who underwent ventilation/perfusion (VQ) single-photon emission CT (SPECT), CT pulmonary angiography (CTPA) or a Doppler ultrasound scan of the lower legs, as well as a control group of 89 non-pregnant age-and sex-matched patients who underwent VQ SPECT during the same period. Imaging outcomes were recorded, and radiation doses were calculated for individual patients. Results: VQ SPECT and CTPA were equally likely to diagnose pulmonary embolism (PE) in about one patient out of every seven patients investigated. One in three CTPA scans was of suboptimal quality. A Doppler ultrasound examination of the legs will find deep venous thrombosis much less often, in about 1 patient out of every 15 patients investigated. The prevalence of PE in pregnant patients (as diagnosed by VQ SPECT) was similar to that in the non-pregnant, age-and sex-matched control group. The effective dose and the absorbed radiation dose to the maternal breast were lower with VQ SPECT. The foetal dose is comparable for both VQ SPECT and CTPA. Conclusion: VQ SPECT and CTPA provide a similar diagnostic yield for diagnosing PE during pregnancy, but VQ SPECT does so with a lower radiation dose to the mother (effective dose and breast dose). Advances in knowledge: Ours is the first report of the diagnostic performance of VQ SPECT, rather than planar VQ scans, in pregnancy in a routine clinical setting.

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Section: Dosimetrymentioning

confidence: 99%

Diagnosing venous thromboembolism in pregnancy

Grüning

Mingo

Gosling

et al. 2016

BJR

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“…1) [7]. Recent publications indicated that in a majority of women in the supine position, a portion of glandular breast tissue is located outside the reduced dose zone and therefore might be under increased risk of over-irradiation even when using organ-based tube current modulation [8,9].…”

Section: Introductionmentioning

confidence: 99%

Organ-based tube current modulation in a clinical context: Dose reduction may be largely overestimated in breast tissue

et al. 2015

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“…Bismuth breast shielding was previously reported to reduce radiation exposure to the breasts by approximately 30 without affecting images 2,[6][7][8][9] ; now this study indicates that X-CARE could be used as a viable alternative. In atomic bomb survivors the radiation dose-response relationship for breast cancer is linear, with a relative risk per Gray of 1.9 10 .…”

Section: Discussionmentioning

confidence: 64%

Reduced Radiation Exposure to the Mammary Glands in Thoracic Computed Tomography using Organ-based Tube-current Modulation

Munechika

Ohgiya

Gokan

et al. 2013

Showa Univ J Med Sci

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: Organ-based tube-current modulation has been used to reduce radiation exposure to speci c organs. However, there are no reports yet published on reducing radiation exposure in clinical cases. In this study, we assessed the reduction in radiation exposure to the mammary glands during thoracic computed tomography CT using X-CARE. In a phantom experiment, the use of X-CARE reduced radiation exposure at the midline of the precordial region by a maximum of 45.1 . In our corresponding clinical study, CT was performed using X-CARE in 15 patients, and without X-CARE in another 15. Compared to the non-X-CARE group, radiation exposure was reduced in the X-CARE group at the midline of the precordial region by 22.3 P 0.05 and at the medial sides of the right and left breasts by 16.8 and 14.2 , respectively P 0.05 for each . Analysis of the visual quality of CT images as well as CT values for the muscles of the chest walls showed no difference in either assessment between the X-CARE and non-Xcare groups P 0.05 . X-CARE thus reduced radiation exposure at the midline of the precordial region and allowed us to obtain consistent CT values without increasing noise. However, this study revealed increases in radiation exposure at the lateral sides of the breasts. It is conceivable that patients breasts were laterally displaced by gravity under the standard thoracic imaging conditions. Further studies that consider factors such as body size and adjustment of imaging conditions may be needed in the future.

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Radiation Dose Estimations to the Thorax Using Organ-Based Dose Modulation

Cited by 39 publications

References 22 publications

Diagnosing venous thromboembolism in pregnancy

Diagnosing venous thromboembolism in pregnancy

Organ-based tube current modulation in a clinical context: Dose reduction may be largely overestimated in breast tissue

Reduced Radiation Exposure to the Mammary Glands in Thoracic Computed Tomography using Organ-based Tube-current Modulation

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