Radiation exposure during computerized tomography-based neuroimaging for acute ischemic stroke: a case-control study

Abstract

Patients and clinicians often raise concerns about radiation exposure to various organs during computerized tomography-based imaging. We evaluated radiation exposure during standard and low-dose imaging protocols for non-contrast computerized tomography, computerized tomography angiography and computerized tomography perfusion of the head. Whether reducing the radiation dose affected the image quality was also evaluated. Radiation data were retrieved for computerized tomography-based imaging studies performed for acute ischemic stroke patients during 2015. The volume-weighted computerized tomography dose index, dose-length product, scan length, effective dose and whole-body integral dose for brain, skin, eye, thyroid and red bone marrow were extracted from dose-tracking software. Dose metrics for low-dose protocols data were compared with standard protocols. The calculated effective doses for noncontrast computerized tomography, computerized tomography angiography and computerized tomography perfusion were 2.56 ± 0.67 mSv, 4.45 ± 2.5 mSv, and 4.47 ± 0.85 mSv, respectively for 391 acute ischemic stroke patients. Corresponding radiation exposures for lowdose protocol (n = 31) were non-contrast computerized tomography (2.36 ± 0.65 mSv), computerized tomography angiography (1.57 ± 0.74 mSv) and computerized tomography perfusion (2.20 ± 0.55 mSv). Overall, the effective dose for one complete stroke imaging protocol (non-contrast computerized tomography + computerized tomography angiography + computerized tomography perfusion) for the standard-dose protocol was 11.48 mSv, which was reduced to 6.13 mSv (46.6% reduction) using a low-dose protocol (p < 0.001). Reduced radiation exposure was noted for other radiosensitive organs. Radiation exposures of sensitive organs are within acceptable limits with standard neuroimaging protocols for acute ischemic stroke. Lower-dose computerized tomography imaging protocols reduced the radiation doses without appreciable deterioration in image quality.

The Impact of Standardized Health Education in Patients with Ischemic Stroke on Patient Management Satisfaction and Quality of Clinical Management Services

“…At present, intravenous thrombolysis is used to treat patients in clinic, which has good curative effect, but standardized management has not been formed in disease health education [ 7 , 8 ]. Therefore, we should find a scientific and standardized health education method to carry out health management and education for their diseases, which can take a vital part in the healthy life, ability, and neurological function recovery of patients [ 9 – 11 ]. In this study, obtained in to our hospital, from September 2019 to December 2021, 220 patients with ischemic stroke were selected as the research objects, and the health management education and training program was formulated to explore its application effect.…”

Computed Tomography of the Head

“…The remaining 8 NCCT studies had unspecified or mixed indications, e.g., evaluation of trauma, skull fracture, amnesia, loss of consciousness, seizure, headache, vomiting, focal neurological deficit, coagulopathy, treatment with anticoagulants, or tumor staging. For two studies comparing SD and LD protocols of multi-modal CT (NCCT, CTA, and CTP), only the NCCT results were extracted [ 50 , 51 ]. The results are summarized in Tables 1 , 2 and 3 .…”

“…Dose reductions ranged from 10 to 36% without impairment of IQ (based on 4 studies, [ 50 – 52 , 54 ]). Reported doses in terms of CTDI vol and DLP ranged from 31.2 to 59.0 mGy and 441.9–1061.9 mGy * cm, respectively.…”

“…2 ; [ 49 ]). Furthermore, excellent IOA (range: 0.80–0.93) regarding overall IQ, anatomic detail, gray-white matter differentiation, and conspicuousness of ischemic demarcation was demonstrated at reduced dose [ 49 , 50 , 52 ]. Furthermore, gray to white matter contrast per dose was found to be markedly increased in the context of acute stroke scans using a reduced dose protocol [ 53 ].…”