Radiation exposure in computed tomography

Bos, Denise; Guberina, Nika; Zensen, Sebastian; Opitz, Marcel; Forsting, Michael; Wetter, Axel

doi:10.3238/arztebl.m2022.0395

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…Mit einer Energiedosis von ca. 5 mGy [ 31 ] liegt die Strahlenexposition bei der modernen Computertomographie deutlich unter der Strahlenexposition, bei der mit einer deterministischen Schädigung des Fetus gerechnet werden muss. Obwohl nach derzeitigem Kenntnisstand in diesen niedrigen Dosisbereichen kein erhöhtes Risiko für Letalität, genetische Schäden, epigenetische Veränderungen, Teratogenität, Wachstumsstörungen oder Sterilität besteht [ 34 ], können stochastische Effekte nicht ausgeschlossen werden.…”

Section: Diskussionunclassified

Pregnant women with COVID-19 ARDS on the intensive care unit

Kalbhenn,

Marx,

Müller-Peltzer

et al. 2024

Anaesthesiologie

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Zusammenfassung Hintergrund Schwangere mit einer SARS-CoV-2-Infektion (COVID-19) haben ein erhöhtes Risiko für einen schweren Verlauf der COVID-19. Die medizinische und ethische Abwägung maternaler und fetaler Risiken und die Priorisierung von Therapieoptionen stellen eine große Herausforderung auf der Intensivstation dar. Eine enge interdisziplinäre Abstimmung ist unabdingbar. Ziel der Arbeit Beschreibung und Diskussion intensivmedizinischer Behandlungsstrategien und des perinatalen anästhesiologischen Managements bei Patientinnen mit COVID-19-ARDS (CARDS). Material und Methoden Analyse von demografischen Daten, Anamnese, klinischem Management, Komplikationen, Indikationen und Management der extrakorporalen Membranoxygenierung (ECMO) sowie des kindlichen Überlebens aller schwangeren Patientinnen, die zwischen März und November 2021 auf der anästhesiologischen Intensivstation eines deutschen Universitätsklinikums wegen eines schweren CARDS behandelt wurden. Ergebnisse Kohorte von 9 konsekutiven Patientinnen mit einem Durchschnittsalter von 30,3 Jahren (Min–Max: 26 bis 40 Jahre) und einem Schwangerschaftsalter von 21 + 3 bis 37 + 2 Wochen. Keine der Patientinnen war gegen SARS-CoV‑2 geimpft. Zwei Patientinnen mussten mit inhalativem Stickstoffmonoxid und venovenöser ECMO behandelt werden. Alle Frauen und 5 Neugeborene haben überlebt. Zwei Patientinnen wurden mit intakter Schwangerschaft nach Hause entlassen. Alle Kinder wurden durch einen Kaiserschnitt entbunden. Es wurden 2 intrauterine fetale Todesfälle beobachtet. Keines der Neugeborenen wurde bei der Geburt positiv auf SARS-CoV‑2 getestet. Diskussion Das peripartale Management erfordert eine enge interdisziplinäre Zusammenarbeit und sollte in der Frühschwangerschaft vorrangig auf das mütterliche Überleben ausgerichtet sein. Die Bauchlagerung, ein wesentlicher, evidenzbasierter Eckpfeiler in der Therapie des akuten Atemnotsyndroms (ARDS), kann auch in fortgeschrittenen Schwangerschaftsstadien sicher angewendet werden. Inhalatives Stickstoffmonoxid (iNO) und extrakorporale Membranoxygenierung (ECMO) sollten als lebensrettende Behandlungsoptionen für sorgfältig ausgewählte Patientinnen in Betracht gezogen werden.

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Section: Diskussionunclassified

Pregnant women with COVID-19 ARDS on the intensive care unit

Kalbhenn,

Marx,

Müller-Peltzer

et al. 2024

Anaesthesiologie

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“…Yet, satisfying image quality, depiction of the gray and white matter, and thus reliable detection of small pathologies and lesions in cranial ncCT is rendered more difficult due to image noise and limited intrinsic differences in the brain parenchyma [3], especially while trying to leave the radiation dose at a reasonable level. With a constantly rising number of CT scans nationally and internationally [4,5,6], and thus increased accumulated radiation exposure and the risks of neoplasia that arise from it [7], new methods to reduce image noise, to increase image quality, and to enable a reduction in dose exposure for the patients have been introduced. Filtered back projection (FBP) has been a standard for CT image reconstruction for over 40 years due to its computational efficiency [8,9].…”

Section: Introductionmentioning

confidence: 99%

Value of vendor-agnostic deep learning image denoising in brain computed tomography: A multi-scanner study

Kapper,

Müller,

Kronfeld

et al. 2024

Rofo

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To evaluate the effect of a vendor-agnostic deep learning denoising (DLD) algorithm on diagnostic image quality of non-contrast cranial computed tomography (ncCT) across five CT scanners.This retrospective single-center study included ncCT data of 150 consecutive patients (30 for each of the five scanners) who had undergone routine imaging after minor head trauma. The images were reconstructed using filtered back projection (FBP) and a vendor-agnostic DLD method. Using a 4-point Likert scale, three readers performed a subjective evaluation assessing the following quality criteria: overall diagnostic image quality, image noise, gray matter-white matter differentiation (GM-WM), artifacts, sharpness, and diagnostic confidence. Objective analysis included evaluation of noise, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and an artifact index for the posterior fossa.In subjective image quality assessment, DLD showed constantly superior results compared to FBP in all categories and for all scanners (p<0.05) across all readers. The objective image quality analysis showed significant improvement in noise, SNR, and CNR as well as for the artifact index using DLD for all scanners (p<0.001).The vendor-agnostic deep learning denoising algorithm provided significantly superior results in the subjective as well as in the objective analysis of ncCT images of patients with minor head trauma concerning all parameters compared to the FBP reconstruction. This effect has been observed in all five included scanners.

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“…MRI is an effective tool for diagnosing ONFH. With the development of 3D reconstruction technology, the 3D model of ONFH and its necrotic volume can be accurately reconstructed and calculated by nite element software 13,14 . In this study, a three-dimensional reconstruction technique reconstructed the necrotic volume of the patient diagnosed with ONFH.…”

Section: Introductionmentioning

confidence: 99%

Investigate an optimal extracorporeal shock wave therapy intervention strategy for osteonecrosis of femoral head : a retrospective analysis

Zhu,

Xiao,

et al. 2024

Preprint

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Purpose: To investigate an optimal ESWT intervention strategy in the management of ONFH. Methods: An analysis of medical records was performed retrospectively on 75 patients who received extracorporeal shock wave therapy(ESWT) between June 2021 and July 2023, all patients affected by ONFH. These patients underwent MRI before treatment, 3 months, and 1 year after treatment to measure their volume; their Harris and VAS were recorded at the corresponding time points. Correlation analysis and regression analysis were performed to examine the correlation between necrotic volume and Harris, VAS before treatment and the correlation between the change of necrotic volume size and the evolution of HHS 1 year after treatment. Results:A statistically significant correlation between the size of the necrotic volume and the Harris and VAS was demonstrated before treatment(P＜0.001). Three months after treatment, there were significant improvements in Harris and VAS(P＜0.001) but unchanged in MRI images. One year after treatment, the Harris, VAS, and size of necrotic volume from 13 patients were significantly improved(P＜0.001), and Linear regression analysis indicated a significant positive correlation between the size of the necrotic volume and clinical improvement(P＜0.001). Conclusion: The volume of osteonecrosis of the femoral head was negatively correlated with Harris and positively correlated with VAS. The reduction of necrotic volume was related to clinical improvement. It shows that the degree of pain is one of the critical references to reflect the size of necrosis and physiotherapists can choose interval between two cycles according to their own changes in pain conditions.

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Radiation exposure in computed tomography

Cited by 5 publications

References 20 publications

Pregnant women with COVID-19 ARDS on the intensive care unit

Pregnant women with COVID-19 ARDS on the intensive care unit

Value of vendor-agnostic deep learning image denoising in brain computed tomography: A multi-scanner study

Investigate an optimal extracorporeal shock wave therapy intervention strategy for osteonecrosis of femoral head : a retrospective analysis

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