Use of radiation dose index monitoring software in a multicenter environment for CT dose optimization

Riccardi, L.; Monte, Francesca De; Cretti, Fabiola; Pini, S.; Zucca, S.; Quattrocchi, M.; Origgi, Daniela; Vecchio, Antonella Del; Giordano, Carlo; Marini, Piergiorgio; Lisciandro, Francesco; Trevisiol, Edoardo; Zefiro, Daniele; Cutaia, C.; D’Ercole, Loredana; Gabusi, M.; Scaggion, A.; Paiusco, M.

doi:10.1007/s11547-018-0925-0

Cited by 9 publications

(6 citation statements)

References 13 publications

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“…In another study (36) the sensitivity for IPSS was 82% while it was 48% for the high dose dexamethasone test and 70% for the CRH test. When compared with other imaging modalities, IPSS showed a high accuracy: in a study performed on 54 patients (37) the accuracy of IPSS was 88% while the accuracy of MRI was 54%; in another study where 84 patients were enrolled, the sensitivity was 40% for CT (38,39), 50% for MRI and 90% for IPSS (40).The diagnostic accuracy of MRI in differentiating central and ectopic Cushing's syndrome was found to be 58% while the accuracy of IPSS was found to be 100% (35). Several studies showed, however, that the diagnostic accuracy is not absolute and both false-negatives (lack of a central/ peripheral gradient in patients with CD) and false positives (presence of a central/peripheral gradient in patients with ectopic ACTH secretion) occur.…”

Section: Inferior Petrosal Sinus Sampling and Its Rule In The Diagnostic Workupmentioning

confidence: 99%

Pituitary magnetic resonance imaging vs. bilateral inferior petrosal sinus sampling: comparison between non-invasive and invasive diagnostic techniques for Cushing’s disease—a narrative review

Tortora¹,

Negro²,

Briganti³

et al. 2020

Gland Surg

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Cushing's syndrome is a pathological clinical condition caused by an exposure of elevated cortisol levels over a long period of time. It is therefore essential to establish what the cause of hypercortisolism is.In most cases (about 80%) the pathological process is due to adrenocorticotropic hormone (ACTH), while in a minor part of the cases (about 20%) the cause is represented by a pathology of the adrenal glands and therefore not related to ACTH. Most patients with ACTH dependent Cushing's syndrome have a pituitary microadenoma; in the remaining cases (30%), the high level of cortisol is linked to an ectopic secretion of ACTH. Surgical removal of the pituitary adenoma represents the treatment of choice in Cushing's disease (CD) patients; it is therefore necessary to identify and precisely locate the pituitary tumour responsible for the secretion of ACTH. Adequate diagnostic information is very often, even with magnetic resonance imaging (MRI), and in these cases we rely on bilateral inferior petrosal sinuses sampling (BIPSS). This procedure is considered the gold standard method for the diagnosis, but like any other diagnostic method it is not free from erroneous results such as false positives or false negatives.

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Section: Inferior Petrosal Sinus Sampling and Its Rule In The Diagnostic Workupmentioning

confidence: 99%

Pituitary magnetic resonance imaging vs. bilateral inferior petrosal sinus sampling: comparison between non-invasive and invasive diagnostic techniques for Cushing’s disease—a narrative review

Tortora¹,

Negro²,

Briganti³

et al. 2020

Gland Surg

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“…Most DMS function from a server (physical, virtual or cloud-based) which is used for data capture, analyses, display of results, and distribution to other interfaced systems. With DMS, the data collection procedure is fully automated and it can be done in many ways using: OCR of the Dose Report images, analysis of the DICOM headers (both are useful mostly for older systems), DICOM-modality performed procedure step and analysis of the Radiation Dose Structured Report (RDSR) generated in all modern CT scanners [36,37]. Support for these RDSR objects appears in the DICOM Conformance Statement document of each CT scanner and other imaging modalities, which can be found on vendor websites [38].…”

Section: Dose Monitoring Systems: Operation Principlesmentioning

confidence: 99%

“…In a DMS the indices CTDI vol w/acq and DLP w/acq are calculated (where w/acq stands for weighted by acquisition), as the average values per acquisition for each examination. The metrics of each series are multiplied by the respective scan lengths and their sum is divided by the scan length sum [37]. In another DMS [78], a similar rationale is used for calculating scan length-weighted CTDI vol , sw SSDE sw surrogate metrics.…”

Section: Statistical Analysis and Reportsmentioning

confidence: 99%

“…For example in Italy, 13 centers having a common DMS (Radiation Dose Monitor, Medsquare, France), collected and analyzed data from 19 CT scanners. Feedback reports, were provided to each of these centers, regarding its performance, in terms of the CTDI vol , in comparison to the overall distributions and against other participants [37].…”

Section: Dose Monitoring Systems As Optimization Toolsmentioning

confidence: 99%

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Radiation dose monitoring in computed tomography: Status, options and limitations

et al. 2020

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In the last few years there has been an increasing interest on radiation dose to patients undergoing various diagnostic or therapeutic procedures with the use of ionizing radiation. Especially for CT examinations and interventional procedures, where it is known that patient doses are much higher than conventional radiography, new norms have been published that require to have appropriate radiation dose indices registered in the patient medical record. Because of these demands, dose monitoring has been recommended and adopted into many clinical practices as a routine procedure for every patient and every examination. Dedicated dose monitoring systems (DMS) that facilitate data collection and processing, statistical comparisons, reporting and management of radiation dose related information have been devised and are being used worldwide. In this review paper, a brief flashback to the reasons that necessitated dose monitoring in radiology will be first presented. Furthermore, since the focus of this manuscript is on CT, the CT dosimetry principles and metrics will be summarized. The limitations of these metrics will be also discussed, so that DMS users are aware of the semantics of the parameters shown in the DMS reports. The operation of DMS systems will be outlined to make users aware of functions, limitations, and available options of DMS systems. Furthermore, the usefulness of DMS systems as an optimization tool will be presented and discussed. Finally, information about the DMS solutions available in the market and relevant links will be presented.

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“…CT is also useful in the classification of parotid gland lesions into benign and malignant tumors but the results were often inconsistent. CT's sensitivity and specificity are low in the post-treatment surveillance (79) and the major limit is represented by the radiation exposure (80)(81)(82)(83).…”

Section: Ctmentioning

confidence: 99%

Narrative review of multiparametric ultrasound in parotid gland evaluation

Martino¹,

Fodor²,

Fresilli³

et al. 2020

Gland Surg

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Disorders affecting parotid gland represent a heterogeneous group comprising congenital, inflammatory and neoplastic diseases which show a focal or diffuse pattern of appearance. The differentiation of neoplastic from non-neoplastic conditions of parotid glands is pivotal for the diagnostic imaging. Frequently there is evidence of overlapping between the clinical and the imaging appearance of the various pathologies. The parotid gland is also often object of study with the combination of different techniques [ultrasound-computed tomography-magnetic resonance imaging (US-CT-MRI), ex.]. Compared to other dominant methods of medical imaging, US has several advantages providing images in real-time at lower cost, and without harmful use of ionizing radiation and of contrast enhancement. B-mode US, and the microvascular pattern color Doppler are usually used as first step evaluation of parotid lesions. Elastography and contrast-enhanced US (CEUS) has opened further possible perspectives to improve the differentiationbetween benign and malignant parotid lesions. The characterization of the parotid tumors plays a crucial role for their treatment planning and for the prediction of possible surgical complications. We present, here an updated review of the most recurrent pathologies of parotid gland focusing on the diagnostic power of multiparametric US including CEUS and ultrasound elastography (USE); limitations, advantages and the main key-points will be presented

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Use of radiation dose index monitoring software in a multicenter environment for CT dose optimization

Cited by 9 publications

References 13 publications

Pituitary magnetic resonance imaging vs. bilateral inferior petrosal sinus sampling: comparison between non-invasive and invasive diagnostic techniques for Cushing’s disease—a narrative review

Pituitary magnetic resonance imaging vs. bilateral inferior petrosal sinus sampling: comparison between non-invasive and invasive diagnostic techniques for Cushing’s disease—a narrative review

Radiation dose monitoring in computed tomography: Status, options and limitations

Narrative review of multiparametric ultrasound in parotid gland evaluation

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