Computed Tomography Radiation Dose Research Articles

New-Generation ASiR-V for Dose Reduction While Maintaining Image Quality in CT: A Phantom Study

Over the last few decades, the need to reduce and optimize patient medical radiation exposure has prompted the introduction of novel reconstruction algorithms in computed tomography (CT). Against this backdrop, the present study aimed to assess whether reduced radiation dose CT images reconstructed with the new-generation adaptive statistical iterative reconstruction (ASiR-V) maintain the same image quality as that of routine image reconstruction. In addition, the optimization of image quality parameters for the ASiR-V algorithm (e.g., an optimal combination of blending percentage and noise index (NI)) was investigated. An abdominal reference phantom was imaged using the routine clinical protocol (fixed noise index of 18 and 40% ASiR reconstruction). Reduced radiation dose CT scans were performed with varying NI (22, 24, and 30) and using the ASiR-V reconstruction algorithm. Quantitative and qualitative analyses of image noise, contrast, and resolution were performed against NI and reconstruction blending percentages. Our results confirm the ability of the ASiR-V algorithm to provide images of high diagnostic quality while reducing the patient dose. All the parameters were improved in ASiR-V images as compared to ASiR. Both quantitative and qualitative analyses showed that the best agreement was obtained for the images reconstructed using ASiR-V with NI24 and a high percentage of blending (70–100%). This preliminary study results show that ASiR-V allows for a significant reduction in patient dose (about 40%) while maintaining a good overall image quality when appropriate NI (i.e., 24) is used.

EVALUATION OF RADIATION DOSE IN MULTI-SLICE COMPUTED TOMOGRAPHY PROTOCOLS OF HEAD AND NECK REGIONS.

In head and neck computed tomography (CT) imaging, the optimisation of radiation dose is crucial due to the presence of radio-sensitive organs. This study aimed to evaluate the radiation dose in multi-slice CT for head and neck examinations. Volume CT dose index, dose length product and effective dose (E) were assessed for 10 head and neck CT scans performed on 292 adult patients (mean age 49.2±15.9y). The study resulted in median E values of 0.82, 1.62, 2.43, 0.93, 1.70, 0.83, 3.55, 6.25, 2.19 and 5.26mSv, respectively, for sinuses (non-contrast (NC)), sinuses (NC) and contrast-enhanced (CE), petrous bone (PTB)/internal auditory meatus (IAM) (NC+CE), PTB/IAM (NC), orbit (NC+CE), orbit (NC), brain with the orbit (NC), brain CT angiography (CTA) subtraction, neck (NC) and brain/neck (NC). Furthermore, the overall radiation doses of this institution were found to be below the values suggested by similar studies. However, optimisation of the dose is required for brain CTA.

Validation of a New Scintillating Fiber Dosimeter for Radiation Dose Quality Control in Computed Tomography.

(1) Background: The IVIscan is a commercially available scintillating fiber detector designed for quality assurance and in vivo dosimetry in computed tomography (CT). In this work, we investigated the performance of the IVIscan scintillator and associated method in a wide range of beam width from three CT manufacturers and compared it to a CT chamber designed for Computed Tomography Dose Index (CTDI) measurements. (2) Methods: We measured weighted CTDI (CTDIw) with each detector in accordance with the requirements of regulatory tests and international recommendations for the minimum, maximum and the most used beam width in clinic and investigated the accuracy of the IVIscan system based on the assessment of the CTDIw deviation from the CT chamber. We also investigated the IVIscan accuracy for the whole range of the CT scans kV. (3) Results: We found excellent agreement between the IVIscan scintillator and the CT chamber for the whole range of beam widths and kV, especially for wide beams used on recent technology of CT scans. (4) Conclusions: These findings highlight that the IVIscan scintillator is a relevant detector for CT radiation dose assessments, and the method associated with calculating the CTDIw saves a significant amount of time and effort when performing tests, especially with regard to new CT technologies.

An Innovative Low-dose CT Inpainting Algorithm based on Limited-angle Imaging Inpainting Model.

With the popularity of computed tomography (CT) technique, an increasing number of patients are receiving CT scans. Simultaneously, the public's attention to CT radiation dose is also increasing. How to obtain CT images suitable for clinical diagnosis while reducing the radiation dose has become the focus of researchers. To demonstrate that limited-angle CT imaging technique can be used to acquire lower dose CT images, we propose a generative adversarial network-based image inpainting model-Low-dose imaging and Limited-angle imaging inpainting Model (LDLAIM), this method can effectively restore low-dose CT images with limited-angle imaging, which verifies that limited-angle CT imaging technique can be used to acquire low-dose CT images. In this work, we used three datasets, including chest and abdomen dataset, head dataset and phantom dataset. They are used to synthesize low-dose and limited-angle CT images for network training. During training stage, we divide each dataset into training set, validation set and testing set according to the ratio of 8:1:1, and use the validation set to validate after finishing an epoch training, and use the testing set to test after finishing all the training. The proposed method is based on generative adversarial networks(GANs), which consists of a generator and a discriminator. The generator consists of residual blocks and encoder-decoder, and uses skip connection. We use SSIM, PSNR and RMSE to evaluate the performance of the proposed method. In the chest and abdomen dataset, the mean SSIM, PSNR and RMSE of the testing set are 0.984, 35.385 and 0.017, respectively. In the head dataset, the mean SSIM, PSNR and RMSE of the testing set are 0.981, 38.664 and 0.011, respectively. In the phantom dataset, the mean SSIM, PSNR and RMSE of the testing set are 0.977, 33.468 and 0.022, respectively. By comparing the experimental results of other algorithms in these three datasets, it can be found that the proposed method is superior to other algorithms in these indicators. Meanwhile, the proposed method also achieved the highest score in the subjective quality score. Experimental results show that the proposed method can effectively restore CT images when both low-dose CT imaging techniques and limited-angle CT imaging techniques are used simultaneously. This work proves that the limited-angle CT imaging technique can be used to reduce the CT radiation dose, and also provides a new idea for the research of low-dose CT imaging.

Estimation of radiation dose associated with bone SPECT/CT and establishing local diagnostic reference levels using size-specific dose estimate

Single-photon emission computed tomography (SPECT) and X-ray computed tomography (CT) is used to diagnose and monitor the skeletal system. However, due to the combination of injected activity and CT radiation dose, its usage is linked to an increase in patient radiation exposure. This study aims to estimate the radiation dose received by patients while undergoing bone SPECT/CT and to establish its local diagnostic reference level (LDRL). In this retrospective study, data from 30 patients who had undergone bone scans were obtained from two hospital imaging devices. The effective doses (E) of the radiopharmaceutical agent and CT components were calculated. Furthermore, the patients' anteroposterior thickness at the midline and lateral widths were measured from their CT images to determine the size-specific dose estimate (SSDE). The mean age of the patients was 53.53 ± 16 years. They were administered an injection activity of 740 MBq of 99mTc-Methyl diphosphonate for SPECT, yielding an E of 2.78 mSv. The mean CTDIvol, DLP, SSDE, and E values for the CT component were 8.76 ± 3.25 mGy, 350 ± 138 mGy cm, 13 ± 4 mGy, and 4.90 ± 1.94 mSv, respectively. Patients received a combined dose of 7.68 mSv from the radiopharmaceuticals and CT. The proposed LDRL for SPECT was comparable to international DRLs, but the CT LDRL was slightly higher. An SSDE-based LDRL is proposed. Moreover, the overall patient dose can be reduced even further by optimizing the injected activity and CT imaging factors.

COMPARISON OF THE 64- AND 80-DETECTOR ROW COMPUTED TOMOGRAPHY AMONG THE CT NUMBER AND RADIATION DOSE DURING LOWER EXTREMITY COMPUTED TOMOGRAPHY ANGIOGRAPHY.

To compare the computed tomography (CT) number and the radiation dose between the 64 (group A) and 80-detector row (group B) during lower extremity computed tomography angiography (LE-CTA). We enrolled 144 patients underwent LE-CTA and compared the CT number for the popliteal arteries, radiation dose and the rate of the optimal CT number during the LE-CTA exceeding 200 HU between the two groups. The CT number for the popliteal arteries and mean dose-length product was significantly higher in Group A than in Group B (P<0.01). The rate of the optimal CT number for the popliteal arteries was 23.6% with Group B scanner and 56.9% with Group A (P<0.05). The 64-detector row CT was significantly higher in the CT number for the popliteal arteries, radiation dose and rate of the optimal CT number during the LE-CTA than the 80-detector row. Depiction ability did not improve by using a high CT scanner with a wider detector during LE-CTA.

Substantiation of a new approach to the criteria for assessing the radiation dose of patients during computed tomography

BACKGROUND: In accordance with the requirements of the IAEA basic safety standards and the International Commission on Radiation Protection, comparing the radiation dose for patients undergoing computed tomography (CT) in diagnostic and treatment clinics with national or international DRLs is important for controlling medical radiation doses. The search for ways to improve DRLs calculations determines the relevance of such studies.&#x0D; AIM: To analyze the dependence of effective doses (EDs) in CT of different body parts on patients weight and to calculate the standard ED for the patient (70 and 80 kg).&#x0D; MATERIALS AND METHODS: CT acquisition protocols in 209 patients were single phase (SP) CT, while 114 patients underwent multi-phase (MP) CT. ED was calculated according to the normalized coefficients for each body area. The values of standard ED was calculated by data approximation using linear function of ED relatively body weight for each type CT scanner and body area scanned.&#x0D; RESULTS: The increase in ED following a CT examination was proportional to the body weight of patients. For SP and MP CT scans, the standard EDs were calculated according to all body areas. The mean ED, median ED, and DRLs (mSv) in these groups was slightly higher than standard ED (mSv) if the criterion was 70 kg and were close to standard ED if the criterion was 80 kg. These values give a basis for improving the guidelines concerning the recommended limits of radiation doses for CT in individual patients according to indications and body parts studied.&#x0D; CONCLUSIONS: In the study, a methodology for assessing and comparing the dose of CT-radiation at two hospitals in the two CT scanners, considering weight of a standard patient, is described. Our results show that the calculation and analysis of the standard ED of CT-examining areas of the body instead of mean ED and median ED help to compare the radiation exposure in different medical facilities more properly. Given the recent sharp increase in the number of CT studies, not exceeding the standard ED for patients with CT will reduce the long-term consequences in the form of oncological pathology among the population.

The use of artificial intelligence and deep learning reconstruction in urological computed tomography: Dose reduction at ghost level

Abstract Objective: The objective of the study is to demonstrate that with the use of artificial intelligence (AI) in computed tomography (CT), radiation doses of CT kidney-ureter-bladder (KUB) and CT urogram (CTU) can be reduced to less than that of X-ray KUB and CT KUB, respectively, while maintaining the good image quality. Materials and Methods: We reviewed all CT KUBs (n = 121) performed in September 2019 and all CTUs (n = 74) performed in December 2019 at our institution. The dose length product (DLP) of all CT KUBs and each individual phase of CTU were recorded. DLP of each scan done with new scanner (Canon Aquilion One Genesis with AiCE [CAOG]) which uses AI and deep learning reconstruction (DLR) were compared against traditional non-AI scanner (GE OPTIMA 660 [GEO-660]). We also compared DLPs of both scanners against the United Kingdom, National Diagnostic Reference Levels (NDRL) for CT. Results: One hundred and twenty-one patient’s CT KUBs and 74 patient’s CTUs were reviewed. For CT KUB group, the mean DLP of 81/121 scans done using AI/DLR scanner (CAOG) was 77.8 mGy cm (1.16 mSv), while the mean DLP of 40/121 CT KUB done with GEO-660 was 317.1 mGy cm (4.75 mSv). For CTU group, the mean DLP for 46/74 scans done using AI/DLR scanner (CAOG) was 401.9 mGy cm (6 mSv), compared to mean DLP of 1352.6 mGy cm (20.2 mSv) from GEO-660. Conclusion: We propose that CT scanners using AI/DLR method have the potential of reducing radiation doses of CT KUB and CTU to such an extent that it heralds the extinction of plain film XR KUB for follow-up of urinary tract stones. To the best of our knowledge, this is the first study comparing CT KUB and CTU doses from new scanners utilizing AI/DLR technology with traditional scanners using hybrid iterative reconstruction technology. Moreover, we have shown that this technology can markedly reduce the cumulative radiation burden in all urological patients undergoing CT examinations, whether this is CT KUB or CTU.

CT Image Quality Assessment by a Channelized Hotelling Observer: Optimization of Adaptive Statistical Iterative Reconstruction for Radiation Dose Reduction and Improving Image Quality of Pediatric Abdominal CT Scan

Background: Iterative reconstruction (IR) techniques have tried to reduce the radiation dose of computed tomography (CT) scans while maintaining the image quality. One of the IR techniques is the adaptive statistical iterative reconstruction (ASIR). Increasing the amount of ASIR in image reconstruction can lead to the emergence of artifacts and reduce the ability to detect objects with low contrast. Objective: This study aimed to optimize the ASIR technique to reduce the radiation dose and increase image quality in pediatric abdominal CT. Methods: This is a phantom study performed using variable tube current (40,100,140 and 200mA) and ASIR level (ASIR 10% to ASIR 100%). Various criteria including noise, high-contrast spatial resolution, and Channelized Hotelling observer’s model were used to compare image quality at different captured levels. In this study CHO model was used for low contrast detectability. Results: The result was quit promising in the term of CHO’s used for mentioned purposes. The noise of reconstructed images with 30% ASIR and higher levels had a significant difference compared to the reconstructed images by the Filter Back Projection (FBP) method (P &lt; 0.05). The spatial resolution of the images with tube currents of 140, 100, and 40 mA reconstructed with 30, 50, and 80% levels of ASIR technique was equal to 0.8 ± 0.144 pairs of lines per millimeter. The amount of the spatial resolution of images obtained with standard radiation dose and reconstructed by FBP method was 1 pair of lines per mm (p&gt; 0.05). Conclusion: Based on the results of this study, using 50% ASIR for the pediatric population can reduce the radiation dose on abdominal and pelvic CT scans by 50% while maintaining image quality. Furthermore using ASIR 50% only for the reconstruction of abdominal and pelvic images in children at standard radiation dose leads to optimal image quality.

Paediatric Computed Tomography Radiation Dose Optimization Strategies– A Single Centre Experience

Paediatric Computed Tomography Radiation Dose Optimization Strategies– A Single Centre Experience

A Pediatric Cervical Spine Clearance Guideline Leads to Fewer Unnecessary Computed Tomography Scans and Decreased Radiation Exposure.

Physical examination and computed tomography (CT) are useful to rule out cervical spine injury (CSI). Computed tomography scans increase lifetime cancer risk in children from radiation exposure. Most CSI in children occur between the occiput and C4. We developed a cervical spine (C-spine) clearance guideline to reduce unnecessary CTs and radiation exposure in pediatric trauma patients. A pediatric C-spine clearance guideline was implemented in September 2018 at our Level 2 Pediatric Trauma Center. Guidance included CT of C1 to C4 to scan only high-yield regions versus the entire C-spine and decrease radiation dose. A retrospective cohort study was conducted comparing preguideline and postguideline of all pediatric trauma patients younger than 8 years screened for CSI from July 2017 to December 2020. Primary endpoints included the following: number of full C-spine and C1 to C4 CT scans and radiation dose. Secondary endpoints were CSI rate and missed CSI. Results were compared using χ 2 and Wilcoxon rank-sum test with P < 0.05 significant. The review identified 726 patients: 273 preguideline and 453 postguideline. A similar rate of total C-spine CTs were done in both groups (23.1% vs 23.4%, P = 0.92). Full C-spine CTs were more common preguideline (22.7% vs 11.9%, P < 0.001), whereas C1 to C4 CT scans were more common post-guideline (11.5% vs 0.4%, P < 0.001). Magnetic resonance imaging utilization and CSIs identified were similar in both groups. The average radiation dose was lower postguideline (114 vs 265 mGy·cm -1 ; P < 0.001). There were no missed CSI. A pediatric C-spine clearance guideline led to increasing CT of C1 to C4 over full C-spine imaging, reducing the radiation dose in children. Level IV, therapeutic.

Assessment of Adult's Abdominopelvic Computed Tomography Radiation Doses in Amhara Region, Ethiopia.

Computed Tomography plays a priceless role for diagnostic and therapeutic purpose; however, applying an optimized Computed Tomography Technique to produce qualified image while delivering minimum radiation dose to patients is the common challenge. The main objective of this study was to establish local diagnostic reference levels for adult patients who visited abdominopelvic Computed Tomography examination. A total of 158 patients who had taken abdominopelvic Computed Tomography examination from three selectedAmhara region hospitals were investigated. Both prospective and retrospective techniques of data collection were used while collecting the data in the entire sample. Two GE - Optima Computed Tomography 540 (16 slices) and one Phillips - Brilliance (64slices), were employed during data collections. Data for patient demographics scan protocols, Computed Tomography dose descriptors and machine specifications were collected and analyzed by using SPSS software version 26. The third quartile estimated computed tomography dose index volume and dose length product, which is the local Diagnostic Reference Levels, were 12 mGy and 1904 cm.mGy respectively. The investigated local Diagnostic Reference Levels of Computed Tomography Dose index volume (mGy) was comparable to other international Diagnostic Reference Levels. However, the third quartile value of dose length product (cm.mGy) was higher than other reported international Diagnostic Reference Levels. The values of local Diagnostic Reference Levels presented in this work can be used as a baseline upon which future dose measurements can be compared in Amhara region.

Sample Size and Estimation of Standard Radiation Doses for Pediatric Brain CT.

Estimation of the standard radiation dose at each imaging facility is required for radiation dose management, including establishment and utilization of the diagnostic reference levels. We investigated methods to estimate the standard dose for pediatric brain computed tomography (CT) using a small number of data. From 980 pediatric brain CT examinations, 25, 50, and 100 examinations were randomly extracted to create small, medium, and large datasets, respectively. The standard dose was estimated by applying grouping and curve-fitting methods for 20 datasets of each sample size. For the grouping method, data were divided into groups according to age or body weight, and the standard dose was defined as a median value in each group. For the curve-fitting methods, logarithmic, power, and bilinear functions were fitted to plots of radiation dose against age or weight, and the standard dose was calculated at the designated age or weight using the derived equation. When the sample size was smaller, the random variations of the estimated standard dose were larger. Better estimation of the standard dose was achieved with the curve-fitting methods than with the grouping method. Power fitting appeared to be more effective than logarithmic and bilinear fittings for suppressing random variation. Determination of the standard dose for pediatric brain CT by the curve-fitting method is recommended to improve radiation dose optimization at facilities performing the imaging procedure infrequently.

Low-dose abdominopelvic computed tomography in patients with lymphoma: An image quality and radiation dose reduction study.

This study aimed to evaluate image quality, the detection rate of enlarged lymph nodes, and radiation dose exposure of ultralow-dose and low-dose abdominopelvic computed tomography (CT) in patients with lymphoma. Patients with lymphoma who underwent abdominopelvic CT using dual-source scanner were retrospectively recruited from a single center. CT images were obtained at 90 kVp dual-source mode reformatted in three data sets using the advanced modelled iterative reconstruction algorithm: 100% (standard-dose CT), 66.7% (low-dose CT), and 33.3% (ultralow-dose CT). Two radiologists analyzed subjective image quality and detection of abdominal enlarged lymph nodes on ultralow-dose, low-dose, and standard-dose CT blindly and independently. The results were compared with reference standards. Three readers (two radiologists and one hematologist) reviewed overall image quality and spleen size. In total, 128 consecutive CT scans (77 complete response, 44 partial response, 6 progressive disease, and 1 initial evaluation) from 86 patients (64 B-cell lymphoma, 14 T/NK-cell lymphoma, and 8 Hodgkin’s lymphoma cases) were assessed. The enlarged lymph node-based detection rates for two readers were 97.0% (96/99) and 94.0% (93/99) on standard-dose CT, 97.0% (96/99) and 94.0% (93/99) on low-dose CT, and 94.0% (93/99) and 89.9% (89/99) on ultralow-dose CT. Overall image quality was 3.8 ± 0.5, 3.9 ± 0.5, and 4.1 ± 0.5 on ultralow-dose CT; 4.7 ± 0.4, 4.6 ± 0.5, and 4.8 ± 0.3 on low-dose CT; and 4.8 ± 0.4, 4.7 ± 0.4, and 4.9 ± 0.2 on standard-dose CT, according to two radiologists and one hematologist, respectively. Intraclass correlation coefficients of spleen size were 0.90 (95% confidence interval [CI], 0.87–0.93), 0.91 (95% CI, 0.88–0.93), and 0.91 (95% CI, 0.88–0.93) on ultralow-dose, low-dose, and standard-dose CT, respectively. Mean effective radiation doses of standard-dose, low-dose, and ultralow-dose CT were 5.7 ±1.8 mSv, 3.8 ± 1.2 mSv, and 1.9 ± 0.6 mSv, respectively. Our findings suggest that ultralow-dose and low-dose CT, even with radiation doses reduced by 66.7% and 33.3%, respectively, maintained adequate image quality. These imaging modalities may be employed for follow-up lymphoma evaluation in consideration of the long surveillance periods.

The impact of ASiR-V on abdominal CT radiation dose and image quality – A phantom study

IntroductionTo investigate how ASiR-V and kVp changes in Computed tomography (CT) affect radiation dose and image quality, when using automatic tube current modulation (ATCM) for different sized phantoms. MethodsA liver-phantom with two different liver inserts (QRM, Moehrendorf, Germany), with extension rings, representing fat, were additionally applied to the phantom to simulate patients of different sizes (small: 30cm diameter, medium: 35cm and large: 40cm). Abdominal scans were performed on a 256 slice CT scanner (GE Healthcare, Milwaukee, WI, USA), with consistent pitch (0.992), rotation time (0.5s), slice thickness (0.625mm) and collimation (80mm), while other parameters were varied (kVp: 80/100/120/140; Noise Index: 13/22; mA interval 80-720, ASiR-V: 30/60/100%). CTDI and DLP was recorded for each scan and image quality was assessed using objective metrics in predefined anatomic areas (HU and noise). Radiation dose and image quality metrics were compared between protocols. ResultsCTDI decreased by 80% from ASIR-V 30% to ASiR-V 100% for prescribed NI 13, and by 79% for the prescribed NI of 22. For 100% ASiR-V and a prescribed NI of 22 the CTDI remained the same regardless of phantom size for the different kVp settings. Pairwise comparison revealed significant differences in CTDI (p < 0.0001) for all combinations of prescribed NI and ASIR-V levels, except the difference between ASIR-V levels of 30 and 60%, with a prescribed NI of 13 (p = 0.124).When data from the three phantom sizes were combined, increasing ASIR-V from 30-100%, resulted in noise decreases of 22% for NI of 13 and by 8% for NI of 22. Notably, image quality in the low contrast area of the liver insert was impaired when the large phantom was scanned with 100% ASiR-V and either 80/100kVp (NI 22), because of the large reduction in tube current applied (down to 80 mA). ConclusionSubstantial radiation dose reductions (up to 80%) resulted from increasing ASiR-V levels. However, image quality deteriorates when 100% ASiR-V is applied due to low applied tube current by the ATCM.

Development and verification of a novel system for computed tomography scanner model construction in Monte Carlo simulations

The accuracy of Monte Carlo (MC) simulations in estimating the computed tomography radiation dose is highly dependent on the accuracy of CT scanner model. A system was developed to observe the 3D model intuitively and to calculate the X-ray energy spectrum and the bowtie (BT) filter model more accurately in Monte Carlo N-particle (MCNP). Labview's built-in Open Graphics Library (OpenGL) was used to display basic surfaces, and constructive solid geometry (CSG) method was used to realize Boolean operations. The energy spectrum was calculated by simulating the process of electronic shooting and the BT filter model was accurately modeled based on the calculated shape curve. Physical data from a study was used as an example to illustrate the accuracy of the constructed model. RMSE between the simulation and the measurement results were 0.97% and 0.74% for two filters of different shapes. It can be seen from the comparison results that to obtain an accurate CT scanner model, physical measurements should be taken as the standard. The energy spectrum library should be established based on Monte Carlo simulations with modifiable input files. It is necessary to use the three-segment splicing modeling method to construct the bowtie filter model.

Computed Dosimeter Dose Index on a 16-Slice Computed Tomography Scanner.

A computed tomography dose index can be used to quantify the radiation dose received during a CT scan and it is an indicator of the radiation dose to the polymetaylenmetaAcrylate (PMMA) standardized phantom. The objective of this study was 2-fold. The first was to measure the computed tomography (CT) radiation dose for the head and body polymetaylelenmetaAcrylate (PMMA) phantoms and to determine the accuracy of the CT radiation dose parameter displayed on the CT scanner console; these were measured in this investigation and compared with the dose displayed on the CT scanner console. The dose was calculated using the formalism described in the American Association of Physics in Medicine (AAPM) Report 96. The second was to compare the dosimetric results of the head and body polymetaylelenmetaAcrylate (PMMA) phantoms with dose reference levels published in international journals, as well as to measure the central cumulative dose (DL′ (0)), as recommended by the American Association of Physics in Medicine (AAPM) report 111. This is a new, cutting-edge methodology for estimating the CT radiation dosage provided by the abdomen, thorax, and head of a PMMA phantom. We used a Philips Big Bore CT scanner with 16 slices. A CT dosimeter head phantom with a diameter of 16 cm, a CT dosimeter body phantom with a diameter of 32 cm, a 100 mm pencil chamber (PC), and a 20 mm short chamber (SC) were employed. These were coupled to an electrometer and a dosimetric readout device. The measured volume computed tomography dose index (CTDIvol) values were in good agreement with the CT radiation dose displayed on the corresponding CT scanner console. The percentage disagreement was less than 10%, with a maximal difference of 1.7% and 5.5% for the body and head phantom, respectively. The central cumulative dose (DL (0)) measurements (for L′ = 100 mm) also matched nominal or the corresponding computed tomography dose index (CT) scanner console volume computed tomography dose index (CTDIvol) values. In this case, the agreement is always below 3% for abdomen scans and 1.0% for head examinations. This result implies that the radiation dose supplied by the 16-slice computed tomography (CT) system was in good agreement with the international dose reference level and we observed something different.

A STUDY OF URINARY TRACT ABNORMALITIES: ROLE OF LOW DOSE MDCT UROGRAPHY

Introduction: Computed Tomography (CT) urography is more accurate in detection of renal masses, urinary tract tumors, inflammatory lesion, calculi and other causes of urinary tract obstruction compared with intravenous urography. The standard single bolus MDCT Urography protocol comprises three to four phases, consists of non-contrast, corticomedullary, nephrographic and excretory phases. A major disadvantage is a high radiation dose, which is 8-10 times higher than an IVP examination. In comparison, an split-bolus, dual-phase technique scans the urinary system in the non-contrast and combined nephrographic-excretory phases. This study aimed to compare the total CT radiation dose of patient and image quality in standard MDCTU protocol and low dose MDCTU protocol. Methodology: In this hospital based prospective study total 100 patients (50 tests and 50 controls) were compared for radiation dose and subjective image quality assessment between standard dose MDCTU protocol [non contrast scan at 120kvp , followed by contrast enhanced corticomedullary phase and excretory phase] and low dose MDCTU protocol (non contrast scan (at 80 kvp), followed by contrast enhanced synchronus corticomedullary phase and excretory phase acquisition by using split bolus contrast administration technique) . Result: In the standard dose MDCTU protocol in unenhanced and enhanced phase, patients received mean net effective dose of 18.83 mSv and in the low dose protocol, patients received mean net effective dose of 9.06 mSv with significant 52% dose reduction (P value &lt;0.001). In Standard dose protocol in unenhanced phase, optimal resolution in 82% patients, moderately grainy/poor resolution in 14% and significantly grainy/very poor resolution in 4% patients. In low dose protocol, optimal resolution in 64% patients, mild to moderately grainy/poor resolution in 22% and significantly grainy/very poor resolution in 14% patients with no significant difference in image quality in both protocol (P value&gt;0.05). In low dose protocol, mild to moderately grainy/poor resolution images (22%) of unenhanced phase reviewed together with normal dose good qualitysynchronus corticomedullary and excretory phase images to diagnosis the almost same spectrum of pathology like standard dose protocol. Conclusion: In low dose MDCT Urography radiation dose reduction of approx 50% is possible with no significant difference in image quality in line to ALARA principle (As low as reasonably achievable), facilitating diagnosis of urological pathologies.

Factors affecting dose-length product of computed tomography component in whole-body positron emission tomography/computed tomography

In whole-body positron emission tomography (PET)/computed tomography (CT), it is important to optimise the CT radiation dose. We have investigated factors affecting the dose-length product (DLP) of the CT component of whole-body PET/CT and derived equations to predict the DLP. In this retrospective study, 1596 whole-body oncology PET/CT examinations with 18F-fluorodeoxyglucose were analysed. Automatic exposure control was used to modulate radiation dose in CT. Considering age, weight, sex, arm position (up, down, one arm up), scan range (up to the mid-thigh or feet), scan mode (spiral or respiratory-triggered nonspiral) and the presence of a metal prosthesis as potential factors, multivariate analysis was performed to identify independent predictors of DLP and to determine equations to predict DLP. DLP values were predicted using the obtained equations, and compared with actual values. Among body size indices, weight best correlated with DLP in examinations performed under the standard imaging conditions (arms: up; scan range: up to the mid-thigh; scan mode: spiral; and no metal prosthesis). Multivariate analysis indicated that weight, arm position, scan range and scan mode were substantial independent predictors; lowering the arms, extending the scan range and using respiratory-triggered imaging, as well as increasing weight, increased DLP. The degree of the DLP increase tended to increase with increasing weight. The DLP values were predicted using equations that considered these parameters were in excellent agreement with the actual values. The DLP for the CT component of whole-body PET/CT is affected by weight, arm position, scan range and scan mode, and can be predicted with excellent accuracy using these factors.

Pulmonary CT scans of white rabbits using the selective photon shield technique of the third-generation dual-source CT

This study aims to optimise the protocol for the low-dose pulmonary computed tomography (CT) scanning of infants by studying the effects of the selective photon shield (SPS) technique of the third-generation dual-source CT (DSCT) on the image quality and radiation dose of a chest CT in white rabbits under different tube currents. Twelve white rabbits of a similar weight to an infant were selected and randomly divided into an experimental group and a control group. The experimental groups (A1–A5) were scanned at low dose by the third-generation DSCT using SPS under different tube current × time (60, 50, 40, 30, and 20 mAs). The control group (B) was scanned under a conventional tube voltage (100 kV) and current × time (20 mAs). Advanced model iterative reconstruction at strength three was used for the objective and subjective evaluation of the image quality and radiation dose of the lung and mediastinal windows. With the standard deviation of the air in the trachea as image noise, the signal-to-noise ratio (SNR), contrast-to-noise ratio, and CT values of each site were evaluated. Radiation doses were compared using the volume CT dose index, dose length product, and effective dose. The differences in subjective image quality between groups A2 and B were not statistically significant (P = 0.34). The differences in the SNRs of the lung and mediastinal windows between groups A2 and B were not statistically significant (P > 0.05). The radiation dose of group A2 was 83.2% lower than that of group B. The SPS of the third-generation DSCT under 50 mAs might be applied in the pulmonary CT examination of infants.