Image Radiation Dose Research Articles

Clinical Low-Dose Photon-Counting CT for the Detection of Urolithiasis: Radiation Dose Reduction Is Possible without Compromising Image Quality.

Background: This study evaluated the feasibility of reducing the radiation dose in abdominal imaging of urolithiasis with a clinical photon-counting CT (PCCT) by gradually lowering the image quality level (IQL) without compromising the image quality and diagnostic value. Methods: Ninety-eight PCCT examinations using either IQL70 (n = 31), IQL60 (n = 31) or IQL50 (n = 36) were retrospectively included. Parameters for the radiation dose and the quantitative image quality were analyzed. Qualitative image quality, presence of urolithiasis and diagnostic confidence were rated. Results: Lowering the IQL from 70 to 50 led to a significant decrease (22.8%) in the size-specific dose estimate (SSDE, IQL70 4.57 ± 0.84 mGy, IQL50 3.53 ± 0.70 mGy, p < 0.001). Simultaneously, lowering the IQL led to a minimal deterioration of the quantitative quality, e.g., image noise increased from 9.13 ± 1.99 (IQL70) to 9.91 ± 1.77 (IQL50, p = 0.248). Radiologists did not notice major changes in the image quality throughout the IQLs. Detection rates of urolithiasis (91.3-100%) did not differ markedly. Diagnostic confidence was high and not influenced by the IQL. Conclusions: Adjusting the PCCT scan protocol by lowering the IQL can significantly reduce the radiation dose without significant impairment of the image quality. The detection rate and diagnostic confidence are not impaired by using an ultra-low-dose PCCT scan protocol.

Factors Affecting Implementation of Radiological Protection Aspects of Imaging in Radiotherapy

Dramatic improvements in radiotherapy equipment have allowed radiation fields to be conformed to tumours for more accurate treatment. Successful delivery often requires imaging at every treatment fraction, a method known as image guided radiation therapy (IGRT). But increased X-ray imaging exposes patients to doses that carry risks of inducing second cancers in normal tissues. Therefore, reductions in high-dose treatment margins achieved with IGRT must be balanced against detriments from greater imaging doses. ICRP Task Group 116 has been set up to prepare guidance on radiological protection aspects of IGRT. Factors affecting the optimization of radiological protection are the modalities used, the frequency of imaging, the image acquisition parameters influencing image quality and radiation dose, and the volume of normal tissue included in the images. The Task Group has undertaken two projects: (1) a snapshot survey of radiotherapy imaging practices across six continents, which has shown that use of kV cone beam CT (CBCT) increases with Human Development Index for the country; and (2) a project looking at ways for measuring CBCT doses that could be applied more widely. The results highlight the need for raising awareness of imaging doses, and development of the dose quantities displayed on imaging equipment used in radiotherapy.

An assessment of the dose and image quality difference between AP and PA positioned adult radiographic knee examinations

IntroductionKnee X-rays are a standard examination to diagnose multiple conditions ranging from traumatic injuries, degeneration, and cancer. This study explores the differences between adult Anterior-Posterior (AP) and Posterior-Anterior (PA) weight-bearing knee examinations using absorbed radiation dose data and image quality. MethodsThe study modelled and compared AP and PA knee X-ray radiation dose data using Monte-Carlo software, an Ion Chamber, and thermoluminescence dosemeters (TLDs) on a Rando phantom. Imaging parameters used were 66kVp, 4mAs, 100cm distance and 13 × 24cm collimation. The interval data analysis used a two-tailed t-test. The image quality of a sample of the AP and PA knee X-rays was assessed using Likert 5-point ordinal Image Quality Scoring (IQS) and the Wilcoxon matched pairs test. ResultsMonte-Carlo modelling provided limited results; the Ion Chamber data for absorbed dose provided no variation between AP and PA positions but was similar to the AP TLD dose. The absorbed doses recorded with batches of TLDs demonstrated a 27.4% reduction (46.1μGy; p=0.01) in Skin Entrance Dose (ESD) and 9 - 58% dose reduction (1.6 – 16.4μGy; p=0.00-0.2) to the tissues and organs while maintaining diagnostic image quality (p=0.67). ConclusionThe study has highlighted the various challenges of using different dosimetry approaches to measure absorbed radiation dose in extremity (knee) X-ray imaging. The Monte-Carlo simulated absorbed knee dose was overestimated, but the simulated body organ/tissue doses were lower than the actual TLD absorbed doses. The Ion Chamber absorbed doses did not differentiate between the positions. The TLD organ/tissue absorbed doses demonstrated a reduction in dose in the PA position compared to the AP position, without a detrimental effect on image quality. The study findings in laboratory conditions raise awareness of opportunities and potential to lower radiation dose, with further study replicated in a clinical site recommended.

Assessment of the knowledge level of radiographers and CT technologists regarding computed tomography parameters in Iran

ObjectiveTo evaluate the knowledge of CT technologists and radiographers concerning CT parameters, in order to keep CT users be aware of all CT parameters and their impact on image quality and patient dose while keeping their knowledge up to date. MethodsThis cross-sectional descriptive-analytic study was conducted in Zanjan province, Iran, using a valid and reliable online questionnaire with 53 questions distributed to 153 radiology personnel. Each questionnaire included questions about demographic characteristics and CT parameters, including kVp, mAs, image noise, slice thickness, pitch and automatic tube current modulation (ATCM), and the effects of these parameters on image quality and radiation dose. ResultsA response rate of 61.0% (94/153) was achieved. This study enrolled 30 radiographers and 64 CT technologists. There was no significant difference in the mean scores of the two groups (52.16 ± 9.90 vs. 56.09 ± 12.00, t ​= ​−1.545, P ​= ​0.126). CT personnel had the highest and lowest knowledge scores in image reconstruction (t ​= ​−28.33, P ​= ​0.001) and mAs (t ​= ​4.27, P ​= ​0.590), respectively, whereas radiographers had the highest and lowest knowledge scores in the fields of image noise (t ​= ​9.85, P ​= ​0.015) and kVp (t ​= ​−12.73, P ​= ​0.007), respectively. ConclusionsThe total knowledge scores of CT technologists and radiographers for various scan parameters affecting image quality and dose were insufficient. Thus, it is recommended that regular retraining courses be held to enhance and update technologists’ knowledge.

Low dose pediatric chest computed tomography on a photon counting detector system – initial clinical experience

BackgroundWith the clinical release of a photon counting detector-based computed tomography (CT) system, the potential benefits of this new technology need to be evaluated clinically. Literature concerning this new generation of detector is sparse, especially in the field of pediatric radiology. Therefore, this study outlines our initial experience with ultra-low dose chest CT imaging on the new photon counting CT system.Materials and methodsA pediatric phantom (1-year old, CIRS ATOM phantom, model 704 [CIRS-computerized imaging reference system, Norfolk, VA]) was scanned at different dose levels and different image quality levels to define a protocol for clinical examinations. Next, 20 consecutive pediatric non-contrast ultra-low dose chest CT examinations were evaluated for radiation dose and diagnostic image quality using a 4-point Likert-scale—1 = excellent, 4 = bad image quality—by two radiologists in a consensus reading. This retrospective analysis was approved by the local research ethics committee.ResultsChest CT examinations performed at ultra-low radiation dose (effective dose 0.19 ± 0.07 mSv; size-specific dose estimate 0.45 ± 0.14 mGy) in pediatric patients ages (2.6 ± 1.8 years) show good to excellent image quality for lung structures (1.4 ± 0.4) and moderate image quality for soft tissue structures (2.8 ± 0.2).ConclusionPediatric ultra-low dose chest CT examinations are feasible with the new generation photon counting detector-based CT system. The benefits of this technology must be evaluated for pediatric patients from the outset.

A feasibility study of different GSI noise indexes and concentrations of contrast medium in hepatic CT angiography of overweight patients: image quality, radiation dose, and iodine intake.

To conduct a comparative study of image quality, radiation dose, and iodine intake in hepatic computed tomographic angiography (CTA) of overweight patients with different Gemstone Spectral Imaging (GSI) noise indexes combined with different concentrations of contrast medium. Ninety patients with a body mass index of ≥ 25kg/m2 were divided into three groups (A, B and C), each with 30 patients. The three groups underwent hepatic CTA with different NI of 7, 11 and 15, respectively, and were injected with different iodine concentrations of 370, 350 and 320mgI/mL, respectively. Five sets of images at 40-60keV (interval, 5keV) were reconstructed in each group. The CT value, image noise, contrast-to-noise ratio (CNR) and subjective score of the hepatic artery and vein, and portal vein in different monochromatic image sets were analyzed to select the optimal energy level in each group. The differences in CT value, image noise, CNR and a subjective score of hepatic artery and vein, portal vein in the optimal monochromatic images among the three groups were compared, the volume CT dose index (CTDIvol) and dose-length product (DLP) were recorded, and the effective dose and iodine intake were calculated. The 40keV was determined to be the optimal energy level for the monochromatic image sets in each group. No significant group differences were noted in the CT value, image noise, CNR, and subjective image scores of the hepatic artery and vein, and portal vein for the optimal monochromatic images (P > 0.05). Compared with group A, the effective dose and iodine intake in group B were reduced by 50.18% and 9.3%, and by 58.12% and 14.23% in group C, respectively. A low-concentration contrast medium combined with a high-noise GSI index in hepatic CTA of overweight patients can reduce the radiation dose and iodine intake while ensuring image quality.

ORIGIN, an EU project targeting real-time 3D dose imaging and source localization in brachytherapy: Commissioning and first results of a 16-sensor prototype

The ORIGIN project targets the production and qualification of a real-time radiation dose imaging and source localization system for both Low Dose Rate (LDR) and High Dose Rate (HDR) brachytherapy treatments, namely radiotherapy based on the use of radioactive sources implanted in the patient’s body. This goal will be achieved through a 16-fiber sensor system, engineered to house in a clear-fiber tip a small volume of the scintillator to allow point-like measurements of the delivered dose. Each fiber is optically coupled to a sensor with single photon sensitivity (Silicon Photomultipliers — SiPMs) operating in counting mode. The readout is based on the CITIROC1A ASIC by WEEROC, embedded in the FERS-DT5202 scalable platform designed by CAEN S.p.A. Linearity and sensitivity together with the fiber response uniformity, system stability, and measurement reproducibility are key features for a instrument aiming to perform dose measurements. Characterization was carried out in the laboratory, using an X-ray cabinet; preliminary dose rate measurements were performed in clinical conditions.

Impact of Photon-Counting Detector Computed Tomography on Image Quality and Radiation Dose in Patients With Multiple Myeloma.

Computed tomography (CT) is an established method for the diagnosis, staging, and treatment of multiple myeloma. Here, we investigated the potential of photon-counting detector computed tomography (PCD-CT) in terms of image quality, diagnostic confidence, and radiation dose compared with energy-integrating detector CT (EID-CT). In this prospective study, patients with known multiple myeloma underwent clinically indicated whole-body PCD-CT. The image quality of PCD-CT was assessed qualitatively by three independent radiologists for overall image quality, edge sharpness, image noise, lesion conspicuity, and diagnostic confidence using a 5-point Likert scale (5 = excellent), and quantitatively for signal homogeneity using the coefficient of variation (CV) of Hounsfield Units (HU) values and modulation transfer function (MTF) via the full width at half maximum (FWHM) in the frequency space. The results were compared with those of the current clinical standard EID-CT protocols as controls. Additionally, the radiation dose (CTDIvol) was determined. We enrolled 35 patients with multiple myeloma (mean age 69.8 ± 9.1 years; 18 [51%] males). Qualitative image analysis revealed superior scores (median [interquartile range]) for PCD-CT regarding overall image quality (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), edge sharpness (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), image noise (4.0 [4.0-4.0] vs. 3.0 [3.0-4.0]), lesion conspicuity (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), and diagnostic confidence (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]) compared with EID-CT (P ≤ 0.004). In quantitative image analyses, PCD-CT compared with EID-CT revealed a substantially lower FWHM (2.89 vs. 25.68 cy/pixel) and a significantly more homogeneous signal (mean CV ± standard deviation [SD], 0.99 ± 0.65 vs. 1.66 ± 0.5; P < 0.001) at a significantly lower radiation dose (mean CTDIvol ± SD, 3.33 ± 0.82 vs. 7.19 ± 3.57 mGy; P < 0.001). Whole-body PCD-CT provides significantly higher subjective and objective image quality at significantly reduced radiation doses than the current clinical standard EID-CT protocols, along with readily available multi-spectral data, facilitating the potential for further advanced post-processing.

Reduced-Dose Full-Body CT in Lymphoma Follow-up: A Pilot Study.

How to reduce the radiation dose received from full-body CT scans during the follow-up of lymphoma patients is a concern. The aim of the study was to investigate the image quality and radiation dose of reduced-dose full-body computerized tomography (CT) in lymphoma patients during the follow-up. 121 patients were included and divided into conventional CT group (group 1, 120-kVp, n = 61) or reduced-dose CT group (group 2, 100-kVp combined dual-energy CT (DECT), n = 60). 140-kVp polychromatic images and 70-keV monochromatic images were reconstructed from DECT. The abdominal virtual non-enhanced (VNE) images were reconstructed from monochromatic images. Two radiologists rated the overall image quality with a five-point scale and graded the depiction of lesions using a four-point scale. The objective image quality was evaluated using image noise, signal-to-noise ratio, and contrast-to-noise ratio. The radiation dose and image quality were compared between the groups. The comparable subjective image quality was observed between 70-keV and 120-kVp images in the neck, while 120-kVp images showed better objective image quality. 70-keV images showed better objective image quality in the chest. While the subjective image quality of abdominal VNE images was inferior to that of true non-enhanced images, the improved objective image quality was observed in VNE images. In the abdominal arterial phase, similar subjective image quality was observed between the groups. Abdominal 70-keV images in the arterial phase showed improved objective image quality. Similar image quality was obtained in the abdominal venous phase between the groups. The effective radiation dose in group 2 showed a significant reduction. The application of reduced-dose full-body CT can significantly reduce the radiation dose for lymphoma patients during the follow-up while maintaining or improving the image quality.

Initial Clinical Experience With Coronary CT Angiography Performed on Dual Source Photon Counting CT Using Different Cardiac Scan Modes-Analysis of Image Quality and Radiation Dose

Initial Clinical Experience With Coronary CT Angiography Performed on Dual Source Photon Counting CT Using Different Cardiac Scan Modes-Analysis of Image Quality and Radiation Dose

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.

Evaluating the Knowledge of Computed Tomography Parameters between Radiographers and Undergraduate Students in Medina, Saudi Arabia

This study aims to evaluate employees (i.e., radiographers) and undergraduate students’ knowledge of Computed Tomography (CT) parameters and their impact on image quality and radiation dose. A cross-sectional questionnaire study was conducted at four hospitals in Medina, KSA. The survey consisted of 12 close-ended multiple-choice questions related to computed tomography technical parameters. The survey was distributed with a comprehensive explanation to the respondents, and all of the responses remained anonymous with no questions related to identity were asked. Forty respondents were included in this study. Of those, 14 students were from level eight, 11 students were from level six, nine were interns and six were employees. There was a twofold difference in the answers between undergraduate students and radiographers despite the experience gap between both groups. Students were able to answer most of the questions correctly. Only few questions sparked controversy due to the major difference of answers when both groups were compared. The understanding level of the respondents varies among students and employees, where most of the correct answers were given by the former. The main reason for this could be due to the variation in the respondents' qualification. The employees in this study were only technicians with diploma degree.

EYE RADIATION DOSE SAVING IN HEAD CT EXAMINATIONS USING COPPER-BISMUTH RADIATION SHIELD.

The aim of the present study is to fabricate a new shield with an optimal combination of copper and bismuth to protect the eyes in the head computed tomography (CT) examinations without compromising image quality. Radiation shields with different compositions were constructed. Computed Tomography Dose Index phantom was used to evaluate the effectiveness of shields in dose reduction and their impact on image quality quantitatively. The shield that caused the least noise in the phantom study was selected for human study. The 10%Bi-90%Cu shield had the least effect on increasing the image noise, and also no remarkable artifact was seen in the CT image of the phantom. The patient study showed that only in 25% of the study group the artifact was observed so that it did not distort the interpretation of the image. It can be concluded that the 10%Bi-90%Cu shield is flexible and durable and would be safely used in the clinic to reduce the eye radiation dose in head CT imaging without compromising image quality.

Diagnostic accuracy of lower-dose cardiac CT in evaluating young infants with non-coronary complex congenital heart disease on a 64-slice multidetector CT scanner.

Redoable precise and non-invasive diagnostic imaging modality with the least radiation dose is essential for infants with congenital heart disease (CHD) . To investigate the accuracy and estimate the radiation dose of our cardiac computed tomography (CCT) protocol. A total of 82 infants with CHD underwent non-ECG-gated CCT without contrast timing scanning techniques and were retrospectively studied. The image quality and radiation dose were estimated. The radiation dose was compared statistically to virtual retrospective ECG-gated and prospective ECG-triggering scanning modes. The diagnostic accuracy was assessed assuming the surgical results as the diagnostic gold standard. Most exams showed a high quality with low radiation doses compared to previous studies. The mean effective dose (ED) was 0.39 ± 1.2, significantly lower than that of the virtual retrospective ECG-gated and prospective ECG-triggering scanning and lower than in previous studies. Our CCT protocol has achieved a diagnostic accuracy of 99.52% with a sensitivity of 94.83% and specificity of 99.91%. Non-ECG-gated CCT without contrast timing techniques can detect the non-coronary cardiovascular defects of CHD in infants with an ultralow radiation dose and a high diagnostic accuracy.

Contrast-Enhanced Chest Computed Tomography (CT) Scan with Low Radiation and Total Iodine Dose for Lung Cancer Detection Using Adaptive Statistical Iterative Reconstruction

Background: Contrast-enhanced chest computed tomography (CT) is useful for the detection and follow-up of patients with lung cancer. However, reaching balance between diagnostic image quality, radiation dose, and iodixanol dose is a cause of concern. Objectives: To investigate the clinical value of adaptive statistical iterative reconstruction (ASIR) in reducing the iodixanol content and radiation dose during contrast-enhanced chest CT scan for patients diagnosed with lung masses/nodules based on the analysis of image quality. Patients and Methods: This prospective study was conducted on 80 patients diagnosed with nodules or masses, who required contrast-enhanced chest CT scans. The experimental group (n = 40) was subjected to iohexol at a high concentration (350 mgI/L) with a tube voltage of 120 kVp and a filter back projection (FBP) reconstruction algorithm. The comparison group (n = 40) was subject to iodixanol at a lower concentration (270 mgI/L) with a tube voltage of 100 kVp and ASIR (blending ratio, 40%). The radiation dose and total iodixanol content, as well as subjective and objective evaluations of image quality, were analyzed and compared. Results: The two groups obtained non-significantly different subjective scores for five structures detected in the lung window and five structures detected in the mediastinal window, as well as the overall image (P &gt; 0.05 for all). Both the two-group images obtained diagnosis-acceptable scores (≥ 3 points) on displays of 10 structures and overall image quality. The mean CT value of vessels (100 kVp vs. 120 kVp: 314.90 ± 23.42 vs. 308.93 ± 21.40; P &gt; 0.05), standard deviation (13.03 ± 0.88 vs. 12.83 ± 0.90; P &gt; 0.05), and contrast-to-noise ratio (20.77 ± 2.20 vs. 20.36 ± 1.94; P &gt; 0.05) were not significantly different between two groups. However, the CT dose index, dose-length product, effective dose, and total iodine dose were reduced by 27.58%, 36.65%, 36.59%, and 22.86% in the 100-kVp group compared to the 120-kVp group. Conclusion: The ASIR showed great potential in reducing the radiation dose and iodine contrast dose, while maintaining good image quality and providing strong confidence for the diagnosis of lung cancer.

Comparing feasibility of different tube voltages and different concentrations of contrast medium in coronary CT angiography of overweight patients.

To compare image quality, radiation dose, and iodine intake of coronary computed tomography angiography (CCTA) acquired by wide-detector using different tube voltages and different concentrations of contrast medium (CM) for overweight patients. A total of 150 overweight patients (body mass index≥25 kg/m2) who underwent CCTA are enrolled and divided into three groups according to scan protocols namely, group A (120 kVp, 370 mgI/ml CM); group B (100 kVp, 350 mgI/ml CM); and group C (80 kVp, 320 mgI/ml CM). The CT values, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure-of-merit (FOM) of all images are calculated. Images are subjectively assessed using a 5-point scale. In addition, the CT dose index volume (CTDIvol) and dose length product (DLP) of each patient are recorded. The effective radiation dose (ED) is also calculated. Above data are then statistically analyzed. The mean CT values, SNR, CNR, and subjective image quality of group A are significantly lower than those of groups B and C (P < 0.001), but there is no significant difference between groups B and C (P > 0.05). FOMs show a significantly increase trend from group A to C (P < 0.001). The ED values and total iodine intake in groups B and C are 30.34% and 68.53% and 10.22% and 16.85% lower than those in group A, respectively (P < 0.001). The lower tube voltage and lower concentration of CM based on wide-detector allows for significant reduction in iodine load and radiation dose in CCTA for overweight patients comparing to routine scan protocols. It also enhances signal intensity of CCTA and maintains image quality.

Oncology-specific radiation dose and image noise reference levels in adult abdominal-pelvic CT

ObjectivesTo provide our oncology-specific adult abdominal-pelvic CT reference levels for image noise and radiation dose from a high-volume, oncologic, tertiary referral center. MethodsThe portal venous phase abdomen-pelvis acquisition was assessed for image noise and radiation dose in 13,320 contrast-enhanced CT examinations. Patient size (effective diameter) and radiation dose (CTDIvol) were recorded using a commercial software system, and image noise (Global Noise metric) was quantified using a custom processing system. The reference level and range for dose and noise were calculated for the full dataset, and for examinations grouped by CT scanner model. Dose and noise reference levels were also calculated for exams grouped by five different patient size categories. ResultsThe noise reference level was 11.25 HU with a reference range of 10.25–12.25 HU. The dose reference level at a median effective diameter of 30.7 cm was 26.7 mGy with a reference range of 19.6–37.0 mGy. Dose increased with patient size; however, image noise remained approximately constant within the noise reference range. The doses were 2.1–2.5 times than the doses in the ACR DIR registry for corresponding patient sizes. The image noise was 0.63–0.75 times the previously published reference level in abdominal-pelvic CT examinations. ConclusionsOur oncology-specific abdominal-pelvic CT dose reference levels are higher than in the ACR dose index registry and our oncology-specific image noise reference levels are lower than previously proposed image noise reference levels. Advances in knowledgeThis study reports reference image noise and radiation dose levels appropriate for the indication of abdomen-pelvis CT examination for cancer diagnosis and staging. The difference in these reference levels from non-oncology-specific CT examinations highlight a need for indication-specific, dose index and image quality reference registries.

Anemia Detection with Contrast-enhanced Photon-counting CT

HomeRadiologyVol. 305, No. 2 PreviousNext CommunicationsFree AccessErratumAnemia Detection with Contrast-enhanced Photon-counting CTJonathan D. Dodd, Roisin MacDermottJonathan D. Dodd, Roisin MacDermottJonathan D. DoddRoisin MacDermottPublished Online:Oct 24 2022https://doi.org/10.1148/radiol.229023MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Originally published in:https://doi.org/10.1148/radiol.221471Erratum in:https://doi.org/10.1148/radiol.229023The quote on the first page was changed to read …became clearly visible on noncontrast CT images in canine hearts. The dose-length product unit was changed to mGy ∙ cm, and the associated value was changed from 59 to 592. Reference 4 DOI was changed to https://doi.org/10.1148/radiol.220063.Article HistoryPublished online: Oct 24 2022Published in print: Nov 2022 FiguresReferencesRelatedDetailsAccompanying This ArticleAnemia Detection with Contrast-enhanced Photon-counting CTJul 26 2022RadiologyRecommended Articles Influence of Heart Rate on Image Quality and Radiation Dose Exposure in Coronary CT AngiographyRadiology2021Volume: 300Issue: 3pp. 701-703Slow and Steady Wins the Race: Lower Heart Rates Improve Diagnostic Quality for Coronary CT AngiographyRadiology2021Volume: 300Issue: 3pp. 704-705Radiation Dose Reduction by Using CT with Iterative Model Reconstruction in Patients with Pulmonary Invasive Fungal InfectionRadiology2018Volume: 288Issue: 1pp. 285-292Evaluation of Kidney Stones with Reduced–Radiation Dose CT: Progress from 2011−2012 to 2015−2016—Not There YetRadiology2017Volume: 286Issue: 2pp. 581-589MRI of Iron Oxide Nanoparticles and Myeloperoxidase Activity Links Inflammation to Brain Edema in Experimental Cerebral MalariaRadiology2018Volume: 290Issue: 2pp. 359-367See More RSNA Education Exhibits Usefulness of Spiral Flow Tube for Saline Chaser Capable of Improving Visualization Ability of Subclavian Artery in Cervical CT AngiographyDigital Posters2019Optimization of One-beat 256 Row Detector Coronary CT Angiography Using Low Contrast Media Protocols in Patients with Free Breathing under Automatic Tube Voltage SelectionDigital Posters2018Coronary CT Angiography with Wide Coverage Detector: How to Optimize Contrast Injection and Scan Protocol Based on Patient Size to Reduce Contrast and Radiation DosesDigital Posters2018 RSNA Case Collection Cardiac MyxomaRSNA Case Collection2020Chiari 1 malformation RSNA Case Collection2020Epiploic AppendagitisRSNA Case Collection2022 Vol. 305, No. 2 Metrics Altmetric Score PDF download

Assessing the impact of binaural and non-binaural auditory beat intervention to pain and compression in mammography

IntroductionPain and discomfort has a negative impact on a patient's overall experience and may impact on subsequent re-attendance to mammography. Pain during mammography remains a significant issue. Assessment of interventions to reduce levels of pain associated with mammography are essential to increase attendance to breast services and improve user experience. MethodsParticipants (n = 60) were invited to take part in the study at one hospital Trust within the UK. Postal invitations were sent 2 weeks prior to appointment to patients older than 40 years with previous mammography attendance at the same Trust to allow for comparison of previous and current pain scores/compression values. Patients were randomised into 3 groups: Binaural music (BM), non-binaural music (NBM) and standard care (C). A numerical rating scale (NRS) was used to rate pain. ResultsPatient tolerance is increased by the application of both the non-binaural and binaural music. Binaural music was most effective in improving patient tolerance (p = 0.02). When applied compression increased some patients recorded less pain, which may have implications to image quality and radiation dose for patients. Binaural music reduces the perception of mammographic pain within this data set. Conclusion5 min exposure to binaural music improves patient experience and tolerance for mammography which could be utilised to improve attendance rates in screening and symptomatic services. Implications for practiceThere is an indication for further research looking at application prior and during interventional biopsies. Music intervention can be offered to patients in the severe pain category who refuse mammography. It is acknowledged from these findings that the introduction of BM and NBM prior to mammography would be a low risk, cost effective intervention within the hospital setting.

"Image Quality Optimization and Radiation Dose Minimization in Bone X-Ray Radiography"

"Image Quality Optimization and Radiation Dose Minimization in Bone X-Ray Radiography"