scholarly journals Chest CT Usage in Covid-19 Pneumonia: Multicenter Study on Radiation Doses and Diagnostic Quality in Brazil

2021 ◽  
Author(s):  
Monica Bernardo ◽  
Fatemeh Homayounieh ◽  
Maria Cristina Rodel Cuter ◽  
Luiz Mário Bellegard ◽  
Homero Medeiros Oliveira Junior ◽  
...  
Keyword(s):  
Respiratory Motion ◽  
Chest Ct ◽  
Radiation Doses ◽  
Dose Length Product ◽  
Diagnostic Quality ◽  
Ct Dose ◽  
Entire Lung ◽  
Information Number ◽  
Ct Dose Index ◽  
Volume Ct

Abstract We assessed variations in chest CT usage, radiation dose and image quality in COVID-19 pneumonia. Our study included all chest CT exams performed in 533 patients from 6 healthcare sites from Brazil. We recorded patients’ age, gender and body weight and the information number of CT exams per patient, scan parameters and radiation doses (volume CT dose index—CTDIvol and dose length product—DLP). Six radiologists assessed all chest CT exams for the type of pulmonary findings and classified CT appearance of COVID-19 pneumonia as typical, indeterminate, atypical or negative. In addition, each CT was assessed for diagnostic quality (optimal or suboptimal) and presence of artefacts. Artefacts were frequent (367/841), often related to respiratory motion (344/367 chest CT exams with artefacts) and resulted in suboptimal evaluation in mid-to-lower lungs (176/344) or the entire lung (31/344). There were substantial differences in CT usage, patient weight, CTDIvol and DLP across the participating sites.

Use of Multiphase CT Protocols in 18 Countries: Appropriateness and Radiation Doses

2020 ◽  
pp. 084653711988839 ◽  
Author(s):  
Shivam Rastogi ◽  
Ramandeep Singh ◽  
Riddhi Borse ◽  
Petra Valkovic Zujic ◽  
Doris Segota ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Chest Ct ◽  
Radiation Doses ◽  
Energy Agency ◽  
Dose Length Product ◽  
Ct Dose ◽  
Clinical Indications ◽  
Ct Dose Index ◽  
Multiphase Ct ◽  
Routine Chest

Purpose: To assess the frequency, appropriateness, and radiation doses associated with multiphase computed tomography (CT) protocols for routine chest and abdomen–pelvis examinations in 18 countries. Materials and Methods: In collaboration with the International Atomic Energy Agency, multi-institutional data on clinical indications, number of scan phases, scan parameters, and radiation dose descriptors (CT dose–index volume; dose–length product [DLP]) were collected for routine chest (n = 1706 patients) and abdomen–pelvis (n = 426 patients) CT from 18 institutions in Asia, Africa, and Europe. Two radiologists scored the need for each phase based on clinical indications (1 = not indicated, 2 = probably indicated, 3 = indicated). We surveyed 11 institutions for their practice regarding single-phase and multiphase CT examinations. Data were analyzed with the Student t test. Results: Most institutions use multiphase protocols for routine chest (10/18 institutions) and routine abdomen–pelvis (10/11 institutions that supplied data for abdomen–pelvis) CT examinations. Most institutions (10/11) do not modify scan parameters between different scan phases. Respective total DLP for 1-, 2-, and 3-phase routine chest CT was 272, 518, and 820 mGy·cm, respectively. Corresponding values for 1- to 5-phase routine abdomen–pelvis CT were 400, 726, 1218, 1214, and 1458 mGy cm, respectively. For multiphase CT protocols, there were no differences in scan parameters and radiation doses between different phases for either chest or abdomen–pelvis CT ( P = 0.40-0.99). Multiphase CT examinations were unnecessary in 100% of routine chest CT and in 63% of routine abdomen–pelvis CT examinations. Conclusions: Multiphase scan protocols for the routine chest and abdomen–pelvis CT examinations are unnecessary, and their use increases radiation dose.

Dose Is Not Always What It Seems: Where Very Misleading Values Can Result From Volume CT Dose Index and Dose Length Product

2014 ◽  
Vol 11 (3) ◽  
pp. 233-237 ◽  
Author(s):  
J. Anthony Seibert ◽  
John M. Boone ◽  
Sandra L. Wootton-Gorges ◽  
Ramit Lamba
Keyword(s):  
Dose Length Product ◽  
Ct Dose ◽  
Ct Dose Index ◽  
Volume Ct ◽  
Dose Index

Experimental Examination of Radiation Doses Of Dual- and Single-Energy Computed Tomography in Chest And Upper Abdomen in a Phantom Study

2021 ◽  
Author(s):  
Denise Bos ◽  
Britta König ◽  
Sebastian Blex ◽  
Sebastian Zensen ◽  
Marcel Opitz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Arteries ◽  
Phantom Study ◽  
Radiation Doses ◽  
Experimental Examination ◽  
Dose Length Product ◽  
Ct Dose ◽  
Dual Source ◽  
Ct Dose Index ◽  
Upper Abdomen

Abstract The aim of this phantom study is to examine radiation doses of dual- and single-energy computed tomography (DECT and SECT) in the chest and upper abdomen for three different multi-slice CT scanners. A total of 34 CT protocols were examined with the phantom N1 LUNGMAN. Four different CT examination types of different anatomic regions were performed both in single- and dual-energy technique: chest, aorta, pulmonary arteries for suspected pulmonary embolism and liver. Radiation doses were examined for the CT dose index CTDIvol and dose-length product (DLP). Radiation doses of DECT were significantly higher than doses for SECT. In terms of CTDIvol, radiation doses were 1.1–3.2 times higher, and in terms of DLP, these were 1.1–3.8 times higher for DECT compared with SECT. The third-generation dual-source CT applied the lowest dose in 7 of 15 different examination types of different anatomic regions.

Reduced Kilovoltage in Computed Tomography–Guided Intervention in a Community Hospital: Effect on the Radiation Dose

2014 ◽  
Vol 65 (4) ◽  
pp. 345-351 ◽  
Author(s):  
Saman Rezazadeh ◽  
Steven J. Co ◽  
Simon Bicknell
Keyword(s):  
Low Dose ◽  
Effective Diameter ◽  
Tube Voltage ◽  
Dose Length Product ◽  
Ct Guided ◽  
Ct Dose ◽  
Patient Size ◽  
Ct Dose Index ◽  
Volume Ct ◽  
Dose Index

Purpose The purpose of this study was to determine whether low-kilovoltage (80 or 100 kV) computed tomography (CT)-guided interventions performed in a community-based hospital are feasible and to compare radiation exposure incurred with conventional 120 kV potential. Materials and Methods Effective doses (ED) received by patients who underwent CT-guided intervention were analysed before and after a low-dose kilovoltage protocol was instituted in our department. We performed CT-guided procedures of 93 consecutive patients by using conventional 120-kV tube voltage (50 patients) and a low voltage of 80 or 100 kV for the remainder of this cohort. Automatic tube current modulation was enabled to obtain the best image quality. Procedure details were prospectively recorded and included examination site and type, slice width, tube voltage and current, dose length product, volume CT dose index, and size-specific dose estimate. Dose length product was converted to ED to account for radiosensitivity of specific organs. Statistical comparisons with test differences in the ED, volume CT dose index, size-specific dose estimate, and effective diameter (patient size) were made by using the Student t test. Results All but 6 of the procedures performed at 80 kV were successful, for a success rate of 86%. At lower voltages, the ED was significantly ( P < .01) reduced, on average, by 57%, 73%, and 65% for the pelvic, chest, and abdomen procedures, respectively. Conclusion A low-dose radiation technique by using 80 or 100 kV results in a high technical success rate for pelvic, chest, and abdomen CT-guided interventional procedures, although dramatically decreasing radiation exposure. There was no significant difference in effective diameter (patient size) between the conventional and the low-dose groups, which would suggest that dose reduction was indeed a result of kVp change and not patient size.

Multiplatform, Non-Breath-Hold Fast Scanning Protocols: Should We Stop Giving Breath-Hold Instructions for Routine Chest CT?

2020 ◽  
pp. 084653712092053
Author(s):  
Ruhani Doda Khera ◽  
Chayanin Nitiwarangkul ◽  
Ramandeep Singh ◽  
Fatemeh Homayounieh ◽  
Subba R. Digumarthy ◽  
...  
Keyword(s):  
Respiratory Motion ◽  
Chest Ct ◽  
Motion Artifacts ◽  
Breath Hold ◽  
Second Phase ◽  
Ct Scanner ◽  
Beam Hardening ◽  
Dose Length Product ◽  
Diagnostic Quality ◽  
Lung Lobe

Objective: We assessed if non-breath-hold (NBH) fast scanning protocol can provide respiratory motion-free images for interpretation of chest computed tomography (CT). Materials and Methods: In our 2-phase project, we first collected baseline data on frequency of respiratory motion artifacts on breath-hold chest CT in 826 adult patients. The second phase included 62 patients (mean age 66 ± 15 years; 21 females, 41 males) who underwent an NBH chest CT on either single-source (n = 32) or dual-source (n = 30) multidetector-row CT scanners. Clinical indications for chest CT, reason for using NBH CT, scanner type, scan duration, and radiation dose (CT dose index volume, dose length product) were recorded. Two thoracic radiologists (R1 and R2) independently graded respiratory motion artifacts (1 = no respiratory motion artifacts with unrestricted evaluation; 2 = minor motion artifacts limited to one lung lobe or less with good diagnostic quality; 3 = moderate motion artifacts limited to 2 to 3 lung lobes but adequate for clinical diagnosis; 4 = poor evaluability or unevaluable from severe motion artifacts; and 5 = limited quality due to other causes like high noise, beam hardening, or metallic artifacts), and recorded pulmonary and mediastinal findings. Descriptive analyses, Cohen κ test for interobserver agreement, and Student t test were performed for statistical analysis. Results: No NBH chest CT were deemed uninterpretable by either radiologist; most NBH CT (R1-59 of 62, 95%; R2-62 of 62, 100%) had no or minimal motion artifacts. Only 3 of 62 (R1) NBH chest CT had motion artifacts limiting diagnostic evaluation for lungs but not in the mediastinum. Conclusion: Non-breath-hold fast protocol enables acquisition of diagnostic quality chest CT free of respiratory motion artifacts in patients who cannot hold their breath.

Volume CT Dose Index and Dose-Length Product Displayed during CT: What Good Are They?

Radiology ◽  
2011 ◽  
Vol 258 (1) ◽  
pp. 236-242 ◽  
Author(s):  
Walter Huda ◽  
Fred A. Mettler
Keyword(s):  
Dose Length Product ◽  
Ct Dose ◽  
Ct Dose Index ◽  
Volume Ct ◽  
Dose Index

Strategies for Reducing Radiation Exposure from Multidetector Computed Tomography in the Acute Care Setting

2013 ◽  
Vol 64 (2) ◽  
pp. 119-129 ◽  
Author(s):  
Aaron Sodickson
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Care Setting ◽  
Patient Specific ◽  
Dose Length Product ◽  
Diagnostic Quality ◽  
X Ray ◽  
Ct Dose ◽  
Ct Dose Index ◽  
The Common

Many tools and strategies exist to enable reduction of radiation exposure from computed tomography (CT). The common CT metrics of x-ray output, the volume CT dose index and the dose-length product, are explained and serve as the basis for monitoring radiation exposure from CT. Many strategies to dose-optimize CT protocols are explored that, in combination with available hardware and software tools, allow robust diagnostic quality CT to be performed with a radiation exposure appropriate for the clinical scenario and the size of the patient. Specific emergency department example protocols are used to demonstrate these techniques.

scholarly journals Whole Body Low Dose Computed Tomography Using Third-Generation Dual-Source Multidetector With Spectral Shaping: Protocol Optimization and Literature Review

Dose-Response ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 155932582097313
Author(s):  
Dario Baldi ◽  
Liberatore Tramontano ◽  
Vincenzo Alfano ◽  
Bruna Punzo ◽  
Carlo Cavaliere ◽  
...  
Keyword(s):  
Effective Dose ◽  
Low Dose ◽  
Whole Body ◽  
Dose Length Product ◽  
Osteolytic Lesions ◽  
Subjective Image Quality ◽  
Ct Dose ◽  
Dual Source ◽  
Ct Dose Index ◽  
Low Dose Computed Tomography

For decades, the main imaging tool for multiple myeloma (MM) patient’s management has been the conventional skeleton survey. In 2014 international myeloma working group defined the advantages of the whole-body low dose computed tomography (WBLDCT) as a gold standard, among imaging modalities, for bone disease assessment and subsequently implemented this technique in the MM diagnostic workflow. The aim of this study is to investigate, in a group of 30 patients with a new diagnosis of MM, the radiation dose (CT dose index, dose-length product, effective dose), the subjective image quality score and osseous/extra-osseous findings rate with a modified WBLDCT protocol. Spectral shaping and third-generation dual-source multidetector CT scanner was used for the assessment of osteolytic lesions due to MM, and the dose exposure was compared with the literature findings reported until 2020. Mean radiation dose parameters were reported as follows: CT dose index 0.3 ± 0.1 mGy, Dose-Length Product 52.0 ± 22.5 mGy*cm, effective dose 0.44 ± 0.19 mSv. Subjective image quality was good/excellent in all subjects. 11/30 patients showed osteolytic lesions, with a percentage of extra-osseous findings detected in 9/30 patients. Our data confirmed the advantages of WBLDCT in the diagnosis of patients with MM, reporting an effective dose for our protocol as the lowest among previous literature findings.

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