Collective Radiation Dose from MDCT: Critical Review of Surveys Studies

Stamm, Gilbert G.

doi:10.1007/174_2011_433

Cited by 4 publications

(2 citation statements)

References 40 publications

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“…These are likely not as accurate as doses based on a comprehensive assessment such as included in this report. Larger surveys are necessary to account for variations based on size and variations that may result from inclusion of a single or small number of scanners [25]. The recently published EUCLID study is also based on a large-scale survey that collected at least 20 CT examinations of standard-sized patients from each hospital for each EUCLID indication [21].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic reference levels and median doses for common clinical indications of CT: findings from an international registry

Bos

Luong

et al. 2021

Eur Radiol

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Ob jectives The European Society of Radiology identified 10 common indications for computed tomography (CT) as part of the European Study on Clinical Diagnostic Reference Levels (DRLs, EUCLID), to help standardize radiation doses. The objective of this study is to generate DRLs and median doses for these indications using data from the UCSF CT International Dose Registry. Methods Standardized data on 3.7 million CTs in adults were collected between 2016 and 2019 from 161 institutions across seven countries (United States of America (US), Switzerland, Netherlands, Germany, UK, Israel, Japan). DRLs (75th percentile) and median doses for volumetric CT-dose index (CTDIvol) and dose-length product (DLP) were assessed for each EUCLID category (chronic sinusitis, stroke, cervical spine trauma, coronary calcium scoring, lung cancer, pulmonary embolism, coronary CT angiography, hepatocellular carcinoma (HCC), colic/abdominal pain, appendicitis), and US radiation doses were compared with European. Results The number of CT scans within EUCLID categories ranged from 8,933 (HCC) to over 1.2 million (stroke). There was greater variation in dose between categories than within categories (p < .001), and doses were significantly different between categories within anatomic areas. DRLs and median doses were assessed for all categories. DRLs were higher in the US for 9 of the 10 indications (except chronic sinusitis) than in Europe but with a significantly higher sample size in the US. Conclusions DRLs for CTDIvol and DLP for EUCLID clinical indications from diverse organizations were established and can contribute to dose optimization. These values were usually significantly higher in the US than in Europe. Key Points • Registry data were used to create benchmarks for 10 common indications for CT identified by the European Society of Radiology. • Observed US radiation doses were higher than European for 9 of 10 indications (except chronic sinusitis). • The presented diagnostic reference levels and median doses highlight potentially unnecessary variation in radiation dose.

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Section: Discussionmentioning

confidence: 99%

Diagnostic reference levels and median doses for common clinical indications of CT: findings from an international registry

Bos

Luong

et al. 2021

Eur Radiol

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show abstract

“…Finally, a third acquisition consisted of a thoracoabdominal scan, 60 s after the end of the second acquisition with the following parameters: tube potential, 120 kV; tube current from 40 to 150 mAs, depending on automatic tube current modulation. The effective delivered radiation dose was calculated as follows: dose-length product provided by the scanner unit multiplied by 0.017 [23]. The average radiation exposure delivered by ungated CT and ECG-gated CT acquisitions was 3.4 ± 0.9 mSv and 11.5 ± 1.8 mSv, respectively.…”

Section: Ecg-gated and Ungated Ctmentioning

confidence: 99%

Pulmonary hypertension due to left heart disease: diagnostic value of pulmonary artery distensibility

et al. 2020

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Objectives To evaluate how pulmonary artery (PA) distensibility performs in detecting pulmonary hypertension due to left heart disease (PH-LHD) in comparison with parameters from ungated computed tomography (CT) and echocardiography. Methods One hundred patients (79 men, mean age = 63 ± 17 years) with either severe heart failure with reduced ejection fraction (HFrEF), aortic stenosis, or primary mitral regurgitation prospectively underwent right heart catheterization, ungated CT, ECG-gated CT, and echocardiography. During the ECG-gated CT, the right PA distensibility was calculated. In ungated CT, dPA, dPA/AA, the ratio of dPA to the diameter of the vertebra, segmental PA diameter, segmental PA-to-bronchus ratio, and the main PA volume were measured; the egg-and-banana sign was recorded. During echocardiography, the tricuspid regurgitation (TR) gradient was measured. The areas under the ROC curves (AUC) of these signs were computed and compared with DeLong test. Correlation between PA distensibility and PA pressure (PAP) was investigated through Pearson's coefficient.Results PA distensibility was lower in patients with PH than in those without PH (11.4 vs. 21.2%, p < 0.001) and correlated negatively with mean PAP (r = − 0.72, p < 0.001). Age, PA size, and mean PAP were independent predictors of PA distensibility. PA distensibility < 18% detected PH-LHD with 96% sensitivity and 73% specificity; its AUC was 0.92, larger than that of any other sign at ungated CT and TR gradient (AUC ranging from 0.54 to 0.83, DeLong: p ranging from 0.020 to < 0.001). Conclusion PA distensibility on an ECG-gated CT can detect PH-LHD better than the parameters reflecting PA dilatation in ungated CT or TR gradient in the echocardiography of patients with severe HFrEF, aortic stenosis, or mitral regurgitation. Key Points• In left heart disease, pulmonary artery distensibility is lower in patients with PH than in those without pulmonary hypertension (11.4 vs. 21.2%, p < 0.001). • In left heart disease, pulmonary artery distensibility detects pulmonary hypertension with an area under the receiver operating curve of 0.92. • In left heart disease, the area under the receiver operating curve of pulmonary artery distensibility for detecting pulmonary hypertension is larger than that of all other signs at ungated CT (p from 0.019 to < 0.001) and tricuspid regurgitation gradient at echocardiography (p = 0.020).

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Organ Equivalent Dose and Lifetime Attributable Risk of Cancer Incidence and Mortality Associated With Cardiac Ct Angiography

Nasab

Deevband

Monfared

et al. 2020

Radiation Protection Dosimetry

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The aim of this study is the calculation of equivalent organ dose and estimation of lifetime attributable risk (LAR) of cancer incidence and mortality related to cardiac computed tomography angiography (CCTA) because the use of CT angiography as a noninvasive diagnostic method has increased. The organ dose has been calculated by ImPACT software based on the volumetric CT dose index (CTDIvol), and LAR of cancer risk incidence and mortality from CCTA has estimated according to the BEIR VII report. The median value of the effective dose was 13.78 ± 6.88 mSv for both genders. In all scanners, the highest median value for LAR of cancer incidence in males and females for lung cancer was 44.20 and 109.17 per 100 000, respectively. And in infants was 5.89 and 12 for lung cancer in males and breast cancer in females, respectively. Also, the median value of LAR of all cancer incidence from single CCTA in adult patients for males and females was 122 and 238 cases, respectively. Maximum LAR of cancer mortality in adults for lung cancer was 40.28 and 91.84 and in pediatrics was 5.69 and 8.50 in males and females, respectively. Despite many benefits of CTA in the heart disease evaluation, according to a high radiation dose in CCTA, to reduce the cancer risk: CCTA should be used cautiously, especially for pediatric and females.

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Collective Radiation Dose from MDCT: Critical Review of Surveys Studies

Cited by 4 publications

References 40 publications

Diagnostic reference levels and median doses for common clinical indications of CT: findings from an international registry

Diagnostic reference levels and median doses for common clinical indications of CT: findings from an international registry

Pulmonary hypertension due to left heart disease: diagnostic value of pulmonary artery distensibility

Organ Equivalent Dose and Lifetime Attributable Risk of Cancer Incidence and Mortality Associated With Cardiac Ct Angiography

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