CT Radiation Dose Optimization and Tracking Program at a Large Quaternary-Care Health Care System

Goenka, Ajit H.; Dong, Frank; Wildman, Bonnie; Hulme, Katie; Johnson, Paul E.; Herts, Brian R.

doi:10.1016/j.jacr.2015.03.037

Cited by 18 publications

(19 citation statements)

References 21 publications

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“…These settings are routinely used for clinical work at our institution. A weightbased approach was used to select the quality reference milliampere second, which, when combined for the two xray tubes, was equal to that of the routine clinical protocol at our institution (24,25). For patients who weighed less than 250 lb (,112.50 kg), the quality the electronic medical records for these patients were retrospectively reviewed by an abdominal imager (N.S.G.)…”

Section: Advances In Knowledgementioning

confidence: 99%

Diagnostic Accuracy of CT Enterography for Active Inflammatory Terminal Ileal Crohn Disease: Comparison of Full-Dose and Half-Dose Images Reconstructed with FBP and Half-Dose Images with SAFIRE

Gandhi¹,

Baker²,

Goenka³

et al. 2016

Radiology

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Purpose To compare the diagnostic accuracy and image quality of computed tomographic (CT) enterographic images obtained at half dose and reconstructed with filtered back projection (FBP) and sinogram-affirmed iterative reconstruction (SAFIRE) with those of full-dose CT enterographic images reconstructed with FBP for active inflammatory terminal or neoterminal ileal Crohn disease. Materials and Methods This retrospective study was compliant with HIPAA and approved by the institutional review board. The requirement to obtain informed consent was waived. Ninety subjects (45 with active terminal ileal Crohn disease and 45 without Crohn disease) underwent CT enterography with a dual-source CT unit. The reference standard for confirmation of active Crohn disease was active terminal ileal Crohn disease based on ileocolonoscopy or established Crohn disease and imaging features of active terminal ileal Crohn disease. Data from both tubes were reconstructed with FBP (100% exposure); data from the primary tube (50% exposure) were reconstructed with FBP and SAFIRE strengths 3 and 4, yielding four datasets per CT enterographic examination. The mean volume CT dose index (CTDIvol) and size-specific dose estimate (SSDE) at full dose were 13.1 mGy (median, 7.36 mGy) and 15.9 mGy (median, 13.06 mGy), respectively, and those at half dose were 6.55 mGy (median, 3.68 mGy) and 7.95 mGy (median, 6.5 mGy). Images were subjectively evaluated by eight radiologists for quality and diagnostic confidence for Crohn disease. Areas under the receiver operating characteristic curves (AUCs) were estimated, and the multireader, multicase analysis of variance method was used to compare reconstruction methods on the basis of a noninferiority margin of 0.05. Results The mean AUCs with half-dose scans (FBP, 0.908; SAFIRE 3, 0.935; SAFIRE 4, 0.924) were noninferior to the mean AUC with full-dose FBP scans (0.908; P < .003). The proportion of images with inferior quality was significantly higher with all half-dose reconstructions than with full-dose FBP (mean proportion: 0.117 for half-dose FBP, 0.054 for half-dose SAFIRE 3, 0.054 for half-dose SAFIRE 4, and 0.017 for full-dose FBP; P < .001). Conclusion The diagnostic accuracy of half-dose CT enterography with FBP and SAFIRE is statistically noninferior to that of full-dose CT enterography for active inflammatory terminal ileal Crohn disease, despite an inferior subjective image quality. (©) RSNA, 2016 Online supplemental material is available for this article.

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Section: Advances In Knowledgementioning

confidence: 99%

Diagnostic Accuracy of CT Enterography for Active Inflammatory Terminal Ileal Crohn Disease: Comparison of Full-Dose and Half-Dose Images Reconstructed with FBP and Half-Dose Images with SAFIRE

Gandhi¹,

Baker²,

Goenka³

et al. 2016

Radiology

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“…Otra opción puede ser automatizar la recolección. Puede ser posible recolectar información de un gran número de pacientes donde estén disponibles los métodos automatizados de registros de valores apropiados de magnitudes de DRLs (>100) por cada instalación (27,28) . Los registros automatizados permiten la recolección de datos de millones de exámenes (29) .…”

Section: Discussionunclassified

Niveles de referencia para diagnóstico: Una herramienta efectiva para la protección radiológica de pacientes

Ubeda

Ruiz-Cruces

et al. 2019

Rev. chil. radiol.

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“…With the increasing use of computed tomography (CT) in diagnostic evaluation, CT‐guided intervention, and screening for lung or colon cancer, radiation‐induced risk for patients undergoing CT scans has received high attention. Medical institutions are adopting CT dose reduction strategies and are implementing patient dose monitoring programs, based on several quality metrics available to the community . A CT system usually provides the volume CT dose index (CTDI vol ) .…”

Section: Introductionmentioning

confidence: 99%

Exam‐level dose monitoring in CT: Quality metric consideration for multiple series acquisitions

Yang

Liu

2019

Medical Physics

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Purpose: Multi-series CT examination is common in the clinic, but no metric is agreed upon to report the overall dose from such an examination. This work proposes a relevant metric for tracking patient dose from multi-series examinations and illustrates the evaluation method through explanatory examples. Materials and methods: In each acquisition series, a previously reported method was used to evaluate the cross-sectional average dose along the z-axis of a water phantom, with inputs of CTDI vol , scan length, tube current, and patient water-equivalent diameter. With a multi-series examination, the dose at each z-location was accumulated over all acquisition series. This method was applied to four clinical CT examinations. In three abdominal/pelvic examinations (patient weight, 107, 79, 79 kg), tube current modulation was applied in five acquisition series with scan lengths of 30-41.8 cm, while tube current was fixed in other series with short scan lengths (1.0, 7.9 cm). In another CT-guided liver ablation procedure (patient weight, 114 kg), 22 series were acquired with constant mA and scan lengths of 1-30 cm. The maximum value of the overall dose profile of each examination was compared to five dose quantities, including CTDI vol,sum and SSDE sum by the ACR CT Dose Index Registry, scan length-weighted CTDI vol and SSDE by a CT dose monitoring platform, and "max z location CTDI vol " by a CT manufacturer. Results: A simple graphic display of dose as a function of the z-axis location was presented for each acquisition series and for the whole examination. Differences up to 43.4% and 42.8%, or down to À93.5%, À93.5%, and À49.0%, were observed between the maximum value of the overall dose profile and five dose quantities (in the above order), respectively. Conclusion: The overall dose profile gives a complete description of z-axis dose distribution for the studied CT examinations under a wide range of patient variables and acquisition conditions, including multiple acquisition series. Simple visualization of the doses across and beyond the scan ranges may provide a new tool for CT dose optimization.

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CT Radiation Dose Optimization and Tracking Program at a Large Quaternary-Care Health Care System

Cited by 18 publications

References 21 publications

Diagnostic Accuracy of CT Enterography for Active Inflammatory Terminal Ileal Crohn Disease: Comparison of Full-Dose and Half-Dose Images Reconstructed with FBP and Half-Dose Images with SAFIRE

Diagnostic Accuracy of CT Enterography for Active Inflammatory Terminal Ileal Crohn Disease: Comparison of Full-Dose and Half-Dose Images Reconstructed with FBP and Half-Dose Images with SAFIRE

Niveles de referencia para diagnóstico: Una herramienta efectiva para la protección radiológica de pacientes

Exam‐level dose monitoring in CT: Quality metric consideration for multiple series acquisitions

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