Estimates of Effective Dose for CT Scans of the Lower Extremities

Saltybaeva, Natalia; Jafari, Mary Ellen; Hupfer, Martin; Kalender, Willi A.

doi:10.1148/radiol.14132903

Cited by 137 publications

(83 citation statements)

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“…They found that CT doses were 4 times higher to the ovaries, 24 times higher to the testicles and 13-30 times more to the knees and ankles. A different study by Saltybaeva et al [23] on standardized models found routine CT measurements at the knee and ankle may not produce clinically significant radiation [23]. However, they ascertained that a CT of the hip requires 28.5 times more radiation than that of the knee in an adult and 14 times more in a newborn.…”

Section: Discussionmentioning

confidence: 96%

Three-dimensional biplanar radiography as a new means of accessing femoral version: a comparitive study of EOS three-dimensional radiography versus computed tomography

Pomerantz

Glaser

Doan³

et al. 2014

Skeletal Radiol

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Section: Discussionmentioning

confidence: 96%

Three-dimensional biplanar radiography as a new means of accessing femoral version: a comparitive study of EOS three-dimensional radiography versus computed tomography

Pomerantz

Glaser

Doan³

et al. 2014

Skeletal Radiol

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“…The multiplication product of DLP and a conversion factor for lower extremities DECTA and CTA examinations [k=0.0056 mSv/(mGy×cm)] yielded the effective radiation dose (14).…”

Section: Radiation Dose Estimationmentioning

confidence: 99%

“…The model accounted for 29% of the total variation. The small number of observations for DECT and conventional CTA at CIA [19,14], EIA [3,2] and SFA [7,6] combined with considerable clustering of cases in the binary categories of factors (gender, BMI, and DM) rendered almost all factor interaction effects untestable as shown in Table 2. …”

mentioning

confidence: 99%

Dual energy CT angiography in peripheral arterial stents: optimal scanning protocols with regard to image quality and radiation dose

Almutairi

Safran

AlZaabi

et al. 2017

Quant. Imaging Med. Surg.

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Background: To determine the optimal scanning protocols of dual energy computed tomography angiography (DECTA) in terms of radiation dose and image quality assessment at different keV levels, and compare it with conventional computed tomography angiography (CTA) in patients treated with peripheral arterial stents.Methods: Twenty-nine patients with previous stent placement in peripheral arteries were evaluated with DECTA. Images were reconstructed with virtual monochromatic spectral imaging (VMS) at 65, 68, 70 and 72 keV and adaptive statistical iterative reconstruction (ASIR) at 50% compared with CTA. Image quality comprising image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were assessed, and radiation dose was compared. Effects of different type of peripheral arterial stents on image quality were also evaluated. Fifty-six uniquely identified stents that were located in common iliac arteries (CIA), external iliac arteries (EIA) and superficial femoral arteries (SFA) were evaluated.Results: Within subjects, the results showed that DECTA images (VMS) had less noise than the CTA images for CIA, EIA and SFA stents, with the lowest noise at 72 keV. Also, the VMS images had greater SNR than the CTA images for the EIA stents (P<0.05); and the VMS images had greater CNR than the CTA images for CIA, EIA, and SFA stents (P<0.001). Also, on CT attenuation, VMS continued to outperform CTA, but to a lesser extent. Between subjects, average VMS noise varied significantly with the type of the stent used (P=0.025) for CIA stents. Radiation dose was highly significant between DECTA and conventional CTA scans (6.98 vs. 7.40 mSv, P=0.047). Conclusions:We conclude that an optimal scanning protocol consisting of 72 keV and 50% ASIR leads to better image quality for DECTA in peripheral arterial stenting when compared to conventional CTA. Quant Imaging Med Surg 2017;7(5):520-531 qims.amegroups.com few motion artifacts, and generation of 3D visualizations (3). Despite these benefits, it has its own limitation, such as the potential risk of contrast medium-induced nephrotoxicity, the presence of blooming artifacts caused by stent struts, and high radiation dose. Further, MDCT has difficulty in differentiating different materials related to peripheral arterial stents. As assessment of in-stent restenosis is closely related to stent materials, this may lead to an overestimation of the lesion severity. Blooming and beam hardening artifacts which are commonly seen in the conventional CT angiography (CTA) hamper the accurate assessment of instent restenosis (4), but these artifacts can be eliminated in dual-energy CT (DECT) applications. Huang et al. reported an improvement of correction with DECT (4). In a recent study by Mangold et al., reduction of blooming artifacts in imaging peripheral arterial stents with improved image quality was achieved when 70 or 80 keV was used (5). Stent lumen visibility for small stents was reported in a phantom study at high keV when the third generation of dual-source CT and DECT wa...

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“…Based on various reports from developing/developed countries [1][2][3][4][5], it is well known and established that the main portion of artificial sources of ionizing radiation to human results from Xray imaging techniques. Therefore, radiation protection legislatures are highly concerned about the long-term effects, such as cancer and genetic effects, resulted from the use of such techniques in medicine.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, radiation protection legislatures are highly concerned about the long-term effects, such as cancer and genetic effects, resulted from the use of such techniques in medicine. Consequently, more attention has been paid to estimate patient doses from these radiological diagnostic procedures, especially the computed tomography (CT), recognized to be responsible for the greater contribution of population cumulative dose from such diagnostic techniques [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Effective and organ doses from common CT examinations in one general hospital in Tehran, Iran

Khoramian

Hashemi

2017

Polish Journal of Medical Physics and Engineering

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Purpose: It is well known that the main portion of artificial sources of ionizing radiation to human results from X-ray imaging techniques. However, reports carried out in various countries have indicated that most of their cumulative doses from artificial sources are due to CT examinations. Hence assessing doses resulted from CT examinations is highly recommended by national and international radiation protection agencies. The aim of this research has been to estimate the effective and organ doses in an average human according to 103 and 60 ICRP tissue weighting factor for six common protocols of Multi-Detector CT (MDCT) machine in a comprehensive training general hospital in Tehran/Iran. Methods: To calculate the patients' effective dose, the CT-Expo2.2 software was used. Organs/tissues and effective doses were determined for about 20 patients (totally 122 patients) for every one of six typical CT protocols of the head, neck, chest, abdomen-pelvis, pelvis and spine exams. In addition, the CT dosimetry index (CTDI) was measured in the standard 16 and 32 cm phantoms by using a calibrated pencil ionization chamber for the six protocols and by taking the average value of CT scan parameters used in the hospital compared with the CTDI values displayed on the console device of the machine. Results: The values of the effective dose based on the ICRP 103 tissue weighting factor were: 0.6, 2.0, 3.2, 4.2, 2.8, and 3.9 mSv and based on the ICRP 60 tissue weighting factor were: 0.9, 1.4, 3, 7.9, 4.8 and 5.1 mSv for the head, neck, chest, abdomen-pelvis, pelvis, spine CT exams respectively. Relative differences between those values were -22, 21, 23, -6, -31 and 16 percent for the head, neck, chest, abdomen-pelvis, pelvis, spine CT exams, respectively. The average value of CTDI v calculated for each protocol was: 27.32 ± 0.9, 18.08 ± 2.0, 7.36 ± 2.6, 8.84 ± 1.7, 9.13 ± 1.5, 10.42 ± 0.8 mGy for the head, neck, chest, abdomen-pelvis and spine CT exams, respectively. Conclusions: The highest organ doses delivered by various CT exams were received by brain (15.5 mSv), thyroid (19.00 mSv), lungs (9.3 mSv) and bladder (9.9 mSv), bladder (10.4 mSv), stomach (10.9 mSv) in the head, neck, chest, and the abdomen-pelvis, pelvis, and spine respectively. Except the neck and spine CT exams showing a higher effective dose compared to that reported in Netherlands, other exams indicated lower values compared to those reported by any other country.

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Estimates of Effective Dose for CT Scans of the Lower Extremities

Abstract: DLP/ED conversion coefficients are provided for lower extremities and allow estimation of ED for commonly used clinical musculoskeletal CT and CT angiographic protocols.

Cited by 137 publications

References 20 publications

Three-dimensional biplanar radiography as a new means of accessing femoral version: a comparitive study of EOS three-dimensional radiography versus computed tomography

Three-dimensional biplanar radiography as a new means of accessing femoral version: a comparitive study of EOS three-dimensional radiography versus computed tomography

Dual energy CT angiography in peripheral arterial stents: optimal scanning protocols with regard to image quality and radiation dose

Effective and organ doses from common CT examinations in one general hospital in Tehran, Iran

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