Female Breast, Lung, and Pelvic Organ Radiation From Dose-Reduced 64-MDCT Thoracic Examination Protocols: A Phantom Study

Litmanovich, Diana; Tack, Denis; Lin, Pei‐Jan Paul; Boiselle, Phillip M.; Raptopoulos, Vassilios; Bankier, Alexander A.

doi:10.2214/ajr.10.6401

Cited by 10 publications

(5 citation statements)

References 33 publications

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“…Our study supports the use of tube voltage and heart rate reduction to decrease ARD and is in synchrony with Matsubara et al who obtained similar results on phantom studies with 64-row CT angiography [18]. Litmanovich et al [20] also found better ARD profile in 64-row MDCT phantom study by using imaging protocols with lower tube voltage which was in consensus with an earlier study by Hurwitz et al [21, 22]. Our study adds to the literature by documenting similar trend of kVp and HR variation on ARD seen in radiosensitive organs when using 320-row mode.…”

Section: Discussionsupporting

confidence: 91%

Absorbed Radiation Dose in Radiosensitive Organs Using 64- and 320-Row Multidetector Computed Tomography: A Comparative Study

et al. 2014

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Aim. To determine absorbed radiation dose (ARD) in radiosensitive organs during prospective and full phase dose modulation using ECG-gated MDCTA scanner under 64- and 320-row detector modes. Methods. Female phantom was used to measure organ radiation dose. Five DP-3 radiation detectors were used to measure ARD to lungs, breast, and thyroid using the Aquilion ONE scanner in 64- and 320-row modes using both prospective and dose modulation in full phase acquisition. Five measurements were made using three tube voltages: 100, 120, and 135 kVp at 400 mA at heart rate (HR) of 60 and 75 bpm for each protocol. Mean acquisition was recorded in milligrays (mGy). Results. Mean ARD was less for 320-row versus 64-row mode for each imaging protocol. Prospective EKG-gated imaging protocol resulted in a statistically lower ARD using 320-row versus 64-row modes for midbreast (6.728 versus 19.687 mGy, P < 0.001), lung (6.102 versus 21.841 mGy, P < 0.001), and thyroid gland (0.208 versus 0.913 mGy; P < 0.001). Retrospective imaging using 320- versus 64-row modes showed lower ARD for midbreast (10.839 versus 43.169 mGy, P < 0.001), lung (8.848 versus 47.877 mGy, P < 0.001), and thyroid gland (0.057 versus 2.091 mGy; P < 0.001). ARD reduction was observed at lower kVp and heart rate. Conclusions. Dose reduction to radiosensitive organs is achieved using 320-row compared to 64-row modes for both prospective and retrospective gating, whereas 64-row mode is equivalent to the same model 64-row MDCT scanner.

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Section: Discussionsupporting

confidence: 91%

Absorbed Radiation Dose in Radiosensitive Organs Using 64- and 320-Row Multidetector Computed Tomography: A Comparative Study

et al. 2014

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“…For CT examinations of the thorax, the breast is always in the scanning range but is not an organ of interest. Any possible effort to reduce radiation dose to the breast should be made considering the radiosensitive glandular tissue of the female breast [4][5][6][7][8]. Bismuth breast shielding is an effective method for reducing the radiation dose in the breast from 29% to 63% [6,[9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Reduced Radiation Exposure of the Female Breast During Low-Dose Chest CT Using Organ-Based Tube Current Modulation and a Bismuth Shield: Comparison of Image Quality and Radiation Dose

Kim

Sung

Choi

et al. 2013

American Journal of Roentgenology

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“…These values achieved are at the very low end of the dose ranges published 5,18,20,21 despite being obtained in routine clinical settings and in an unselected population with a wide range of BMI, spanning from 15.8 to 48.8. Additionaly, the lower radiation dose achieved with iterative image reconstruction was associated with a significantly better objective and subjective image quality than standard filtered back projection, suggesting possible further dose reduction.…”

Section: Resultsmentioning

confidence: 90%

“…Given the vast variety of protocols, techniques, and (if implemented) dose reduction strategies published in the literature, the dose ranges for routine pulmonary MDCTA vary substantially. Organ doses to the breast ranged from 3.9 to 20 mGy 15,20,21 . However, in the study of Hurwitz et al 18 , on 120 kV and 140 kV protocols, large anthropomorphic phantom measurements showed average breast doses of 44 mGy at 120 kV and even 62 mGy when scanning at 140 kV (without breast shielding).…”

Section: Discussionmentioning

confidence: 99%

Iterative reconstruction of pulmonary MDCT angiography: Effects on image quality, effective dose and estimated organ dose to the breast

Žižka¹,

Ryška²,

Štěpanovská³

et al. 2014

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims.To compare the image characteristics, effective dose and estimated organ dose to the female breast in pulmonary MDCT angiography (MDCTA), reconstructed with either standard filtered back projection (FBP), or iterative reconstruction in image space (IRIS). Methods. Pulmonary MDCTA performed in 116 females (age 18 -77 years; body mass index 15 -48) was reconstructed with FBP (n=52) or IRIS (n=64). Scans were acquired on a 128-row MDCT system using automatic tube current modulation, 100 kV tube voltage, and a quality reference mAs value of 120 (FBP) and 80 (IRIS). Dose was calculated from CT dose index (CTDIvol) and dose length product (DLP) values utilising ImPACT software. Image noise was measured within the pulmonary artery. Qualitative visual assessment of the scans was performed (1=negligible noise, 5=noise obscuring diagnostic information). Results. The average CTDIvol yielded 4.33 mGy for FBP and 3.54 mGy for IRIS, respectively (18.2% decrease). The average effective scan dose was 2.73±0.57 mSv (FBP) and 2.29±0.68 mSv (IRIS), respectively (16.1% decrease). The estimated average organ dose to the breast decreased from 5.1±1.1 mGy (FBP) to 4.2±1.2 mGy (IRIS, 17.6% decrease). No nondiagnostic scans (score 5) were encountered in either group. Significant improvement in image noise levels (P<0.01) and subjective image quality (P<0.02) were noted in IRIS group. Conclusion. Pulmonary MDCTA utilizing a 100 kV technique, automatic tube current modulation, and iterative image reconstruction offers robust results in routine conditions among an unselected female population, with breast doses being comparable to two-view digital mammography. Moreover, iterative reconstruction offers improvements in both image noise and visual perception of the scans, thus suggesting a potential for further dose reduction.

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Female Breast, Lung, and Pelvic Organ Radiation From Dose-Reduced 64-MDCT Thoracic Examination Protocols: A Phantom Study

Abstract: The results of this anthropomorphic phantom study showed substantial and significant variation in radiation doses to the breast and lungs depending on the scanning protocol used with the potential for over threefold dose reduction.

Cited by 10 publications

References 33 publications

Absorbed Radiation Dose in Radiosensitive Organs Using 64- and 320-Row Multidetector Computed Tomography: A Comparative Study

Absorbed Radiation Dose in Radiosensitive Organs Using 64- and 320-Row Multidetector Computed Tomography: A Comparative Study

Reduced Radiation Exposure of the Female Breast During Low-Dose Chest CT Using Organ-Based Tube Current Modulation and a Bismuth Shield: Comparison of Image Quality and Radiation Dose

Iterative reconstruction of pulmonary MDCT angiography: Effects on image quality, effective dose and estimated organ dose to the breast

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