Patient doses in CT Examinations in 18 countries: initial results from international atomic energy agency projects

Muhogora, W.E.; Ahmed, Nada A.; Beganović, Adnan; Benider, A.; Ciraj-Bjelac, Olivera; Gershan, Vesna; Gershkevitsh, E.; Grupetta, E.; Kharita, M.H.; Manatrakul, N.; Milaković, Milomir; Ohno, Kazuko; Omrane, L. Ben; Ptáček, Jaroslav; Schandorf, Cyril; Shabaan, Mohamed Samir; Stoyanov, D.; Toutaoui, N.; Wambani, Jeska S.; Rehani, Madan M.

doi:10.1093/rpd/ncp144

Cited by 50 publications

(23 citation statements)

References 14 publications

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“…It is increasingly being documented that patient doses are higher than necessary and that the image quality in CT often exceeds the level needed for confident diagnosis. 139 These results also explain the >7-fold variability in median radiation doses for coronary CT angiography in the PROTECTION I survey. 66 These findings need to penetrate widely among imaging specialists, including cardiologists, radiologists, and radiographers.…”

Section: Discussionmentioning

confidence: 71%

SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT

Halliburton

Abbara

Chen

et al. 2011

Journal of Cardiovascular Computed Tomography

450

271

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Over the last few years, computed tomography (CT) has developed into a standard clinical test for a variety of cardiovascular conditions. The emergence of cardiovascular CT during a period of dramatic increase in radiation exposure to the population from medical procedures and heightened concern about the subsequent potential cancer risk has led to intense scrutiny of the radiation burden of this new technique. This has hastened the development and implementation of dose reduction tools and prompted closer monitoring of patient dose. In an effort to aid the cardiovascular CT community in incorporating patient-centered radiation dose optimization and monitoring strategies into standard practice, the Society of Cardiovascular Computed Tomography has produced a guideline document to review available data and provide recommendations regarding interpretation of radiation dose indices and predictors of risk, appropriate use of scanner acquisition modes and settings, development of algorithms for dose optimization, and establishment of procedures for dose monitoring.

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Section: Discussionmentioning

confidence: 71%

SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT

Halliburton

Abbara

Chen

et al. 2011

Journal of Cardiovascular Computed Tomography

450

271

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“…They are classified as suggested action levels above which a facility should review its methods and determine if acceptable image quality can be achieved at lower doses, and also considered as investigational levels applied in the identification of unusually high radiation doses [6][7][8][9]. The importance of DRLs for assessing existing protocols, developing new and improved protocols, and as a dose optimization tool for promotion of good practices in CT imaging has been affirmed [10][11][12][13][14][15][16][17][18]. According to the Australian Radiation Protection and Nuclear Safety [19], DRLs provide a common dose metric for the comparison of DRLs between facilities, protocols and modalities, assess dose impacts of newly introduced protocols, and provide compliance with the relevant state and territory regulatory requirements.…”

Section: Introductionmentioning

confidence: 99%

Comparison of 640-slice Aquilon ONE CT scanner’s measured dosimetric parameters with ICRP dose reference levels for head, chest and abdominal CT examinations

et al. 2016

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Background: Diagnostic reference levels (DRLs) are optimum range of values or diagnostic standard data for a particular procedure by which other imaging measurements must be compared for purposes of optimizing patient dose and radiation safety in medical imaging. This study aimed to compare measured dosimetric parameters of the latest 640-Slice Aquilion ONE CT scanner with established DRLs for adult and pediatric head, chest and abdominal examinations as a quality assurance test in order to recommend appropriate radiological safety solutions if differences existed. Methods: A prospective and retrospective study design was applied in this work. Data of measured CT dosimetric parameters (patient administered doses) such as dose length product and CT dose index were generated for pediatric head, chest and abdominal examinations using the Aquilion ONE CT scanner. The generated database was compared with established international standard DRLs. SPSS version 16 software was used for data processing and analysis. Results: The measured volume weighted CT dose index (CTDI vol ) and dose length products (DLPs) were generally lower than the ICRP and other internationally recommended DRLs. In particular, the relative deviations from the DRLs were head (CTDI vol = −57.5 %, DLP = −33.8 %, p-value = 0.001), chest (CTDI vol = −94.3 %, DLP = −86.6 %, p-value = 0.002), and abdomen (CTDI vol = −91.0 %, DLP = −75.2 %, p-value = 0.001) for pediatric examinations, and head (CTDI vol = +5. 5 %, DLP = −4.0 %, p-value = 0.001), chest (CTDI vol = −80.3 %, DLP = −56.6 % p-value = 0.001), abdomen (CTDI vol = −6. 8 %, DLP = −54.7 %, p-value = 0.001) for adult examinations respectively. Conclusion: The CTDI vol and DLP administered doses for both pediatric and adult examinations were lower than their respective DRLs except adult head examination where the measured CTDI vol was 5.5 % higher than the standard reference dose. Optimization of practice is needed to reduce dose to head CT examinations when using 640-slice Aquilion ONE CT scanner.

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“…It is likely that a similar situation exists in developing countries as well. In attempts to establish programmes on radiological protection of patients during CT procedures in developing countries, the International Atomic Energy Agency (IAEA) initiated projects to assess the current situation (15,16) . For paediatric patients the interest was 2-fold: to investigate the frequency of paediatric CT examinations in participating countries and assess the magnitude of CT doses to paediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Paediatric CT examinations in 19 developing countries: frequency and radiation dose

Muhogora¹,

Ahmed²,

AlSuwaidi

et al. 2010

Radiation Protection Dosimetry

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The aims of this study were to investigate the frequency of computed tomography (CT) examinations for paediatric patients below 15 y of age in 128 CT facilities in 28 developing countries of Africa, Asia and Eastern Europe and to assess the magnitude of CT doses. Radiation dose data were available from 101 CT facilities in 19 countries. The dose assessment was performed in terms of weighted CT dose index (CTDI(w)), volume CT index and dose length product (DLP) for chest, chest (high resolution), lumbar spine, abdomen and pelvis CT examinations using standard methods. The results show that on average the frequency of paediatric CT examinations was 20, 16 and 5 % of all CT examinations in participating centres in Africa, Asia and Eastern Europe, respectively. Eleven CT facilities in six countries were found to use adult CT exposure parameters for paediatric patients, thus indicating limited awareness and the need for optimisation. CT images were of adequate quality for diagnosis. The CTDI(w) variations ranged up to a factor of 55 (Africa), 16.3 (Asia) and 6.6 (Eastern Europe). The corresponding DLP variations ranged by a factor of 10, 20 and 8, respectively. Generally, the CTDI(w) and DLP values in Japan are lower than the corresponding values in the three regions in this study. The study has indicated a stronger need in many developing countries to justify CT examinations in children and their optimisation. Awareness, training and monitoring of radiation doses is needed as a way forwards.

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Patient doses in CT Examinations in 18 countries: initial results from international atomic energy agency projects

Cited by 50 publications

References 14 publications

SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT

SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT

Comparison of 640-slice Aquilon ONE CT scanner’s measured dosimetric parameters with ICRP dose reference levels for head, chest and abdominal CT examinations

Paediatric CT examinations in 19 developing countries: frequency and radiation dose

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