Radiation doses in CT examinations from the West China Hospital, Sichuan University and setting local diagnostic references levels

Li, Zhenlin; Zhang, Jin-Ge; Xia, Chunchao; Zhao, Fang; Zhang, Kai; Li, Yuming; Lei, Li; Pu, Jun; Peng, Wanlin; Liu, Keling; Guo, Yumei

doi:10.21037/atm-20-5443

Cited by 8 publications

(4 citation statements)

References 27 publications

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“…Relatively low average ED values were obtained from the analysis of over 150,000 studies conducted in the Chinese province of Sichuan. Specifically, for chest CT scans, they were 5.1 mSv [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Redefining Radiation Metrics: Evaluating Actual Doses in Computed Tomography Scans

Sabiniewicz-Ziajka,

Szarmach,

Grzywińska

et al. 2024

Biomedicines

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Background: Computed tomography (CT) contributes significantly to the collective dose from medical sources, raising concerns about potential health risks. However, existing radiation dose estimation tools, such as volume computed tomography dose index (CTDIvol), dose-length product (DLP), effective dose (ED), and size-specific dose estimate (SSDE), have limitations in accurately reflecting patient exposure. This study introduces a new parameter, size-specific dose-length product (DLPss), aiming to enhance the precision of radiation dose estimation in real-life scenarios. Methods: A retrospective analysis of 134 chest CT studies was conducted. Relationships between CTDIvol and anthropometric parameters were examined, and SSDE was calculated based on effective diameter. Additionally, the novel parameter, DLPss, was introduced, considering scan length and cross-sectional dimensions. Results: Analysis reveals variations in scan length, effective diameter, and CTDIvol between genders. Strong correlations were observed between CTDIvol and effective diameter, particularly in men. The average CTDIvol for the entire group was 7.83 ± 2.92 mGy, with statistically significant differences between women (7.38 ± 3.23 mGy) and men (8.30 ± 2.49 mGy). SSDE values showed significant gender differences, with men exhibiting higher values. The average SSDE values for women and men were 9.15 ± 2.5 mGy and 9.6 ± 2.09 mGy, respectively, with a statistically significant difference (p = 0.03). The newly introduced DLPss values ranged around 343.90 ± 81.66 mGy·cm for the entire group, with statistically significant differences between women (323.53 ± 78.69 mGy·cm) and men (364.89 ± 79.87 mGy·cm) (p < 0.05), providing a comprehensive assessment of total radiation dose. Conclusion: The study highlights the need for accurate radiation dose estimation, emphasizing the impact of CT examination parameters on dose variability. The proposed DLPss parameter offers a promising approach to enhancing precision in assessing radiation risk during CT scans. Further research is warranted to explore additional parameters for a comprehensive understanding of radiation exposure and to optimize imaging protocols for patient safety.

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Section: Discussionmentioning

confidence: 99%

Redefining Radiation Metrics: Evaluating Actual Doses in Computed Tomography Scans

Sabiniewicz-Ziajka,

Szarmach,

Grzywińska

et al. 2024

Biomedicines

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“…For example, the extremities have a low risk of radiation-induced carcinogenesis, whereas solid organs, including the lungs, and particularly glandular organs, such as the thyroid and mammary glands, have a much higher risk (45). the same exposed body part may even receive varying radiation doses depending on the effective dose when undergoing a Ct scan (53)(54)(55). to reduce the harm of radiation to the human body, the dose in each X-ray examination needs to be minimized.…”

Section: Enhancing Medical Knowledge and Education Regarding Radiatio...mentioning

confidence: 99%

Recommendations for reducing exposure to medical X‑ray irradiation (Review)

Shi

Sun

2022

Med Int

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With the increasing frequency of X-ray examinations in clinical medicine, public concern regarding the harm caused by exposure to X-ray radiation is also increasing. However, some physicians are not completely aware of the dangers of exposure to X-ray irradiation. Individuals specialized in this field, including physicians, have a better understanding of these dangers, which limits the use of X-rays in medicine. the present study aimed to address strategies for reducing the harm caused by exposure to medical X-rays and increase public awareness regarding X-ray radiation. through a literature search and review, combined with the current status of clinical X-ray examination and the authors' professional experience, the present study highlights the importance of reducing X-ray exposure, and proposes several specific recommendations and measures for reducing the frequency or dose of X-ray irradiation. On the whole, the finding discussed in the present review suggest the minimal use of medical X-ray examinations and that alternative tests should be selected whenever possible. When medical X-ray screening and treatments are necessary, the risk-benefit ratio should be assessed, possibly aiming to achieve avoidable exposure. Further attention should be paid to protect sensitive glands and reduce the risks in children.

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“…The SSDE is calculated by multiplying the reported CTDI vol value from a scan by coefficients dependent on patient size, which can be determined from CT images using measurement tools on the scanner. The CTDI vol measured from the 32 cm body phantom will be lower than the SSDE in smaller patients such as those typical of the population in Southeast Asia [6,7]. Therefore, there is a need for a method that would provide a better indication of doses to tissues within the trunk for this and other populations of smaller stature.…”

Section: Introductionmentioning

confidence: 99%

“…D w can be calculated using attenuation values from axial images at each position along the longitudinal direction, but calculation of D w requires sophisticated computer software. Studies calculating mean absorbed doses for organs covered by the primary beam, such as the liver, stomach, and kidney, show strong relationships between SSDE and calculated organ doses [6,[12][13][14]. Therefore, it would be useful to be able to calculate values for the SSDE for sections of the trunk including these organs in order to provide assessments of the organ doses, which can give better indications of risk than the effective dose [15].…”

Section: Introductionmentioning

confidence: 99%

Simplified approach to estimation of organ absorbed doses for patients undergoing abdomen and pelvis CT examination

2021

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The volumetric computed tomography (CT) dose index (CTDIvol) is the measure of output displayed on CT consoles relating to dose within a standard phantom. This gives a false impression of doses levels within the tissues of smaller patients in Southeast Asia. A size-specific dose estimate (SSDE) can be calculated from the CTDIvol to provide an assessment of doses at specific positions within a scan using size-specific conversion factors. SSDE is derived using the water equivalent diameter (D w) of the patient, but calculation of D w requires sophisticated computer software. This study aimed to evaluate relationships between D W and effective diameter (D Eff), which can be measured more readily, in order to estimate SSDE at various positions within a routine clinical abdomen and pelvis CT examination for Thai patients. An in-house ImageJ algorithm was developed to measure D w, effective diameter (D Eff), and SSDE on CT slices located at the heart, liver, kidneys, colon, and bladder, on 181 CT examinations of abdomen and pelvis. Relationships between D Eff and D w were determined, and values of organ absorbed dose using D Eff were estimated. This approach was validated using a second cohort of 54 patients scanned on a different CT scanner. The results revealed that ratios between D Eff and D w at the heart level were 1.11–1.13 and those for the others were about 1.00. Additionally, the SSDE/CTDIvol ratio was estimated for each organ in terms of exponential functions using the relationships between D w and D Eff for individual organs. In summary, this study proposed a simple method for estimation of organ absorbed doses for Southeast Asian patients undergoing abdomen and pelvis CT examinations where sophisticated computer software is not available.

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Radiation doses in CT examinations from the West China Hospital, Sichuan University and setting local diagnostic references levels

Cited by 8 publications

References 27 publications

Redefining Radiation Metrics: Evaluating Actual Doses in Computed Tomography Scans

Redefining Radiation Metrics: Evaluating Actual Doses in Computed Tomography Scans

Recommendations for reducing exposure to medical X‑ray irradiation (Review)

Simplified approach to estimation of organ absorbed doses for patients undergoing abdomen and pelvis CT examination

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