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Radiation Dose         Share on Facebook

Adult Patients

  • “ Although all users should generally use automated tube current modulation, users must be careful about using this software in obese patients, children, and patients with metallic hardware.”
    CT Scan Parameters and Radiation Dose: Practical Advise for Radiologists
    Raman SP, Mahesh M, Blasko RV, Fishman EK
    J Am Coll Radiol 2013;10:840-846
  • “ The National Council on Radiation Protection and Measurements will continue working with ACEP, the American College of Radiology, other professional organizations, and government agencies to support and promote effective campaigns such as Image Gently, Image Wisely and Choosing Wisely.”
    Applications of Justification and Optimization in Medical Imaging: Examples of Clinical Guidance for Compute Tomography Use in Emergency Medicine
    Sierzenski PR et al.
    J Am Coll Radiol 2014;11:36-44
  • “ The use of all forms of medical imaging is based on physician decisions, including those of emergency physicians and consulting radiologists, with the understanding that the benefit of the chosen procedure should outweigh the patients potential risks of exposure to ionizing radiation (justification).”
    Applications of Justification and Optimization in Medical Imaging: Examples of Clinical Guidance for Compute Tomography Use in Emergency Medicine
    Sierzenski PR et al.
    J Am Coll Radiol 2014;11:36-44
  • "Potential measures include provision of patient information material, review of CT protocols and indications, promotion of alternative studies, use of decision support software, automatic tube current modulation, bismuth shields, improved image reconstruction algorithms, empowerment of technologists to adjust protocols, and calculation of radiation dose for possible reporting."

    CT Radiation Dose: What Can You Do Right Now in Your Practice?
    Coakley FV et al.
    AJR 2011; 196:619-625

     

  • "This special report aims to inform the medical community about the many challenges involved in managing radiation in a way that maximizes the benefit-risk ratio. The report discusses the state of current knowledge and key questions in regard to sources of medical imaging radiation exposure, radiation risk estimation, dose reduction strategies, and regulatory options."

    Managing Radiation Use in Medical Imaging: A Multifaceted Challenge
    Hricak H et al.
    Radiology 2011;258:889-905

     

  • "Compared with the standard dose examination, a 31-64% reduction in radiation dose was estimated for NI levels of 18-25, which corresponds to image noise of 19-27 HU in subcutaneous fat."

    Low-Dose CT Examinations in Crohn’s Disease: Impact on Image Quality, Diagnostic Performance, and Radiation Dose
    Kambadakone AR et al.
    AJR 2010;195:78-88

  • "Processed MDCT images with the introduction of noise to simulate low-dose MDCT examinations with Noise Index (NI) levels of 18-25 allows substantial dose reduction for CT examinations in Crohn’s disease without compromising diagnostic information."

    Low-Dose CT Examinations in Crohn’s Disease: Impact on Image Quality, Diagnostic Performance, and Radiation Dose
    Kambadakone AR et al.
    AJR 2010;195:78-88

  • "Despite a significant reduction in perceived image quality, diagnostic efficacy in detective active inflammatory Crohn’s disease of the terminal ileum was not significantly reduced by the dose reduction methods"

    Effect of Altering Automatic Exposure Control Settings and Quality Reference mAs on Radiation Dose, Image Qualit, and Diagnostic Efficacy in MDCT Enterography of Active Inflammatory Crohn’s Disease
    Allen BC et al.
    AJR 2010; 195:89-100

  • "Substantial dose reduction can be achieved using weight based quality reference mAs and altering AEC settings without affecting diagnostic efficacy in active inflammatory Crohn’s disease of the terminal ileum. However, subjective image quality can be compromised at these dose settings, depending on radiologist preference."

    Effect of Altering Automatic Exposure Control Settings and Quality Reference mAs on Radiation Dose, Image Qualit, and Diagnostic Efficacy in MDCT Enterography of Active Inflammatory Crohn’s Disease
    Allen BC et al.
    AJR 2010; 195:89-100

  • "For 64-MDCT the CTDI vol decreased from 15.72 to 11.42 mGy and 11.42 to 9.25 mGy between original to intermediate and intermediate to final dose levels."

    Effect of Altering Automatic Exposure Control Settings and Quality Reference mAs on Radiation Dose, Image Qualit, and Diagnostic Efficacy in MDCT Enterography of Active Inflammatory Crohn’s Disease
    Allen BC et al.
    AJR 2010; 195:89-100

  • "Substantial dose reduction can be achieved using weight based quality reference mAs and altering AEC (automatic exposure control) settings without affecting diagnostic efficacy in active inflammatory Crohn’s disease of the terminal ileum."

    Effect of Altering Automatic Exposure Control Settings and Quality Reference mAs on Radiation Dose, Image Qualit, and Diagnostic Efficacy in MDCT Enterography of Active Inflammatory Crohn’s Disease
    Allen BC et al.
    AJR 2010; 195:89-100

  • Limiting Scan Dosage to the Patient: Pearls
    - Limit the field of view to the study ordered. There is no need to scan the lung above the liver or to scan beneath the symphysis in routine cases
    - In multiphase studies determine what areas need the multiple acquisitions and which do not
    - Choose the right protocol depending on patient size and body habitus
  • Designing the Optimal Scan Protocol for the patient: Decisions
    - What phases of acquisition are needed? (non-contrast, arterial, venous, excretory or delayed phase)
    - What slice collimation, slice thickness and interscan spacing is needed for the optimal protocol for the patient?
    - Do we use oral and/or IV contrast? If yes decide on the best oral agent (water, positive contrast, VolLumen) and the delay time for the study, as well as selecting the IV contrast agent and defining volumes to use and the specific injection protocols.
    - The goal of a customized CT protocol for each patient as opposed to the “one size fits all” approach is one of the trends in dose reduction
  • "On the basis of our results, radiologists with access to a dual source scanner can change their renal mass protocol to a dual phase acquisition, decreasing radiation exposure by 35%."

    Dual Energy CT in patients Suspected of Having Renal masses: Can Virtual Nonenhanced Images Replace True Nonenhanced Images?
    Graser A et al
    Radiology 2009; 252:443-440

  • "A reduction from 120 kV to 90 kV led to as much as a 35% reduction in the radiation dose, without sacrifice of low contrast detectability at CT."

    Radiation Dose Reduction without Degradation of Low Contrast Detectability at Abdominal Multisection CT with a Low-Tube Voltage Technique: Phantom Study
    Funama Y et al.
    Radiology 2005; 237:905-910
  • "The technique with low tube voltage should be used only in patients whose body weight is less than 80 kg."

    Radiation Dose Reduction without Degradation of Low Contrast Detectability at Abdominal Multisection CT with a Low-Tube Voltage Technique: Phantom Study
    Funama Y et al.
    Radiology 2005; 237:905-910
  • "By decreasing the tube voltage, the amount of contrast material can be reduced without image quality degradation. In scans obtained with a low tube voltage, the radiation dose can be reduced as much as 56.8%, and higher contrast material enhancement can be achieved."

    Abdominal CT with Low Tube Voltage: Preliminary Observations about radiation Dose, Contrast Enhancement, Image Quality, and Noise
    Nakayama Y et al.
    Radiology 2005; 237:945-951