Musculoskeletal local diagnostic reference levels

Congress:

EuroSafe Imaging 2018

Poster Number:

ESI-0069

Type:

EuroSafe Imaging

Keywords:

Radiation safety, Plain radiographic studies, Fluoroscopy, CT, Radioprotection / Radiation dose, Musculoskeletal system, Action 2 - Clinical diagnostic reference levels (DRLs), Action 3 - Optimisation, diagnostic reference levels, image quality, Dosimetric comparison

Authors:

J. Santos, A. Brito, R. B. Guisantes, S. Rodrigues, G. Paulo, F. Caseiro Alves

DOI:

10.1594/esi2018/ESI-0069

DOI-Link:

https://dx.doi.org/10.1594/esi2018/ESI-0069

Fig. 1: Figure 1 - Example of diameter measures skin-to-skin performed in radiography...

Fig. 2: Figure 2 - Example of diameter measures for CT examinations performed...

Fig. 3: Figure 3 – Dose values for radiography procedures, described in DAP...

Fig. 4: Figure 4 – Dose values for CT examinations obtain in this study, described in...

Background/introduction

Musculoskeletal pathologies are the main causes of chronic pain and physical disability (1) and medical imaging procedures are crucial to diagnose and follow up the treatment of these disorders (2). Different image modalities, that use ionising radiation, are used successively used in emergency departments, consultation and surgery (3-5). In order to decrease the population risk is critical to analyse the diagnostic reference levels (DRL) of the musculoskeletal procedures (6).

Description of activity and work performed

Objective: The aim of this study was to establish local DRL’s for musculoskeletal in all the image modalities: plain radiography, computed tomography (CT) and fluoroscopy. Material and methods: A retrospective analysis of Digital Imaging and Communications in Medicine (DICOM) headers was performed to analyse Dose Are Product (DAP-mGy.cm2) for radiography and fluoroscopy procedures and Dose Length Product (DLP - mGy.cm) and CT dose index (CTDIvol - mGy) for CT examinations. The most frequent musculoskeletal examinations were selected: pelvis, knee and spine (cervical, dorsal, lumbar) radiography;...

Conclusion and recommendations

The analysis of 288 examinations allowed the calculation of 14 local DRL’s. The majority of obtained values are lower than the literature. Based on this study optimisation measures were define for some procedures in order to harmonised the practice and decrease the patient risk.

Personal/organisational information

Joana Santos Adjunct Professor, BSc Hons, MSc, PhD. Medical Imaging and Radiotherapy Department Coimbra Health School, Polytechnic Institute of Coimbra, Portugal Filipe Caseiro Alves, MD PhD Head of Imaging Department Coimbra HospitalandUniversitary Centre, Portugal

References

1 - Fialho, S. C. M. S.; Castro, G. R. W.; Zimmermann, A. F.; Ribeiro, G. G.; Neves, F. S.; Pereira, I. A.; Fialho GL. Avaliacao dos sistema musculo-esquelético na unidade de emergência. Elsevier. 2011;51(3):244-248. http://www.scielo.br/pdf/rbr/v51n3/en_v51n3a05.pdf.   2 - Tonkopi E, et al. Local diagnostic reference levels for typical radiographic procedures. Can Assoc Radiol J. 2012;63(4):237-241. doi:10.1016/j.carj.2011.02.004. 3 – Kalra MK, et al. CT Radiation: Key Concepts for Gentle and Wise Use. RadioGraphics. 2015;35(6):1706-1721. doi:10.1148/rg.2015150118. . 4 -Gehrig LMB. Orthopedic surgery. Am J Surg. 2011;202(3):364-368. doi:10.1016/j.amjsurg.2011.06.007...