Dose reduction chest computed tomography in cystic fibrosis: A systematic review.

Congress:

EuroSafe Imaging 2019

Poster Number:

ESI-0027

Type:

EuroSafe Imaging

Keywords:

Action 7 - Radiation protection of children, Action 4 - Dose management systems, Action 2 - Clinical diagnostic reference levels (DRLs), Thorax, Lung, Radioprotection / Radiation dose, CT, CT-High Resolution, Comparative studies, Dosimetry, Radiation effects, Outcomes, Genetic defects

Authors:

K. P. Sheahan, D. Glynn, F. boland, O. O’Connor, A. Brady, M. A. Maher

DOI:

10.26044/esi2019/ESI-0027

DOI-Link:

https://dx.doi.org/10.26044/esi2019/ESI-0027

Fig. 1: Flowchart of search process and study selection

Fig. 2: Baseline Characteristics

Fig. 3: Summary of Outcome Findings

Fig. 4: Risk of Bias within studies

Background/introduction

Cystic Fibrosis (CF) is a multi-systemic, life-limiting, autosomal recessive disorder that affects 1 in 3,200-3,300 newborns (1).Currently, computed tomography (CT) is considered superior to pulmonary function tests and chest radiography for the assessment of CF-related lung disease. However, with developments in managing CF continuing to drive dramatic improvements in survival (2)and increased use of CT for patients with CF (3), the associated cumulative ionizing radiation lends caution to its routine use for serial monitoring of CF related lung disease due to the potential carcinogenic consequences.The...

Description of activity and work performed

Methods A systematic search of PubMed, the Cochrane library, Embase, and Scopus was performed. Primary outcome was the reported reduced effectivedoseand secondary outcome was image quality. Articles concerning dose reduction chest CT compared to standard dose chest CT in CF patients were included. Two authors screened and selected articles. All studies were subjected to an assessment of quality (QUADAS-2 Tool). Results A pre-determined search strategy yielded 134 articles. Duplicates were removed,screening of titles/abstracts and full text review of 32 articles was performed. 12 studies were...

Conclusion and recommendations

This review foundthat iterative reconstruction and reduced number of image slices facilitates chest CT with substantially decreased radiation dose for monitoring CF lung disease. For patients with CF, a low dose chest CT protocol could be considered to replace higher dose chest CT given the potential for high cumulative exposure to radiation in this cohort. Dose levels approaching those of chest radiographs, can be achieved, particularly given the mean reduced dose of 0.28mSv in this review. 75% of included studies demonstrated image quality that was...

Personal/organisational information

Dr. Kevin P. Sheahan Specialist Registrar Radiology Mercy/Cork University Hospitals. Cork Ireland [email protected]

References

1. Lau K, Jackson D, Ardley N, Prasa J. Ultra-low dose CT: Its efficacy in cystic fibrosis assessment. Journal of Medical Imaging and Radiation Oncology. 2013;57:42. 2. Castellani C, Duff AJA, Bell SC, Heijerman HGM, Munck A, Ratjen F, et al. ECFS best practice guidelines: the 2018 revision. Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society. 2018;17(2):153-78. 3. O'Connell OJ, McWilliams S, McGarrigle A, O'Connor O, Shanahan F, Mullane D, et al. Radiological imaging in cystic fibrosis and associated radiation...