Pearls and pitfalls for fast imaging, low dose and high quality in emergency radiology

Congress:

EuroSafe Imaging 2018

Poster Number:

ESI-0053

Type:

EuroSafe Imaging

Keywords:

CT, Emergency, Action 3 - Image quality assessment based on clinical indications, Action 2 - Clinical diagnostic reference levels (DRLs), Action 4 - Quality of radiological equipment, Action 3 - Optimisation, diagnostic reference levels, image quality, Radiation safety, Acute

Authors:

M. R. Onur, E. Akpinar, I. Idilman, M. N. Özmen, D. Akata

DOI:

10.1594/esi2018/ESI-0053

DOI-Link:

https://dx.doi.org/10.1594/esi2018/ESI-0053

Fig. 1: Fig. 1: CT protocols should be determined due to patient demographics, body...

Fig. 2: Fig. 2: CT scan parameters which affect radiation exposure include detector...

Fig. 3: Fig. 3: Pitch values, dynamic collimation and selection of appropriate scan...

Fig. 4: Fig. 4: AEC should be used in accordance with isocentering of patient in CT...

Background/introduction

Emergency Radiology Learning Objectives Patient and CT scanner parameters effecting radiation dose in CT protocols. Pearls and pitfalls in reducing radiation dose with preserving image quality and fast scanning in emergency settings. Understanding the relationship between parameters used in radiation dose management. Introduction/Background o CT examinations with optimal radiation dose and image quality can be accomplished by appropriate CT protocol. Protocols should be tailored on the basis of patient age, body region, and clinical indication (Fig. 1). o Image quality mainly depends on adequate X-ray...

Description of activity and work performed

Description of activity and work performed We reviewed the CT dose reduction principles and implementation of these principles to different emergency settings. 1. Before CT scan o Most effective way to reduce radiation dose is to question the appropriateness of CT order. o Appropriate CT order should be in accordance with integration of clinical decision rules and expert panel appropriateness criteria into imaging algorithms. o Importation of outside hospital imaging examinations from CD to the Picture Archive and Communication System (PACS) was shown to reduce...

Conclusion and recommendations

Appropriate and safe application of CT in emergency radiology necessitates acquisition of CT images with fast and low dose technique with high quality. Awareness of required clinical information is mainstay for appropriate CT protocol. Timely review of scanning protocols and associated radiation doses is essential to ensure that protocols are correctly configured and updated on a regular basis.

Personal/organisational information

1. Mehmet Ruhi Onur (submitting author), Associate Professor, e-mail:[email protected] Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey 2. Erhan Akpinar, Professor, Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey 3. Ilkay Idilman, Associate Professor, Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey 4. Mustafa Nasuh Ozmen, Professor, Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey 5. Deniz Akata, Professor, Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Turkey

References

References 1. Sodickson A, Opraseuth J, Ledbetter S. Outside imaging in emergency department transfer patients: CD import reduces rates of subsequent imaging utilization. Radiology 2011;260(2):408–13. 2.Kalra MK, Sodickson AD, Mayo-Smith WW.CT Radiation: Key Concepts for Gentle and Wise Use. Radiographics 2015; 35(6):1706-21. 3. ACR-AAPM practice guideline for diagnostic reference levels and achievable doses in medical x-ray imaging, rev 2014. http://www.acr.org/Quality-Safety/Standards-Guidelines/ Practice-Guidelines. 4. Singh S, Kalra MK, Thrall JH, Mahesh M. Pointers for optimizing radiation dose in head CT protocols. J Am Coll Radiol 2011; 8(8):591–593....