Optimisation of pediatric CT protocols: low dose chest CT for patients with osteosarcoma and Ewing sarcoma.

Congress:

EuroSafe Imaging 2020

Poster Number:

ESI-05239

Type:

EuroSafe Imaging

Keywords:

Performed at one institution, Observational, Retrospective, Quality assurance, Image verification, Dosimetric comparison, Technical aspects, Staging, Radiation safety, CT, Radioprotection / Radiation dose, Paediatric, Oncology, Action 7 - Radiation protection of children

Authors:

V. Rossetti, G. Di rosa, O. Rampado, S. Bertana, F. Bertolino, R. Ropolo

DOI:

10.26044/esi2020/ESI-05239

DOI-Link:

https://dx.doi.org/10.26044/esi2020/ESI-05239

Table 1: Description of patients and examination sample

Fig. 1: CTDIvol vs patient age for different CT protocols and Dose Reference Level....

Fig. 3: Frequencies of Image Quality scores

Fig. 6: Examples of deep image analysis with Physico Dose Tracking System. A)...

Background/introduction

Osteosarcoma and Ewing sarcoma are the most frequent paediatric bone tumors, mainly affecting subjects aged between 10 and 19, and it is extremely rare in children before the age of 5 [1]. Since both of these tumors have a high probability of lung metastases, patients undergo a CT scan every 3 months in the first two years after the onset of the illness, and then one CT scan a year. It is compulsory to minimize the probability of radiation damage [2] so the low dose...

Description of activity and work performed

The work was carried out in two steps. First, a retrospective analysis of all chest CT performed in our radiology department on osteosarcoma and Ewing sarcoma paediatric patients who underwent the first staging CT in the period 2013-2017 was carried out. All the exams were performed using a GE LightSpeed Pro32 scanner equipped with tube current modulation but without any iterative reconstruction method. A total number of 39 patients and 190 acquisitions were selected. The exams, resident on the PACS (Fuji Synapse), were retrieved and...

Conclusion and recommendations

After a deep analysis of all collected data and a critical review of the images in the light of their IQ scores, we could identify the most frequent problems, namely: high noise, wrong protocol choice, wrong selection of the scanning length, malfunctioning of the AEC due to centering errors and wrong positioning of patient gonads shielding (Fig. 6). One of the main problems regarding protocol choice was that the dedicated “Chest osteo low dose – children” protocol was frequently used without changing parameters according to...

Personal/organisational information

V. Rossetti; AOU Città della Salute e della scienza, Turin/IT - nothing to disclose O. Rampado; Turin/IT - nothing to disclose G. Di Rosa; Turin/IT - nothing to disclose S. Bertana; Turin/IT - nothing to disclose F. Bertolino; Turin/IT - nothing to disclose R. Ropolo; Turin/IT - nothing to disclose

References

Casali, P.G. et al. ESMO Clinical Practice Guideline, “Bone sarcomas: ESMO –PaedCan–EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up”, Annals of Oncology 29 (Supplement 4): iv79–iv95, 2018 doi:10.1093/annonc/mdy31 ICRP, Khong PL, Ringertz H et al (2013) ICRP publication 121: radiological protection in paediatric diagnostic and interventional radiology. Ann ICRP 42:1–63 Valentin J, International Commission on Radiation Protection (2007), International Commission on Radiation Protection. Managing patient dose in multi-detector computed tomography (MDCT). ICRP Publication 102. Ann ICRP 37:1–79 European Commission, Radiation Protection 185 “European Guidelines...