Fifty patients exposed to the highest radiation dose on a single CT examination in a tertiary hospital: why and how?

Congress:

EuroSafe 2022

Poster Number:

ESI-13313

Type:

EuroSafe Imaging

Keywords:

Emergency, Oncology, Radiation physics, CT, CT-Angiography, Diagnostic procedure, Radiation safety, Dosimetric comparison, Quality assurance

Authors:

F. Atak, M. R. Onur, M. N. Özmen, D. Akata

DOI:

DOI-Link:

https://dx.doi.org/

Purpose or learning objective

While CT accounts for approximately 11% of overall diagnostic radiological examinations, it is responsible for 70% of the total effective radiation dose [1]. Therefore, the entire medical community and technology entrepreneurs should have focused on ensuring an optimized benefit-risk ratio for every individual CT examination. According to the ICRP, CT should have no upper radiation dose limit [2,3]. Therefore, it is essential to use as low as possible minimum radiation dose with the best possible imaging quality while performing CT examinations, considering ALARA principles. Furthermore,...

Methods or background

Ten patients for each body part exposed to the highest radiation dose at one acquisition were included in the study among patients who underwent brain, chest, cardiac, monophasic, or multiphasic abdominopelvic CT in the last year. CT dose index volume (CTDIvol), dose length product (DLP), and effective dose (ED) values of 50 CTs were recorded from dose-management software (DoseWatch, the GE Healthcare, USA)(Fig. 1,2). In addition, the relationship between CT dose products and dose-related factors, including body mass index (BMI), tube voltage (kV), tube current-time...

Results or findings

Descriptive statistics are shown inTable-1 and Table-2in detail. According to ACR appropriateness criteria, CT exams were found appropriately ordered in 38 (86.4%) patients(Fig.4). Six clinical scenarios were excluded because they were not included in the guidelines. These were abdominopelvic CT for umbilical discharge; nonenhanced, arterial and venous phase abdominopelvic CT for preoperative evaluation in a living kidney donor; nonenhanced chest CT for follow-up after COVID-19; enhanced chest CT for lung metastasis screening of a cancer patient; nonenhanced and enhanced head CT for follow-up of a...

Conclusion

Awareness of the main factors causing high radiation dose in CT exams helps to reduce dose per study and variation in dose across patients. Total scan length is an independent predictor of CT radiation dose.

References

Jaffe TA, Hoang JK, Yoshizumi TT, Toncheva G, Lowry C, Ravin C. Radiation dose for routine clinical adult brain CT: Variability on different scanners at one institution.AJR Am J Roentgenol. 2010;195(2):433-438. doi:10.2214/AJR.09.3957 ICRP, 2017. Diagnostic reference levels in medical imaging. ICRP Publication 135 Sanguesa, D. Fabri, P. Soffia. Most frequent causes of radiation dose alerts in CT and how to manage them. EuroSafe Imaging 2019 / ESI-0095. https://dx.doi.org/10.26044/esi2019/ESI-0095 Liao EA, Quint LE, Goodsitt MM, Francis IR, Khalatbari S, Myles JD (2011) Extra Z-axis coverage at...

Personal information and conflict of interest

F. Atak: Nothing to disclose M. R. Onur: Nothing to disclose M. N. Özmen: Nothing to disclose D. Akata: Nothing to disclose

Fig 1: Study overview page in DoseWatch, the GE Healthcare, USA.

Fig 2: Protocol information of the study and dose parameters in DoseWatch, the GE...

Fig 3: Optimal scan range and fair (tolerable) scan range demonstration; calculation...

Fig 4: Clinical scenarios based on ACR appropriateness criteria.

Fig 5: Reasons of increased dose per study.

Fig 6: Table-1. Descriptive statistics.

Fig 7: Table-2. Descriptive statistics.

Fig 8: Table-3. Multivariate regression analysis for predicting factors for DLP in 50...

Fig 9: Table-4. Multivariate regression analysis for predicting factors for DLP in...