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The effects of mis-centering on radiation dose during CT head examination: A phantom study

Isa INC, Rahmat SMS, Dom SM, Kayun Z, Karim MKA

J Xray Sci Technol, 2019;27(4):631-639.
PMID: 31205011 DOI: 10.3233/XST-190491

There are several factors that may contribute to the increase in radiation dose of CT including the use of unoptimized protocols and improper scanning technique. In this study, we aim to determine significant impact on radiation dose as a result of mis-centering during CT head examination. The scanning was performed by using Toshiba Aquilion 64 slices multi-detector CT (MDCT) scanner and dose were measured by using calibrated ionization chamber. Two scanning protocols of routine CT head; 120 kVp/ 180 mAs and 100 kVp/ 142 mAs were used represent standard and low dose, respectively. As reference measurement, the dose was first measured on standard cylindrical polymethyl methacrylate (PMMA) phantom that positioned at 104 cm from the floor (reference isocenter). The positions then were varied to simulate mis-centering by 5 cm from isocenter, superiorly and inferiorly at 109 cm, 114 cm, 119 cm, 124 cm and 99 cm, 94 cm, 89 cm, 84 cm, respectively. Scanning parameter and dose information from the console were recorded for the radiation effective dose (E) measurement. The highest mean CTDIvol value for MCS and MCI were 105.06 mGy (at +10 cm) and 105.51 mGy (at - 10 cm), respectively which differed significantly (p

Matched MeSH terms: Tomography, X-Ray Computed/standards*
Coronary CT angiography with single-source and dual-source CT: comparison of image quality and radiation dose between prospective ECG-triggered and retrospective ECG-gated protocols

Sabarudin A, Sun Z, Yusof AK

Int J Cardiol, 2013 Sep 30;168(2):746-53.
PMID: 23098849 DOI: 10.1016/j.ijcard.2012.09.217

This study is conducted to investigate and compare image quality and radiation dose between prospective ECG-triggered and retrospective ECG-gated coronary CT angiography (CCTA) with the use of single-source CT (SSCT) and dual-source CT (DSCT).

Matched MeSH terms: Tomography, X-Ray Computed/standards*
Fulltext Consensus survey on pre-procedural safety practices in radiological examinations: a multicenter study in seven Asian regions

Lee YH, Quek ST, Khong PL, Lee CS, Wu JS, Zhang L, et al.

Br J Radiol, 2020 Sep;93(1113):20200082.
PMID: 32584595 DOI: 10.1259/bjr.20200082

OBJECTIVE: To understand the status of pre-procedural safety practices in radiological examinations at radiology residency training institutions in various Asian regions.
METHODS: A questionnaire based on the Joint Commission International Accreditation Standards was electronically sent to 3 institutions each in 10 geographical regions across 9 Asian countries. Questions addressing 45 practices were divided into 3 categories. A five-tier scale with numerical scores was used to evaluate safety practices in each institution. Responses obtained from three institutions in the United States were used to validate the execution rate of each surveyed safety practice.
RESULTS: The institutional response rate was 70.0% (7 Asian regions, 21 institutions). 44 practices (all those surveyed except for the application of wrist tags for identifying patients with fall risks) were validated using the US participants. Overall, the Asian participants reached a consensus on 89% of the safety practices. Comparatively, most Asian participants did not routinely perform three pre-procedural practices in the examination appropriateness topic.
CONCLUSION: Based on the responses from 21 participating Asian institutions, most routinely perform standard practices during radiological examinations except when it comes to examination appropriateness. This study can provide direction for safety policymakers scrutinizing and improving regional standards of care.
ADVANCES IN KNOWLEDGE: This is the first multicenter survey study to elucidate pre-procedural safety practices in radiological examinations in seven Asian regions.

Matched MeSH terms: Tomography, X-Ray Computed/standards
Fulltext 2017 Multimodality Appropriate Use Criteria for Noninvasive Cardiac Imaging: Expert Consensus of the Asian Society of Cardiovascular Imaging

ASCI Practice Guideline Working Group, Beck KS, Kim JA, Choe YH, Sim KH, Hoe J, et al.

Korean J Radiol, 2017 Nov-Dec;18(6):871-880.
PMID: 29089819 DOI: 10.3348/kjr.2017.18.6.871

In 2010, the Asian Society of Cardiovascular Imaging (ASCI) provided recommendations for cardiac CT and MRI, and this document reflects an update of the 2010 ASCI appropriate use criteria (AUC). In 2016, the ASCI formed a new working group for revision of AUC for noninvasive cardiac imaging. A major change that we made in this document is the rating of various noninvasive tests (exercise electrocardiogram, echocardiography, positron emission tomography, single-photon emission computed tomography, radionuclide imaging, cardiac magnetic resonance, and cardiac computed tomography/angiography), compared side by side for their applications in various clinical scenarios. Ninety-five clinical scenarios were developed from eight selected pre-existing guidelines and classified into four sections as follows: 1) detection of coronary artery disease, symptomatic or asymptomatic; 2) cardiac evaluation in various clinical scenarios; 3) use of imaging modality according to prior testing; and 4) evaluation of cardiac structure and function. The clinical scenarios were scored by a separate rating committee on a scale of 1-9 to designate appropriate use, uncertain use, or inappropriate use according to a modified Delphi method. Overall, the AUC ratings for CT were higher than those of previous guidelines. These new AUC provide guidance for clinicians choosing among available testing modalities for various cardiac diseases and are also unique, given that most previous AUC for noninvasive imaging include only one imaging technique. As cardiac imaging is multimodal in nature, we believe that these AUC will be more useful for clinical decision making.

Matched MeSH terms: Tomography, X-Ray Computed/standards