Strategies for reducing radiation exposure in multi-detector row CT.

Many tools and strategies exist to enable the reduction of radiation exposure from computed tomography (CT). The common CT metrics of x-ray output, CTDI(vol) and DLP, are explained and serve as the basis for monitoring radiation exposure from CT scans. Many strategies to dose optimize CT protocols are explored that, in combination with available hardware and software tools, allow robust diagnostic quality CT scans to be performed with a radiation exposure appropriate for the clinical scenario and the size of the patients. Specific emergency department example protocols are used to demonstrate these techniques.

[1]  E. Olcott,et al.  Split-bolus MDCT urography with synchronous nephrographic and excretory phase enhancement. , 2007, AJR. American journal of roentgenology.

[2]  Jan Menke,et al.  Comparison of different body size parameters for individual dose adaptation in body CT of adults. , 2005, Radiology.

[3]  Natalie N. Braun,et al.  Strategies for reducing radiation dose in CT. , 2009, Radiologic clinics of North America.

[4]  D. Levin,et al.  The effect of self-referral on utilization of advanced diagnostic imaging. , 2011, AJR. American journal of roentgenology.

[5]  J. Boone,et al.  Size-Specific Dose Estimates (SSDE) in Pediatric and Adult Body CT Examinations , 2011 .

[6]  William W. Boonn,et al.  Automated extraction of radiation dose information for CT examinations. , 2010, Journal of the American College of Radiology : JACR.

[7]  P. Shrimpton,et al.  Assessment of Patient Dose in CT , 2004 .

[8]  M. Goske,et al.  Alliance for Radiation Safety in Pediatric Imaging (Image Gently Program): Size-Corrected Dose (A New Patient Dose Estimate) and First Pediatric National Registry for CT Scans , 2011 .

[9]  William H. Judy,et al.  The Measurement, Reporting, and Management of Radiation Dose in CT , 2008 .

[10]  F. Jolesz,et al.  Re: "ACR Appropriateness Criteria® on treatment of uterine leiomyomas". , 2011, Journal of the American College of Radiology : JACR.

[11]  G. Kovacs,et al.  Excluding Pulmonary Embolism at the Bedside without Diagnostic Imaging: Management of Patients with Suspected Pulmonary Embolism Presenting to the Emergency Department by Using a Simple Clinical Model and d-dimer , 2001, Annals of Internal Medicine.

[12]  A. Sodickson,et al.  Patient-centric radiation dose monitoring in the electronic health record: what are some of the barriers and key next steps? , 2010, Journal of the American College of Radiology : JACR.

[13]  Willi A Kalender,et al.  Effects of adaptive section collimation on patient radiation dose in multisection spiral CT. , 2009, Radiology.

[14]  Joel G Fletcher,et al.  Automatic selection of tube potential for radiation dose reduction in CT: a general strategy. , 2009, Medical physics.

[15]  John M Boone,et al.  Reply to "Comment on the 'Report of AAPM TG 204: Size-specific dose estimates (SSDE) in pediatric and adult body CT examinations'" [AAPM Report 204, 2011]. , 2012, Medical physics.

[16]  Alvin C. Silva,et al.  Iterative Reconstruction Technique for Reducing Body Radiation Dose at Ct: Feasibility Study Hara Et Al. Ct Iterative Reconstruction Technique Gastrointestinal Imaging Original Research , 2022 .

[17]  S. Achenbach,et al.  Iterative reconstruction in image space (IRIS) in cardiac computed tomography: initial experience , 2011, The International Journal of Cardiovascular Imaging.

[18]  Michael F McNitt-Gray,et al.  AAPM/RSNA Physics Tutorial for Residents: Topics in CT. Radiation dose in CT. , 2002, Radiographics : a review publication of the Radiological Society of North America, Inc.

[19]  C. Douglas Maynard,et al.  ACR Appropriateness Criteria , 2000 .

[20]  A Laupacis,et al.  The Canadian C-spine rule for radiography in alert and stable trauma patients. , 2001, JAMA.

[21]  J. Boone,et al.  CT dose index and patient dose: they are not the same thing. , 2011, Radiology.

[22]  Michael J. Bronskill,et al.  AMERICAN ASSOCIATION OF PHYSICISTS IN MEDICINE. , 2012, Medical physics.

[23]  Harlan M Krumholz,et al.  Exposure to low-dose ionizing radiation from medical imaging procedures. , 2009, The New England journal of medicine.

[24]  T. Ptak,et al.  Radiation dose is reduced with a single-pass whole-body multi-detector row CT trauma protocol compared with a conventional segmented method: initial experience. , 2003, Radiology.

[25]  Michael J Pentecost,et al.  American College of Radiology white paper on radiation dose in medicine. , 2007, Journal of the American College of Radiology : JACR.

[26]  A. Sodickson,et al.  Cumulative radiation exposure and cancer risk estimates in emergency department patients undergoing repeat or multiple CT. , 2009, AJR. American journal of roentgenology.

[27]  Martin L Gunn,et al.  The obese emergency patient: imaging challenges and solutions. , 2011, Radiographics : a review publication of the Radiological Society of North America, Inc.

[28]  Keith J Strauss,et al.  Image gently: Ten steps you can take to optimize image quality and lower CT dose for pediatric patients. , 2010, AJR. American journal of roentgenology.

[29]  C. McCollough,et al.  CT dose reduction and dose management tools: overview of available options. , 2006, Radiographics : a review publication of the Radiological Society of North America, Inc.

[30]  K S Pentlow,et al.  Radiation dose in CT. , 1992, Radiographics : a review publication of the Radiological Society of North America, Inc.

[31]  J. Herman.  ACR Appropriateness Criteria. , 2010, Current problems in cancer.

[32]  M. Kalra,et al.  Strategies for CT radiation dose optimization. , 2004, Radiology.

[33]  C. Iselin,et al.  Low-dose versus standard-dose CT protocol in patients with clinically suspected renal colic. , 2007, AJR. American journal of roentgenology.

[34]  George A Wells,et al.  The Canadian CT Head Rule for patients with minor head injury , 2001, The Lancet.

[35]  D. Brenner,et al.  Computed tomography--an increasing source of radiation exposure. , 2007, The New England journal of medicine.

[36]  A. Sodickson,et al.  Recurrent CT, cumulative radiation exposure, and associated radiation-induced cancer risks from CT of adults. , 2009, Radiology.

[37]  I. I. Rushakov,et al.  Computed Tomography , 2019, Compendium of Biomedical Instrumentation.

[38]  S. Birnbaum,et al.  Radiation safety in the era of helical CT: a patient-based protection program currently in place in two community hospitals in New Hampshire. , 2008, Journal of the American College of Radiology : JACR.

[39]  Division on Earth.  Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2 , 2006 .

[40]  C. McCollough,et al.  How effective is effective dose as a predictor of radiation risk? , 2010, AJR. American journal of roentgenology.

[41]  Rebecca S Lewis,et al.  Projected cancer risks from computed tomographic scans performed in the United States in 2007. , 2009, Archives of internal medicine.

[42]  H. Litt,et al.  Low kVp imaging for dose reduction in dual-source cardiac CT , 2009, The International Journal of Cardiovascular Imaging.

[43]  Cynthia H McCollough,et al.  The feasibility of patient size-corrected, scanner-independent organ dose estimates for abdominal CT exams. , 2011, Medical physics.

[44]  T. Yoshizumi,et al.  Radiologic and nuclear medicine studies in the United States and worldwide: frequency, radiation dose, and comparison with other radiation sources--1950-2007. , 2009, Radiology.

[45]  C. Becker,et al.  Evaluation of a single-pass continuous whole-body 16-MDCT protocol for patients with polytrauma. , 2009, AJR. American journal of roentgenology.

[46]  W. Huda,et al.  Patient size and radiation exposure in thoracic, pelvic, and abdominal CT examinations performed with automatic exposure control. , 2010, AJR. American journal of roentgenology.

[47]  K. Bae,et al.  Intravenous contrast medium administration and scan timing at CT: considerations and approaches. , 2010, Radiology.

[48]  R. Khorasani.  Can radiology professional society guidelines be converted to effective decision support? , 2010, Journal of the American College of Radiology : JACR.

[49]  Walter Huda,et al.  Patient radiation doses from adult and pediatric CT. , 2007, AJR. American journal of roentgenology.

[50]  A. Sodickson,et al.  Outside imaging in emergency department transfer patients: CD import reduces rates of subsequent imaging utilization. , 2011, Radiology.

[51]  G. Moneta,et al.  Projected Cancer Risks From Computed Tomographic Scans Performed in the United States in 2007 , 2010 .