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Optimization of radiation dose for optimal image quality in head CT examination
Corresponding Author(s) : WidyaNurmayanti
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 8 No. 2 (2020): 2020 Volume 8- Issue -2
Abstract
Indonesian Nuclear Energy Regulatory Agency (Bapeten) has set the head CT DRL value of 50 mGy. CT parameter settings will affect the dose and image quality. Tube current, rotation time, and pitch parameters that used in head CT protocol with infarction case in GoetengTaroenadibrata General Hospital produced a displayed CTDIvol of 78, 7 mGy. The aim of this study was to obtain a head CT protocol with infarction cases that are able to produce optimal image quality and radiation doses that do not exceed DRL. This study was conducted by applying four head CT protocols with tube current, rotation time, and pitch variation with the monitor’s CTDIvol value does not exceed DRL in the low contrast resolution and spatial resolution phantom, also in four sample groups, each of which numbered 15 patients with clinical infarction in which each group received only one treatment. Measurement of physical image quality is done by measuring noise and SNR using the ROI software, and low contrast resolution and spatial resolution which were assessed visually by three medical physicists. Clinical quality was carried out by assessing anatomic and pathological information by three radiologists. Head CT protocol with parameters of 250 mA, rotation time 0.75 seconds, and pitch 0,750 produces the best physical and clinical image quality also radiation reduction up to 53, 8 %.
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[1]. ICRP The 2007 Recommendation of the International Commissions on Radiological Protection, ICRP Publication 103. Ann ICRP, 37(2-4), 2007, 1-332.
[2]. Einstein AJ, Effect of Radiation Exposure from Cardiac Imaging: How Good Are the Data?, J Am CollCardiol, 59(6), 2012, 553-565.
[3]. Computed Tomography (CT) Accreditation Program – Phantom Testing Instructions – Instruction Manual for Testing the ACR CT Phantom.
[4]. Mathews JD, Forsythe AV, Brady Z, Cancer Risk in 680000 People Exposed to Computed Tomography Scans in Childhood or Adolescene: Data Linkage Study of 11 Million Australians, BMJ, 346, 2013, f2360.
[5]. Gonzales AB, Salotti JA, McHugh K, Little MP, Harbron RW, Relationship Between Pediatric CT scan and Subsequent Risk of Leukaemia and Brain Tumors: Assessment of the Impact of Underlying Conditions, Br J Cancer, 2016, 388-394.
[6]. Salinas CL, WintermaxM Neuroimaging of Cerebral Ischemia and Infarction, Neurotherapeutics, 8(1), 2011, 19-27.
[7]. EliseoVano, Donald L Miller, Colin John Martin, Madan M Rehani, ICRP Publication 135: Diagnostic reference Levels in Medical Imaging, 46(1), 2017, 1-144.
[8]. Perka BAPETEN Nomor 8 Tahun TentangKeselamatan Radiasi Dalam Penggunaan Pesawat Sinar-X Radiologi Diagnostik, 2011.
[9]. McCollough CH, McNitt Gray MF, LengShuai, CT Dose Index and Patient Dose: They are not the same thing, Radiology, 250(2), 2011.
[10]. ICRU Report No. 87. Radiation Dose and Image-Quality Assessment in Computed Tomography, Journal of the ICRU, 12(1), 2012.
[11]. Hanan E, Hussein AH, Ahmed M, Assessment of Image Quality Parameters for Computed Tomography in Sudan, Scientific Research Publishing, 7, 2017, 75-84.
[12]. European Guidelines on Quality Criteria for Computed Tomography, 2000.
[13]. Zarb F, Rainford L, McEntee MF, Image Quality Assessment Tools for Optimization of CT Image, The College of Radiographers, 16(2), 2010, 147-153.
[14]. Cohen M, Fischer H, Hamacher J CT of the Head by Use of Reduced Current and Kilovoltage : Relationship Between Image Quality and Dose Reduction, AJNR Am Neuroradiol, 21, 2000, 1654-60
[15]. Saeed RS, Brindhaban A, Al Khalifah KH, Effect mA Reduction on Image Quality Parameters and Patient Dose in Computed Tomography Imaging, Radio Technol, 87(3), 2016, 271-8.
[16]. Beeres M, Wichmann JL, Paul J, CT Chest and Gantry Rotation Time: Does the Rotation Time Influence Image Quality?,ActaRadiologica, 56(8), 2015, 950-954.
[17]. Honda O, Yonagawa M, Hata A, Influence of Gantry Rotation Time and Scan Mode on Image Quality in Ultra-High-Resolution CT System, European Journal of Radiology, 2018.
[18]. Raman SP, Mahesh M, Blasko RV, Fishman EK, CT scan Parameters and Radiation Dose: Practical Advice for Radiologist, J Am CollRadiol, 10, 2013, 840-846.
[19]. McCollough CH, Yu L, Kofler JM, Degradation of CT Low Contrast Spatial Resolution Due To the Use of Iterative Reconstruction and Reduced Dose Levels, Radiology, 276(2), 2015, 499-506.
[20]. Wang J, Fleischmann D, Improving Spatial Resolution at CT: Development, Benefits, and Pitfalls, Radiology, 2018.
[21]. Corona EC, Ferreira IB Verification of CTDI and DLP Values for A Head Tomography Reported by the Manufacturers of the CT Scanners Using A CT Dose Profiler Probe, A Head Phantom and A Piranha Electrometer, IAEA, 2015. [22]. De Crop A, Smeets P, and Hoof TV, Correlation of Clinical and Physical-Technical Image Quality in Chest CT: A Human Cadaver Study Applied on Iterative Reconstruction. BMC Medical Imaging. 2015, 15-23
[23]. Sameer Tipnis, Rajesh Thampy, ZaranRumboldt, Radiation Intensity (CTDIvol) and Visibility of Anatomical Structures in Head CT Examinations, Journal of Applied Clinical Medical Physics, 17(1), 2016.
References
[2]. Einstein AJ, Effect of Radiation Exposure from Cardiac Imaging: How Good Are the Data?, J Am CollCardiol, 59(6), 2012, 553-565.
[3]. Computed Tomography (CT) Accreditation Program – Phantom Testing Instructions – Instruction Manual for Testing the ACR CT Phantom.
[4]. Mathews JD, Forsythe AV, Brady Z, Cancer Risk in 680000 People Exposed to Computed Tomography Scans in Childhood or Adolescene: Data Linkage Study of 11 Million Australians, BMJ, 346, 2013, f2360.
[5]. Gonzales AB, Salotti JA, McHugh K, Little MP, Harbron RW, Relationship Between Pediatric CT scan and Subsequent Risk of Leukaemia and Brain Tumors: Assessment of the Impact of Underlying Conditions, Br J Cancer, 2016, 388-394.
[6]. Salinas CL, WintermaxM Neuroimaging of Cerebral Ischemia and Infarction, Neurotherapeutics, 8(1), 2011, 19-27.
[7]. EliseoVano, Donald L Miller, Colin John Martin, Madan M Rehani, ICRP Publication 135: Diagnostic reference Levels in Medical Imaging, 46(1), 2017, 1-144.
[8]. Perka BAPETEN Nomor 8 Tahun TentangKeselamatan Radiasi Dalam Penggunaan Pesawat Sinar-X Radiologi Diagnostik, 2011.
[9]. McCollough CH, McNitt Gray MF, LengShuai, CT Dose Index and Patient Dose: They are not the same thing, Radiology, 250(2), 2011.
[10]. ICRU Report No. 87. Radiation Dose and Image-Quality Assessment in Computed Tomography, Journal of the ICRU, 12(1), 2012.
[11]. Hanan E, Hussein AH, Ahmed M, Assessment of Image Quality Parameters for Computed Tomography in Sudan, Scientific Research Publishing, 7, 2017, 75-84.
[12]. European Guidelines on Quality Criteria for Computed Tomography, 2000.
[13]. Zarb F, Rainford L, McEntee MF, Image Quality Assessment Tools for Optimization of CT Image, The College of Radiographers, 16(2), 2010, 147-153.
[14]. Cohen M, Fischer H, Hamacher J CT of the Head by Use of Reduced Current and Kilovoltage : Relationship Between Image Quality and Dose Reduction, AJNR Am Neuroradiol, 21, 2000, 1654-60
[15]. Saeed RS, Brindhaban A, Al Khalifah KH, Effect mA Reduction on Image Quality Parameters and Patient Dose in Computed Tomography Imaging, Radio Technol, 87(3), 2016, 271-8.
[16]. Beeres M, Wichmann JL, Paul J, CT Chest and Gantry Rotation Time: Does the Rotation Time Influence Image Quality?,ActaRadiologica, 56(8), 2015, 950-954.
[17]. Honda O, Yonagawa M, Hata A, Influence of Gantry Rotation Time and Scan Mode on Image Quality in Ultra-High-Resolution CT System, European Journal of Radiology, 2018.
[18]. Raman SP, Mahesh M, Blasko RV, Fishman EK, CT scan Parameters and Radiation Dose: Practical Advice for Radiologist, J Am CollRadiol, 10, 2013, 840-846.
[19]. McCollough CH, Yu L, Kofler JM, Degradation of CT Low Contrast Spatial Resolution Due To the Use of Iterative Reconstruction and Reduced Dose Levels, Radiology, 276(2), 2015, 499-506.
[20]. Wang J, Fleischmann D, Improving Spatial Resolution at CT: Development, Benefits, and Pitfalls, Radiology, 2018.
[21]. Corona EC, Ferreira IB Verification of CTDI and DLP Values for A Head Tomography Reported by the Manufacturers of the CT Scanners Using A CT Dose Profiler Probe, A Head Phantom and A Piranha Electrometer, IAEA, 2015. [22]. De Crop A, Smeets P, and Hoof TV, Correlation of Clinical and Physical-Technical Image Quality in Chest CT: A Human Cadaver Study Applied on Iterative Reconstruction. BMC Medical Imaging. 2015, 15-23
[23]. Sameer Tipnis, Rajesh Thampy, ZaranRumboldt, Radiation Intensity (CTDIvol) and Visibility of Anatomical Structures in Head CT Examinations, Journal of Applied Clinical Medical Physics, 17(1), 2016.