Skip to main content
Erschienen in: European Radiology 4/2015

01.04.2015 | Physics

Abdominal CT during pregnancy: a phantom study on the effect of patient centring on conceptus radiation dose and image quality

verfasst von: G. Solomou, A. E. Papadakis, J. Damilakis

Erschienen in: European Radiology | Ausgabe 4/2015

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To investigate the effect of patient centring on conceptus radiation dose and image quality in abdominal CT during pregnancy.

Material and methods

Three anthropomorphic phantoms that represent a pregnant woman at the three trimesters of gestation were subjected to a routine abdominal CT. Examinations were performed with fixed mAs (mAsf) and with the automatic exposure control system (AEC) activated. The percent reduction between mAsf and modulated mAs (mAsmod) was calculated. Conceptus dose (Dc) was measured using thermoluminencent dosimeters. To study the effect of misplacement of pregnant women on Dc, each phantom was positioned at various locations relative to gantry isocentre. Image quality was evaluated on the basis of image noise, signal-to-noise ratio, and contrast-to-noise ratio.

Results

The maximum reduction between mAsf and mAsmod was 59.8 %, while the corresponding DC reduction was 59.3 %. DC was found to decrease by up to 25 % and 7.9 % for phantom locations below and above the isocentre, respectively. Image quality deteriorated when AEC was activated, and it was progressively improved from lower to higher than the isocentre locations.

Conclusion

Centring errors do not result in an increase in Dc. To maintain image quality, accurate centring is required.

Key Points

AEC activation reduces conceptus radiation dose at all gestational stages.
Patients should be accurately aligned at the gantry isocenter.
Patient centring deserves increased attention in clinical practice.
Pregnant patient centring errors do not considerably affect conceptus dose.
Literatur
1.
Zurück zum Zitat Kennedy A (2000) Assessment of acute abdominal pain in the pregnant patient. Semin Ultrasound CT MR 21:64–77CrossRefPubMed Kennedy A (2000) Assessment of acute abdominal pain in the pregnant patient. Semin Ultrasound CT MR 21:64–77CrossRefPubMed
2.
Zurück zum Zitat Wagner LK, Huda W (2004) When a pregnant woman with suspected appendicitis is referred for a CT scan, what should a radiologist do to minimize potential radiation risks? Pediatr Radiol 34:589–590CrossRefPubMed Wagner LK, Huda W (2004) When a pregnant woman with suspected appendicitis is referred for a CT scan, what should a radiologist do to minimize potential radiation risks? Pediatr Radiol 34:589–590CrossRefPubMed
3.
Zurück zum Zitat Goldman SM (2000) Overview of emergency radiological management of the pregnant patient, especially the traumatized pregnant patient. Emerg Radiol 7:198–205CrossRef Goldman SM (2000) Overview of emergency radiological management of the pregnant patient, especially the traumatized pregnant patient. Emerg Radiol 7:198–205CrossRef
4.
5.
Zurück zum Zitat Shetty MK (2010) Abdominal computed tomography during pregnancy: a review of indications and fetal radiation exposure issues. Semin Ultrasound CT MR 3:3–7CrossRef Shetty MK (2010) Abdominal computed tomography during pregnancy: a review of indications and fetal radiation exposure issues. Semin Ultrasound CT MR 3:3–7CrossRef
6.
Zurück zum Zitat Dauer LT, Thornton RH, Miller DL et al (2012) Radiation management for interventions using fluoroscopic or computed tomographic guidance during pregnancy: A joint guideline of the society of interventional radiology and the cardiovascular and interventional radiological society of Europe with endorsement by the Canadian interventional radiology association. J Vasc Interv Radiol 23:19–32CrossRefPubMed Dauer LT, Thornton RH, Miller DL et al (2012) Radiation management for interventions using fluoroscopic or computed tomographic guidance during pregnancy: A joint guideline of the society of interventional radiology and the cardiovascular and interventional radiological society of Europe with endorsement by the Canadian interventional radiology association. J Vasc Interv Radiol 23:19–32CrossRefPubMed
7.
Zurück zum Zitat Damilakis J, Perisinakis K, Voloudaki A, Gourtsoyiannis N (2000) Estimation of fetal radiation dose from computed tomography scanning in late pregnancy. Depth-dose data from routine examinations. Invest Radiol 35:527–533CrossRefPubMed Damilakis J, Perisinakis K, Voloudaki A, Gourtsoyiannis N (2000) Estimation of fetal radiation dose from computed tomography scanning in late pregnancy. Depth-dose data from routine examinations. Invest Radiol 35:527–533CrossRefPubMed
8.
Zurück zum Zitat Damilakis J, Tzedakis A, Perisinakis K, Papadakis AE (2010) A method of estimating conceptus doses resulting from multidetector CT examinations during all stages of gestation. Med Phys 37:6411–6420CrossRefPubMed Damilakis J, Tzedakis A, Perisinakis K, Papadakis AE (2010) A method of estimating conceptus doses resulting from multidetector CT examinations during all stages of gestation. Med Phys 37:6411–6420CrossRefPubMed
9.
Zurück zum Zitat Damilakis J, Perisinakis K, Tzedakis A, Papadakis AE, Karantanas A (2010) Radiation dose from multidetector CT during early gestation: A method that allows for variations in maternal body size and conceptus position. Radiology 257:483–489CrossRefPubMed Damilakis J, Perisinakis K, Tzedakis A, Papadakis AE, Karantanas A (2010) Radiation dose from multidetector CT during early gestation: A method that allows for variations in maternal body size and conceptus position. Radiology 257:483–489CrossRefPubMed
10.
Zurück zum Zitat Goldberg-Stein SA, Liu B, Hahn PF, Lee SI (2012) Radiation dose management: part 2, estimating fetal radiation risk from CT during pregnancy. Am J Roentgenol 198(4):W352–W356CrossRef Goldberg-Stein SA, Liu B, Hahn PF, Lee SI (2012) Radiation dose management: part 2, estimating fetal radiation risk from CT during pregnancy. Am J Roentgenol 198(4):W352–W356CrossRef
11.
Zurück zum Zitat Gilet G, Dunkin JM, Fernandez TJ, Button TM, Budorick NE (2011) Fetal radiation dose during gestation estimated on an anthropomorphic phantom for three generations of CT scanners. Am J Roentgenol 196:1133–1137CrossRef Gilet G, Dunkin JM, Fernandez TJ, Button TM, Budorick NE (2011) Fetal radiation dose during gestation estimated on an anthropomorphic phantom for three generations of CT scanners. Am J Roentgenol 196:1133–1137CrossRef
12.
Zurück zum Zitat Jaffe TA, Neville AM, Anderson-Evans C et al (2009) Early first trimester fetal dose estimation method in a multivendor study of 16- and 64-MDCT scanners and low-dose imaging protocols. Am J Roentgenol 193:1019–1024CrossRef Jaffe TA, Neville AM, Anderson-Evans C et al (2009) Early first trimester fetal dose estimation method in a multivendor study of 16- and 64-MDCT scanners and low-dose imaging protocols. Am J Roentgenol 193:1019–1024CrossRef
13.
Zurück zum Zitat Angel E, Wellnitz CV, Goodsitt MM et al (2008) Radiation dose to the conceptus for pregnant patients undergoing multidetector CT imaging: Monte Carlo simulations estimating fetal dose for a range of gestational age and patient size. Radiology 249:220–227CrossRefPubMedCentralPubMed Angel E, Wellnitz CV, Goodsitt MM et al (2008) Radiation dose to the conceptus for pregnant patients undergoing multidetector CT imaging: Monte Carlo simulations estimating fetal dose for a range of gestational age and patient size. Radiology 249:220–227CrossRefPubMedCentralPubMed
14.
Zurück zum Zitat Bredenholler C, Feuerlein U (2006) Somatom Sensation 16 Application Guide. Medical, Siemens Bredenholler C, Feuerlein U (2006) Somatom Sensation 16 Application Guide. Medical, Siemens
15.
Zurück zum Zitat Kalra M, Maher MM, Toth T et al (2004) Techniques and applications of automatic tube current modulation for CT. Radiology 233:649–657CrossRefPubMed Kalra M, Maher MM, Toth T et al (2004) Techniques and applications of automatic tube current modulation for CT. Radiology 233:649–657CrossRefPubMed
16.
Zurück zum Zitat Kalender W, Wolf H, Suess C (1999) Dose reduction in CT by anatomically adapted tube current modulation. II. Phantom measurements. Med Phys 26:2248–2253CrossRefPubMed Kalender W, Wolf H, Suess C (1999) Dose reduction in CT by anatomically adapted tube current modulation. II. Phantom measurements. Med Phys 26:2248–2253CrossRefPubMed
17.
Zurück zum Zitat McCollough C, Bruesewitz M, Kofler JM (2006) CT dose reduction and dose management tools: Overview of available options. Radiographics 26:503–512CrossRefPubMed McCollough C, Bruesewitz M, Kofler JM (2006) CT dose reduction and dose management tools: Overview of available options. Radiographics 26:503–512CrossRefPubMed
18.
Zurück zum Zitat Greess H, Wolf H, Baum U et al (2000) Dose reduction in computed tomography by attenuation-based on-line modulation of tube current: evaluation of six anatomical regions. Eur Radiol 10:391–394CrossRefPubMed Greess H, Wolf H, Baum U et al (2000) Dose reduction in computed tomography by attenuation-based on-line modulation of tube current: evaluation of six anatomical regions. Eur Radiol 10:391–394CrossRefPubMed
19.
Zurück zum Zitat Gies M, Kalender WA, Wolf H, Suess C (1999) Dose reduction in CT by anatomically adapted tube current modulation. I. Simulation studies. Med Phys 26:2235–2247CrossRefPubMed Gies M, Kalender WA, Wolf H, Suess C (1999) Dose reduction in CT by anatomically adapted tube current modulation. I. Simulation studies. Med Phys 26:2235–2247CrossRefPubMed
20.
Zurück zum Zitat Papadakis AE, Perisinakis K, Damilakis J (2008) Automatic exposure control in pediatric and adult multidetector CT examinations: a phantom study on dose reduction. Med Phys 35:4567–4576CrossRefPubMed Papadakis AE, Perisinakis K, Damilakis J (2008) Automatic exposure control in pediatric and adult multidetector CT examinations: a phantom study on dose reduction. Med Phys 35:4567–4576CrossRefPubMed
21.
Zurück zum Zitat van Straten M, Deak P, Shrimpton P, Kalender W (2009) The effect of angular and longitudinal tube current modulations on the estimation of organ and effective doses in x-ray computed tomography. Med Phys 36:4881–4889CrossRefPubMed van Straten M, Deak P, Shrimpton P, Kalender W (2009) The effect of angular and longitudinal tube current modulations on the estimation of organ and effective doses in x-ray computed tomography. Med Phys 36:4881–4889CrossRefPubMed
22.
Zurück zum Zitat Matsubara K, Koshida K, Suzuki M, Tsujii H, Matsui O (2008) Comparison between 3-D and z-axis automatic tube current modulation technique in multidetector row CT. Radiat Prot Dosimetry 128:106–111CrossRefPubMed Matsubara K, Koshida K, Suzuki M, Tsujii H, Matsui O (2008) Comparison between 3-D and z-axis automatic tube current modulation technique in multidetector row CT. Radiat Prot Dosimetry 128:106–111CrossRefPubMed
23.
Zurück zum Zitat Namasivayam S, Kalra MK, Pottala KM, Waldrop SM, Hudqins PA (2006) Optimization of z-axis automatic exposure control for multidetector row CT evaluation of neck and comparison with fixed tube current technique for image quality and radiation dose. Am J Neuroradiol 27:2221–2225PubMed Namasivayam S, Kalra MK, Pottala KM, Waldrop SM, Hudqins PA (2006) Optimization of z-axis automatic exposure control for multidetector row CT evaluation of neck and comparison with fixed tube current technique for image quality and radiation dose. Am J Neuroradiol 27:2221–2225PubMed
24.
Zurück zum Zitat Kalra MK, Maher MM, Kamath RS et al (2004) Sixteen- detector row CT of abdomen and pelvis: study for optimization of z-axis modulation technique performed in 153 patients. Radiology 233:241–249CrossRefPubMed Kalra MK, Maher MM, Kamath RS et al (2004) Sixteen- detector row CT of abdomen and pelvis: study for optimization of z-axis modulation technique performed in 153 patients. Radiology 233:241–249CrossRefPubMed
25.
Zurück zum Zitat Karla MK, Toth TL (2012) Patient centering in MDCT: Dose effects. In: Tack D et al (eds) Radiation dose from multidetector CT. Springer-Verlag, Berlin, pp 273–278 Karla MK, Toth TL (2012) Patient centering in MDCT: Dose effects. In: Tack D et al (eds) Radiation dose from multidetector CT. Springer-Verlag, Berlin, pp 273–278
26.
Zurück zum Zitat Toth TL, Zhanyu GE, Daly MP (2007) The influence of patient centering on CT dose and image noise. Med Phys 34:3093–3101CrossRefPubMed Toth TL, Zhanyu GE, Daly MP (2007) The influence of patient centering on CT dose and image noise. Med Phys 34:3093–3101CrossRefPubMed
27.
Zurück zum Zitat Perisinakis K, Seimenis I, Tzedakis A, Papadakis AE, Damilakis J (2013) The effect of head size/shape, miscentering and bowtie filter on peak patient tissue doses from modern brain perfusion 256-slice CT: how can we minimize the risk for deterministic effects? Med Phys 40(1):011911CrossRefPubMed Perisinakis K, Seimenis I, Tzedakis A, Papadakis AE, Damilakis J (2013) The effect of head size/shape, miscentering and bowtie filter on peak patient tissue doses from modern brain perfusion 256-slice CT: how can we minimize the risk for deterministic effects? Med Phys 40(1):011911CrossRefPubMed
28.
Zurück zum Zitat Li J, Udayasankar U, Toth TL, Small WC, Karla MK (2008) Application of automatic vertical positioning software to reduce radiation exposure in multidetector row computed tomography of the chest. Invest Radiol 43:447–452CrossRefPubMed Li J, Udayasankar U, Toth TL, Small WC, Karla MK (2008) Application of automatic vertical positioning software to reduce radiation exposure in multidetector row computed tomography of the chest. Invest Radiol 43:447–452CrossRefPubMed
29.
Zurück zum Zitat Matsubara K, Koshida K, Ichikawa K et al (2009) Misoperation of CT automatic tube current modulation systems with inappropriate patient centering: Phantom studies. Am J Roentgenol 192:862–865CrossRef Matsubara K, Koshida K, Ichikawa K et al (2009) Misoperation of CT automatic tube current modulation systems with inappropriate patient centering: Phantom studies. Am J Roentgenol 192:862–865CrossRef
30.
Zurück zum Zitat Papadakis AE, Perisinakis K, Damilakis J (2014) Automatic exposure control in CT: the effect of patient size, anatomical region and prescribed modulation strength on tube current and image quality. Eur Radiol 24:2520–2531CrossRefPubMed Papadakis AE, Perisinakis K, Damilakis J (2014) Automatic exposure control in CT: the effect of patient size, anatomical region and prescribed modulation strength on tube current and image quality. Eur Radiol 24:2520–2531CrossRefPubMed
31.
Zurück zum Zitat Papadakis AE, Perisinakis K, Oikonomou I, Damilakis J (2011) Automatic exposure control in pediatric and adult computed tomography examinations: can we estimate organ and effective dose from mean mAs reduction? Invest Radiol 46:654–662CrossRefPubMed Papadakis AE, Perisinakis K, Oikonomou I, Damilakis J (2011) Automatic exposure control in pediatric and adult computed tomography examinations: can we estimate organ and effective dose from mean mAs reduction? Invest Radiol 46:654–662CrossRefPubMed
32.
Zurück zum Zitat Papadakis AE, Perisinakis K, Damilakis J (2007) Angular on-line tube current modulation in multidetector CT examinations of children and adults: the influence of different scanning parameters on dose reduction. Med Phys 34:2867–2874CrossRef Papadakis AE, Perisinakis K, Damilakis J (2007) Angular on-line tube current modulation in multidetector CT examinations of children and adults: the influence of different scanning parameters on dose reduction. Med Phys 34:2867–2874CrossRef
Metadaten
Titel
Abdominal CT during pregnancy: a phantom study on the effect of patient centring on conceptus radiation dose and image quality
verfasst von
G. Solomou
A. E. Papadakis
J. Damilakis
Publikationsdatum
01.04.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 4/2015
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3505-2

Weitere Artikel der Ausgabe 4/2015

European Radiology 4/2015 Zur Ausgabe

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.