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A comparative study of radiation doses between phantom and patients via CT angiography of the intra-/extra-cranial, pulmonary, and abdominal/pelvic arteries

Radiological Physics and Technology volume 12, pages 374–381 (2019)Cite this article

Abstract

This study aimed to evaluate effective dose and size-specific dose estimate (SSDE) of computed tomography angiography (CTA) examination using an anthropomorphic phantom. We included three CTA examination protocols to evaluate the intra- and extra-cranial arteries, pulmonary artery (CTPA), and abdominal vessels. Patient SSDEs were measured retrospectively to estimate patient dose, relative to the bodyweight of the patient and volume CT dose index (CTDIvol). Our findings revealed that the highest dose was absorbed by the left lobe of the thyroid gland during intra-/extra-cranial CTA and CTPA, that is, 14.11 ± 0.24 mGy and 16.20 ± 3.95 mGy, respectively. However, the highest absorbed dose in abdominal/pelvic CTA was the gonads (8.98 ± 0.30 mGy), while other radiosensitive organs in intra- and extra-cranial CTA, CTPA, and abdominal/pelvic CTA did not demonstrate significant differences between organs/structures with p value 0.88, 0.11, and 0.54, respectively. The estimated effective dose in intra-/extra-cranial CTA was lower in patients (0.80 ± 0.60 mSv) than in the phantom (0.83 mSv), but it was the opposite for CTPA, with the effective dose being higher in patients (7.54 ± 3.09 mSv) than in the phantom (6.68 mSv). Similar to the effective dose, only CTPA SSDEs were significantly higher in men than in women (19.74 ± 4.79 mGy versus 7.9 mGy). Effective dose and SSDE are clinically relevant parameters that can help estimate a more accurate patient dose based on a patient’s size.

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References

  1. Jayakrishnan VK, White PM, Aitken D, Crane P, McMahon AD, Teasdale EM. Subtraction helical CT angiography of intra- and extracranial vessels: technical considerations and preliminary experience. AJNR Am J Neuroradiol. 2003;24:451–5.

    PubMed  Google Scholar 

  2. Schueller-Weidekamm C, Schaefer-Prokop CM, Weber M, Herold CJ, Prokop M. CT angiography of pulmonary arteries to detect pulmonary embolism: improvement of vascular enhancement with low kilovoltage settings. Radiology. 2006;241:899–907. https://doi.org/10.1148/radiol.2413040128.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sabarudin A, Siong TW, Chin AW, Hoong NK, Karim MKA. A comparison study of radiation effective dose in ECG-gated coronary CT angiography and calcium scoring examinations performed with a dual-source CT scanner. Sci Rep. 2019;9:4374. https://doi.org/10.1038/s41598-019-40758-5.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  4. Bombiński P, Warchoł S, Brzewski M, Biejat A, Dudek-Warchoł T, Krzemień G, et al. Lower-dose CT urography (CTU) with iterative reconstruction technique in children—initial experience and examination protocol. Pol J Radiol. 2014;79:137–44. https://doi.org/10.12659/PJR.890729.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bischoff B, Hein F, Meyer T, Hadamitzky M, Martinoff S, Schömig A, et al. Impact of a reduced tube voltage on CT angiography and radiation dose: results of the PROTECTION I study. JACC Cardiovasc Imaging. 2009;2:940–6. https://doi.org/10.1016/j.jcmg.2009.02.015.

    Article  PubMed  Google Scholar 

  6. Boone JM, Brink JA, Edyvean S, Huda W, Leitz W, McCollough CH, et al. Radiation dose and image-quality assessment in computed tomography. J ICRU. 2012;12:9–149. https://doi.org/10.1093/jicru/ndt006.

    Article  Google Scholar 

  7. Karim MKA, Hashim S, Bradley DA, Bahruddin NA, Ang WC, Salehhon N. Assessment of knowledge and awareness among radiology personnel regarding current computed tomography technology and radiation dose. J Phys Conf Ser. 2016;694:012031. https://doi.org/10.1088/1742-6596/694/1/012031.

    Article  Google Scholar 

  8. Karim MKA, Hashim S, Sabarudin A, Bradley DA, Bahruddin NA. Evaluating organ dose and radiation risk of routine CT examinations in Johor Malaysia. Sains Malays. 2016;45:567–73.

    Google Scholar 

  9. Brenner DJ. Minimising medically unwarranted computed tomography scans. Ann ICRP. 2012;41:161–9. https://doi.org/10.1016/j.icrp.2012.06.004.

    CAS  Article  PubMed  Google Scholar 

  10. Rehani MM, Ciraj-Bjelac O, Al-Naemi HM, Al-Suwaidi JS, El-Nachef L, Khosravi HR, et al. Radiation protection of patients in diagnostic and interventional radiology in Asian countries: impact of an IAEA project. Eur J Radiol. 2012;81:e982–9. https://doi.org/10.1016/j.ejrad.2012.06.019.

    Article  PubMed  Google Scholar 

  11. Kalender WA, Buchenau S, Deak P, Kellermeier M, Langner O, van Straten M, et al. Technical approaches to the optimisation of CT. Phys Med. 2008;24:71–9. https://doi.org/10.1016/j.ejmp.2008.01.012.

    Article  PubMed  Google Scholar 

  12. Hashim S, Karim MKA, Bakar KA, Sabarudin A, Chin AW, Saripan MI, et al. Evaluation of organ doses and specific k effective dose of 64-slice CT thorax examination using an adult anthropomorphic phantom. Radiat Phys Chem. 2016;126:14–20. https://doi.org/10.1016/j.radphyschem.2016.05.004.

    CAS  Article  Google Scholar 

  13. Musa Y, Hashim S, Khalis Abdul Karim M. Direct and indirect entrance surface dose measurement in X-ray diagnostics using nanoDot OSL dosimeters. J Phys Conf Ser. 2019;1248:012014. https://doi.org/10.1088/1742-6596/1248/1/012014.

    CAS  Article  Google Scholar 

  14. Karim MKA, Rahim NA, Matsubara K, Hashim S, Mhareb MHA, Musa Y. The effectiveness of bismuth breast shielding with protocol optimization in CT Thorax examination. J Xray Sci Technol. 2019;27:139–47. https://doi.org/10.3233/XST-180397.

    CAS  Article  PubMed  Google Scholar 

  15. Ma C-M, Seuntjens JP. Mass-energy absorption coefficient and backscatter factor ratios for kilovoltage X-ray beams. Phys Med Biol. 1999;44:131–43.

    CAS  Article  Google Scholar 

  16. ICRP. Compendium of Dose Coefficients based on ICRP publication 60. ICRP Publication 119. Ann ICRP. 2012;41(Suppl.).

  17. Huda W, Magill D, He W. CT effective dose per dose length product using ICRP 103 weighting factors. Med Phys. 2011;38:1261. https://doi.org/10.1118/1.3544350.

    Article  PubMed  Google Scholar 

  18. Huda W. Computing patient specific effective doses and radiation risks in CT. Phys Med. 2012;28:333. https://doi.org/10.1016/j.ejmp.2012.06.008.

    Article  Google Scholar 

  19. Pourjabbar S, Singh S, Padole A, Saini A, Blake MA, Kalra MK. Size-specific dose estimates: localizer or transverse abdominal computed tomography images? World J Radiol. 2014;6:210–7. https://doi.org/10.4329/wjr.v6.i5.210.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Commission E. European guidelines on quality criteria for computed tomography. EUR 16262 EN. 1997.

  21. Karim MKA, Hashim S, Bradley DA, Bakar KA, Haron MR, Kayun Z. Radiation doses from computed tomography practice in Johor Bahru, Malaysia. Radiat Phys Chem. 2016;121:69–74. https://doi.org/10.1016/j.radphyschem.2015.12.020.

    CAS  Article  Google Scholar 

  22. Laqmani A, Regier M, Veldhoen S, Backhaus A, Wassenberg F, Sehner S, et al. Improved image quality and low radiation dose with hybrid iterative reconstruction with 80 kV CT pulmonary angiography. Eur J Radiol. 2014;83:1962–9. https://doi.org/10.1016/j.ejrad.2014.06.016.

    Article  PubMed  Google Scholar 

  23. Patel R, Blake GM, Fogelman I. Radiation dose to the patient and operator from a peripheral dual X-ray absorptiometry system. J Clin Densitom. 1999;2:397–401. https://doi.org/10.1016/S1094-6950(06)60405-8.

    CAS  Article  PubMed  Google Scholar 

  24. Schoepf UJ, Costello P. CT angiography for diagnosis of pulmonary embolism: state of the art. Radiology. 2004;230:329–37. https://doi.org/10.1148/radiol.2302021489.

    Article  PubMed  Google Scholar 

  25. Cao JX, Wang YM, Lu JG, Zhang Y, Wang P, Yang C. Radiation and contrast agent doses reductions by using 80-kV tube voltage in coronary computed tomographic angiography: a comparative study. Eur J Radiol. 2014;83:309–14. https://doi.org/10.1016/j.ejrad.2013.06.032.

    Article  PubMed  Google Scholar 

  26. Sabarudin A, Mustafa Z, Nassir KM, Hamid HA, Sun Z. Radiation dose reduction in thoracic and abdomen–pelvic CT using tube current modulation: a phantom study. J Appl Clin Med Phys. 2015;16:319–28.

    Article  Google Scholar 

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Acknowledgements

The authors are grateful to the staff of HUKM for their technical assistance during the data collection process. The authors also wish to acknowledge the support received from Geran IPM Universiti Putra Malaysia (project no: GP/IPM/UPM/9619800).

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Affiliations

  1. Department of Physics, Faculty of Science, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia

    M. K. A. Karim & N. A. Muhammad

  2. Programme of Diagnostic Imaging and Radiotherapy, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia

    A. Sabarudin

  3. Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia

    K. H. Ng

Authors
  1. M. K. A. Karim
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  2. A. Sabarudin
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  3. N. A. Muhammad
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  4. K. H. Ng
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Correspondence to M. K. A. Karim.

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Ethical approval

The research protocols were approved by the institution’s research ethical committee with ethical number UKMPPI/111/8/JEP-2018-012.

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Karim, M.K.A., Sabarudin, A., Muhammad, N.A. et al. A comparative study of radiation doses between phantom and patients via CT angiography of the intra-/extra-cranial, pulmonary, and abdominal/pelvic arteries. Radiol Phys Technol 12, 374–381 (2019). https://doi.org/10.1007/s12194-019-00532-8

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  • DOI: https://doi.org/10.1007/s12194-019-00532-8

Keywords

  • CT angiography
  • Effective dose
  • Dose-length product
  • Absorbed dose
  • Size-specific dose estimate