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Radiation dose exposure in patients affected by lymphoma undergoing repeat CT examinations: how to manage the radiation dose variability

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Abstract

Purpose

To assess the variability of radiation dose exposure in patients affected by lymphoma undergoing repeat CT (computed tomography) examinations and to evaluate the influence of different scan parameters on the overall radiation dose.

Materials and methods

A series of 34 patients (12 men and 22 women with a median age of 34.4 years) with lymphoma, after the initial staging CT underwent repeat follow-up CT examinations. For each patient and each repeat examination, age, sex, use of AEC system (Automated Exposure Control, i.e. current modulation), scan length, kV value, number of acquired scans (i.e. number of phases), abdominal size diameter and dose length product (DLP) were recorded. The radiation dose of just one venous phase was singled out from the DLP of the entire examination. All scan data were retrieved by our PACS (Picture Archiving and Communication System) by means of a dose monitoring software.

Results

Among the variables we considered, no significant difference of radiation dose was observed among patients of different ages nor concerning tube voltage. On the contrary the dose delivered to the patients varied depending on sex, scan length and usage of AEC. No significant difference was observed depending on the behaviour of technologists, while radiologists’ choices had indirectly an impact on the radiation dose due to the different number of scans requested by each of them.

Conclusions

Our results demonstrate that patients affected by lymphoma who undergo repeat whole body CT scanning may receive unnecessary overexposure. We quantified and analyzed the most relevant variables in order to provide a useful tool to manage properly CT dose variability, estimating the amount of additional radiation dose for every single significant variable. Additional scans, incorrect scan length and incorrect usage of AEC system are the most relevant cause of patient radiation exposure.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University of Pisa, Via Roma 67, 56100, Pisa, Italy

    Fabio Paolicchi, Giacomo Aringhieri & Davide Caramella

  2. Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, 56124, Pisa, Italy

    Luca Bastiani

  3. Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy

    Davide Guido

  4. Degli Infermi Hospital, Via dei Ponderanesi 2, 13875, Piedmont, Ponderano, Italy

    Antonio Dore

Authors
  1. Fabio Paolicchi
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  2. Luca Bastiani
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  3. Davide Guido
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  4. Antonio Dore
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  5. Giacomo Aringhieri
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  6. Davide Caramella
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Correspondence to Fabio Paolicchi.

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Paolicchi, F., Bastiani, L., Guido, D. et al. Radiation dose exposure in patients affected by lymphoma undergoing repeat CT examinations: how to manage the radiation dose variability. Radiol med 123, 191–201 (2018). https://doi.org/10.1007/s11547-017-0826-7

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  • DOI: https://doi.org/10.1007/s11547-017-0826-7

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