A completed audit cycle of the lateral scan projection radiograph in CT pulmonary angiography (CTPA); the impact on scan length and radiation dose
Aim To investigate the effect of incorporating a lateral scan projection radiograph (topogram) in addition to the standard frontal topogram on excess scan length in computed tomography pulmonary angiography (CTPA) and to quantify the impact on effective dose. Materials and methods Fifty consecutive...
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| Veröffentlicht in: | Clinical radiology 2013-06, Vol.68 (6), p.574-579 |
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| creator | Rodrigues, J.C.L Negus, I.S Manghat, N.E Hamilton, M.C.K |
| description | Aim To investigate the effect of incorporating a lateral scan projection radiograph (topogram) in addition to the standard frontal topogram on excess scan length in computed tomography pulmonary angiography (CTPA) and to quantify the impact on effective dose. Materials and methods Fifty consecutive patients referred for exclusion of pulmonary embolism who had undergone a CTPA examination with conventional frontal topogram to plan scan length (protocol A) were compared with 50 consecutive patients who had undergone a CTPA study with frontal and additional lateral topogram for planning (protocol B) in a retrospective audit. Optimal scan length was defined from lung apex to lung base. Mean excess scan length beyond these landmarks was determined. The mean organ doses to the thyroid, liver, and stomach, as well as mean effective dose, were estimated using standard conversion factors. Results The mean excess scan length was significantly lower in protocol B compared to the protocol A cohort (19.5 ± 17.4 mm [mean ± standard deviation] versus 39.1 ± 20.4 mm, p |
| doi_str_mv | 10.1016/j.crad.2012.11.016 |
| format | Article |
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Materials and methods Fifty consecutive patients referred for exclusion of pulmonary embolism who had undergone a CTPA examination with conventional frontal topogram to plan scan length (protocol A) were compared with 50 consecutive patients who had undergone a CTPA study with frontal and additional lateral topogram for planning (protocol B) in a retrospective audit. Optimal scan length was defined from lung apex to lung base. Mean excess scan length beyond these landmarks was determined. The mean organ doses to the thyroid, liver, and stomach, as well as mean effective dose, were estimated using standard conversion factors. Results The mean excess scan length was significantly lower in protocol B compared to the protocol A cohort (19.5 ± 17.4 mm [mean ± standard deviation] versus 39.1 ± 20.4 mm, p < 0.0001). The mean excess scan length below the lung bases was significantly lower in the protocol B cohort compared to the protocol A group (7.5 ± 12.7 mm versus 23 ± 16.6 mm, p < 0.0001), as were the mean organ doses to the stomach (4.24 ± 0.81 mGy versus 5.22 ± 1.06 mGy, p < 0.0001) and liver (5.60 ± 0.64 mGy versus 6.38 ± 0.81 mGy, p < 0.0001). A non-significant reduction in over-scanning above the apices in protocol B was observed compared with protocol A (12 ± 8.8 mm versus 16.2 ± 13.6 mm, p = 0.07), which equated to lower mean thyroid organ dose in (3.28 ± 1.76 mGy versus 4.11 ± 3.11 mGy, p = 0.104). Conclusion The present audit indicates that incorporation of a lateral topogram into the CTPA protocol, together with radiographer education, reduces excess scan length, which significantly reduces the dose to the liver and stomach, and potentially lowers the dose to the thyroid. This simple dose-saving technique can be applied to all CT investigations of the chest on all CT systems with immediate effect.</description><identifier>ISSN: 0009-9260</identifier><identifier>EISSN: 1365-229X</identifier><identifier>DOI: 10.1016/j.crad.2012.11.016</identifier><identifier>PMID: 23541095</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Aged ; Humans ; Male ; Middle Aged ; Pulmonary Artery - diagnostic imaging ; Pulmonary Embolism - diagnostic imaging ; Radiation Dosage ; Radiation Injuries - prevention & control ; Radiology ; Retrospective Studies ; Tomography, X-Ray Computed - methods</subject><ispartof>Clinical radiology, 2013-06, Vol.68 (6), p.574-579</ispartof><rights>The Royal College of Radiologists</rights><rights>2012 The Royal College of Radiologists</rights><rights>Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-e39c39da6faafdf8c782eb3b64cb7d6e0d233db0074fd3f61290e5d4604a893</citedby><cites>FETCH-LOGICAL-c411t-e39c39da6faafdf8c782eb3b64cb7d6e0d233db0074fd3f61290e5d4604a893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0009926012006058$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23541095$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rodrigues, J.C.L</creatorcontrib><creatorcontrib>Negus, I.S</creatorcontrib><creatorcontrib>Manghat, N.E</creatorcontrib><creatorcontrib>Hamilton, M.C.K</creatorcontrib><title>A completed audit cycle of the lateral scan projection radiograph in CT pulmonary angiography (CTPA); the impact on scan length and radiation dose</title><title>Clinical radiology</title><addtitle>Clin Radiol</addtitle><description>Aim To investigate the effect of incorporating a lateral scan projection radiograph (topogram) in addition to the standard frontal topogram on excess scan length in computed tomography pulmonary angiography (CTPA) and to quantify the impact on effective dose. Materials and methods Fifty consecutive patients referred for exclusion of pulmonary embolism who had undergone a CTPA examination with conventional frontal topogram to plan scan length (protocol A) were compared with 50 consecutive patients who had undergone a CTPA study with frontal and additional lateral topogram for planning (protocol B) in a retrospective audit. Optimal scan length was defined from lung apex to lung base. Mean excess scan length beyond these landmarks was determined. The mean organ doses to the thyroid, liver, and stomach, as well as mean effective dose, were estimated using standard conversion factors. Results The mean excess scan length was significantly lower in protocol B compared to the protocol A cohort (19.5 ± 17.4 mm [mean ± standard deviation] versus 39.1 ± 20.4 mm, p < 0.0001). The mean excess scan length below the lung bases was significantly lower in the protocol B cohort compared to the protocol A group (7.5 ± 12.7 mm versus 23 ± 16.6 mm, p < 0.0001), as were the mean organ doses to the stomach (4.24 ± 0.81 mGy versus 5.22 ± 1.06 mGy, p < 0.0001) and liver (5.60 ± 0.64 mGy versus 6.38 ± 0.81 mGy, p < 0.0001). A non-significant reduction in over-scanning above the apices in protocol B was observed compared with protocol A (12 ± 8.8 mm versus 16.2 ± 13.6 mm, p = 0.07), which equated to lower mean thyroid organ dose in (3.28 ± 1.76 mGy versus 4.11 ± 3.11 mGy, p = 0.104). Conclusion The present audit indicates that incorporation of a lateral topogram into the CTPA protocol, together with radiographer education, reduces excess scan length, which significantly reduces the dose to the liver and stomach, and potentially lowers the dose to the thyroid. This simple dose-saving technique can be applied to all CT investigations of the chest on all CT systems with immediate effect.</description><subject>Aged</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pulmonary Artery - diagnostic imaging</subject><subject>Pulmonary Embolism - diagnostic imaging</subject><subject>Radiation Dosage</subject><subject>Radiation Injuries - prevention & control</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0009-9260</issn><issn>1365-229X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kk9v0zAYxi0EYt3gC3BAPo5DMv9J0kagSVXFYNKkTVoP3CzHftM6OHawE6R-DT4xTls4cOBk2X6en_U-jxF6R0lOCa1uulwFqXNGKMspzdPRC7SgvCozxupvL9GCEFJnNavIBbqMsZu3BSteowvGy4KSulygX2usfD9YGEFjOWkzYnVQFrBv8bgHbOUIQVoclXR4CL4DNRrvcHrY-F2Qwx4bhzdbPEy2906GA5Zud7464OvN9mn94eMRZfpBqhEn8xFmwe3GfVLrI0wesdpHeINetdJGeHter9Dz3eft5mv28PjlfrN-yFRB6ZgBrxWvtaxaKVvdrtRyxaDhTVWoZqkrIJpxrhtClkWreVtRVhModVGRQq5qfoWuT9Q01I8J4ih6ExVYKx34KQrKizrFRShNUnaSquBjDNCKIZg-jSooEXMTohNzE2JuQlAq0lEyvT_zp6YH_dfyJ_ok-HQSQJrxp4EgojLgFGgTUshCe_N__u0_dmWNM0ra73CA2PkpuJSeoCIyQcTzXP78FSgjpCLliv8GoouwaA</recordid><startdate>20130601</startdate><enddate>20130601</enddate><creator>Rodrigues, J.C.L</creator><creator>Negus, I.S</creator><creator>Manghat, N.E</creator><creator>Hamilton, M.C.K</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130601</creationdate><title>A completed audit cycle of the lateral scan projection radiograph in CT pulmonary angiography (CTPA); the impact on scan length and radiation dose</title><author>Rodrigues, J.C.L ; Negus, I.S ; Manghat, N.E ; Hamilton, M.C.K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-e39c39da6faafdf8c782eb3b64cb7d6e0d233db0074fd3f61290e5d4604a893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pulmonary Artery - diagnostic imaging</topic><topic>Pulmonary Embolism - diagnostic imaging</topic><topic>Radiation Dosage</topic><topic>Radiation Injuries - prevention & control</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rodrigues, J.C.L</creatorcontrib><creatorcontrib>Negus, I.S</creatorcontrib><creatorcontrib>Manghat, N.E</creatorcontrib><creatorcontrib>Hamilton, M.C.K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rodrigues, J.C.L</au><au>Negus, I.S</au><au>Manghat, N.E</au><au>Hamilton, M.C.K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A completed audit cycle of the lateral scan projection radiograph in CT pulmonary angiography (CTPA); the impact on scan length and radiation dose</atitle><jtitle>Clinical radiology</jtitle><addtitle>Clin Radiol</addtitle><date>2013-06-01</date><risdate>2013</risdate><volume>68</volume><issue>6</issue><spage>574</spage><epage>579</epage><pages>574-579</pages><issn>0009-9260</issn><eissn>1365-229X</eissn><abstract>Aim To investigate the effect of incorporating a lateral scan projection radiograph (topogram) in addition to the standard frontal topogram on excess scan length in computed tomography pulmonary angiography (CTPA) and to quantify the impact on effective dose. Materials and methods Fifty consecutive patients referred for exclusion of pulmonary embolism who had undergone a CTPA examination with conventional frontal topogram to plan scan length (protocol A) were compared with 50 consecutive patients who had undergone a CTPA study with frontal and additional lateral topogram for planning (protocol B) in a retrospective audit. Optimal scan length was defined from lung apex to lung base. Mean excess scan length beyond these landmarks was determined. The mean organ doses to the thyroid, liver, and stomach, as well as mean effective dose, were estimated using standard conversion factors. Results The mean excess scan length was significantly lower in protocol B compared to the protocol A cohort (19.5 ± 17.4 mm [mean ± standard deviation] versus 39.1 ± 20.4 mm, p < 0.0001). The mean excess scan length below the lung bases was significantly lower in the protocol B cohort compared to the protocol A group (7.5 ± 12.7 mm versus 23 ± 16.6 mm, p < 0.0001), as were the mean organ doses to the stomach (4.24 ± 0.81 mGy versus 5.22 ± 1.06 mGy, p < 0.0001) and liver (5.60 ± 0.64 mGy versus 6.38 ± 0.81 mGy, p < 0.0001). A non-significant reduction in over-scanning above the apices in protocol B was observed compared with protocol A (12 ± 8.8 mm versus 16.2 ± 13.6 mm, p = 0.07), which equated to lower mean thyroid organ dose in (3.28 ± 1.76 mGy versus 4.11 ± 3.11 mGy, p = 0.104). Conclusion The present audit indicates that incorporation of a lateral topogram into the CTPA protocol, together with radiographer education, reduces excess scan length, which significantly reduces the dose to the liver and stomach, and potentially lowers the dose to the thyroid. This simple dose-saving technique can be applied to all CT investigations of the chest on all CT systems with immediate effect.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>23541095</pmid><doi>10.1016/j.crad.2012.11.016</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Humans Male Middle Aged Pulmonary Artery - diagnostic imaging Pulmonary Embolism - diagnostic imaging Radiation Dosage Radiation Injuries - prevention & control Radiology Retrospective Studies Tomography, X-Ray Computed - methods |
| title | A completed audit cycle of the lateral scan projection radiograph in CT pulmonary angiography (CTPA); the impact on scan length and radiation dose |
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