Can We Miniaturize CT Technology for a Successful Mobile Stroke Unit Roll-Out?

Mortality from stroke remains high in Australia, especially for patients located outside the metropolitan cities. This is because they have limited access to specialized stroke facilities for optimal stroke treatment. Mobile stroke units have the capability to take CT scanners out to the patient however current CT commercial scanner designs are large and heavy. As such, this paper aims to design and develop a lightweight CT scanner for use in a mobile stroke unit (either road-based or air-based ambulance) to bring healthcare solution to patients in the rural and remote areas. We used the engineering design optimization approach to redesign and reduce the weight of the existing CT scanner with without compromised it structural performance. We managed to reduce the weight the CT scanner by three-fold while reducing design costs by allowing numerous simulations to be performed using computer software to achieve our design goals. The results are not only useful to optimize CT scanner structure to retrofit on a mobile stroke unit, but also bring the medical device solution to the market and support scalable solution to the larger community. Such an advance will allow for improved equity in healthcare whereby patients can be treated irrespective of location.

Assessment of patient dose and image quality for cardiac CT with breast shields.

Breast shielding can reduce dose to the female breast, a radiosensitive organ receiving significant radiation during computed tomography (CT) chest examinations, particularly in cardiac CT, where Electrocardiogram dose modulation currently precludes the use of radial dose modulation to reduce breast dose. However, breast shields may produce artefacts affecting interpretation of coronary arteries. This study explores the dose savings and the effect of breast shields on image quality with torso and CT dose index body phantoms and an organ dose calculator. Change in dose calculated: 53-63 % (female breast), 82-85 % (lung), 79-84 % (oesophagus) and 76-80 % (effective dose) with larger dose reductions at lower kVp. Image quality is preserved when breast shields are placed after the scout no closer than 10 mm from the skin. Therefore, breast shields can be used in cardiac CT to reduce breast dose without compromising image quality. Revised conversion factors for dose length product to effective dose are suggested for cardiac CT without and with breast shields.