Accuracy of CT dose monitor values: a multicentric study.

Four hundred and ninety-five adult patients in 16 medical centres participated in this study aiming to investigate the congruence between the volume CT dose index (CTDIvol) monitor values and measured ones during common CT procedures, performed by 20 systems. Tube output CTDIair measurements were carried out on single and multislice scanners for any kV, slice thickness, mA and FOV combination used. The maximum/minimum ratio of measured CTDIvol values found to be 3.1, 3.5, 7.4, 7.5, 4.2, 11.3 and 5.5 for head base, head cerebrum, thorax, abdomen, pelvis, cervical spine and lumbar spine protocols, respectively. The mean divergence between the measured and displayed CTDIvol values was 4.2, 3.5, -1.0, 2.7, 4.9, -3.9 and -2.8 % for protocols as mentioned above, respectively. From the perspective of the number of detector rows of the scanners, the mean divergence was -6.7, -6.0, 0.8, -1.1, -0.4, -1.9, -5.3, 5.2 and 10.1 % for single, dual, 4, 6, 16, 24, 64, 128 and dual source 256-slice systems, respectively.

The effect of a combined tube current modulation system on dose delivered to patients undergoing thoracic and abdominal CT with a 128-slice scanner.

Combined tube current modulation techniques (such as Care Dose4D used in this study) during computed tomography (CT) procedures bring together the benefits of the angular and z-axis modulation techniques, measuring X-ray attenuation profile in the z-axis together with the data from the perpendicular x-y direction with a sophisticated algorithm. The purpose of this study was to investigate the radiation dose, in terms of computed tomography dose index (CTDI(vol)), delivered to patients during thoracic and abdominal CT using this technique and compare it with the corresponding CTDI(vol) of the fixed tube current CT technique. The results revealed a 5-32% dose reduction for chest CT and a dose reduction of 7.6-60% for the three-sequence abdominal CT scan of normal and overweight patients. In the case of obese patients a 15.4-18.7% dose increase for chest CT and a (-1.5) - (26.3)% dose increase for the three-stage abdominal examinations for females and males, respectively, was revealed.

Commissioning and constancy protocols for digital angiographic units.

During the European Concerted Action SENTINEL 'Safety and Efficacy for New Techniques and Imaging using New Equipment to Support European Legislation', protocols for commissioning and constancy tests for dynamic digital flat detectors angiography units have been developed in order to harmonise practice among the European counties. The commissioning protocol includes measurements on X-ray tube and generator, patient and detector radiation dose and image quality. The constancy protocol is based on the dose and image quality measurements. The commissioning protocol was tested by SENTINEL partners who expressed an interest in checking their dynamic digital systems using this protocol. The results of basic tests are reported.

Quality assurance (QA) procedures for software: evaluation of an ADC quality system.

Image viewing and processing software in computed radiography manipulates image contrast in such a way that all relevant image features are rendered to an appropriate degree of visibility, and improves image quality using enhancement algorithms. The purpose of this study was to investigate procedures for the quality assessment of image processing software for computed radiography with the use of existing test objects and to assess the influence that processing introduces on physical image quality characteristics. Measurements of high-contrast resolution, low-contrast resolution, spatial resolution, greyscale (characteristic curve) and geometric distortion were performed 'subjectively' by three independent observers and 'objectively' by the use of criteria based on pixel intensity values. Results show quality assessment is possible without the need for human evaluators, using digital images. It was discovered that the processing software evaluated in this study was able to improve some aspects of image quality, without introducing geometric distortion.

Correlation of patient and staff doses in interventional cardiology.

The purpose of this study was to measure staff radiation doses in representative institutions of five European countries performing coronary angiographies (CA) and percutaneous transluminal coronary angioplasties (PTCA), as well as to investigate any correlation with patient doses. Patient doses were recorded in terms of dose-area product (DAP). Staff doses were measured by thermoluminescence dosemeters placed on the operator's left shoulder and left foot. Radiation protection measures were also recorded. Third quartile shoulder and foot doses were 90 and 66 microSv in CA, and 157 and 173 microSv in PTCA, respectively. Shoulder dose was poorly correlated with DAP in CA (R2 = 0.29) and only moderately correlated in PTCA (R2 = 0.69). DAP and foot dose correlation was poor both in CA (R2 = 0.16) and in PTCA (R2 = 0.02). Protective measures taken by staff varied between countries, which may explain the poor correlation of patient and staff radiation doses.

A survey of 14 computed tomography scanners in Greece and 32 scanners in Italy. Examination frequencies, dose reference values, effective doses and doses to organs.

A survey of examination frequencies, dose reference values, effective doses and doses to organs involving 14 scanners from Greece and 32 scanners from Italy was carried out for the years 1999 and 2000. Examination frequencies per scanner and per year were found to be 3590 for Greece and 4520 for Italy. For the types of examinations considered, CDTI(W) and DLP measurements were taken. Also scan lengths used for the same types of examinations were monitored. For the same types of examinations effective doses were calculated by two methods, and it was found that their mean values ranged from 13.1 mSv for thoracic spine to 1.6 mSv for the brain examinations. From the data of the 14 Greek laboratories, doses to organs were calculated and it was found that the thyroid receives 50.2 +/- 19.8 mGy during a cervical spine examination while the gonads receive 17.8 +/- 6.9 mGy during a routine pelvis examination.

Personnel doses in haemodynamic units in Greece.

Personnel of haemodynamic and interventional radiology units receive continuously increasing radiation doses due to extended fluoroscopy. Moreover, there is not a parallel increase in the number of cardiology specialists involved. Doses received by 15 cardiologists and 5 nurses, in 5 Athenian hospitals were measured using thermoluminescence dosemeters (TLD) and film badges. The workload and examination protocol of each cardiologist, the technical characteristics of the X ray unit, as well as availability and use of protective equipment were recorded. Results show that doses measured by TLD and film badges differ due mainly to the irregular wear of the latter. Although X ray units performed comparably with each other, dose per procedure received by each cardiologist varied widely, due to differences in examination protocol and beam collimation used. In all cases, nurses' dose was approximately one fourth of cardiologists' dose. In half of the cases assessed, the protective equipment available was not in full use. Estimation of dose per procedure, taking into account personnel's workload assesses annual personnel doses. Evaluation of risk level and check of compliance with regulatory dose limits should be part of continuing radiation protection education.

Patient dose, image quality and radiographic techniques for common X ray examinations in two Greek hospitals and comparison with European guidelines.

The radiographic technique factors and the quality of each radiographic image for three common examinations (chest PA, pelvis AP and lumbar spine LAT) were compared with the European criteria and entrance surface dose (ESD) was measured for each radiograph in two Greek hospitals. The measurements were carried out using calibrated LiF thermoluminescence dosemeters. The patients were selected so that their weight was close to 70 +/- 10 kg and their height to 170 +/- 10 cm. Effective dose values were calculated using a PC-based Monte Carlo program. All four X ray rooms in the survey achieved mean doses well below the European reference doses. However the mean doses in the X ray rooms differed by a factor of about 3.