The use of pencil ionization chamber with temporal readout capabilities to measure CT beam full width half maximum.

BACKGROUND: Measurement of Computed Tomography (CT) beam width is required by accrediting and regulating bodies for routine physics evaluations due to its direct correlation to patient dose. Current methods for performing CT beam width measurement require special hardware, software, and/or consumable films. Today, most 100-mm pencil chambers with a digital interface used to evaluate Computed Tomography Dose Index (CTDIvol) have a sufficiently high sampling rate to reconstruct a high-resolution dose profile for any acquisition mode. PURPOSE: The goal of this study is to measure the CT beam width from the sampled dose profile under a single helical acquisition with the 100-mm pencil chamber used for CTDIvol measurements. METHODS: The dose profiles for different scanners were measured for helical scans with varying collimation settings using a 100-mm pencil chamber placed at the isocenter and co-moving with the patient table. The measured dose profiles from the 100-mm pencil chamber were corrected for table attenuation by extracting a periodic correction function (PCF) to eliminate table interference. The corrected dose profiles were then deconvolved with the response function of the chamber to compute the beam profile. The beam width was defined by the full width half maximum (FWHM) of the resulting beam profile. Reference dose profiles were also measured using Gafchromic film for comparison. RESULTS: The beam widths, estimated using the innovative deconvolution method from the 100-mm pencil chamber, exhibit an average percentage difference of 1.6 ± 1.8 when compared with measurements obtained through Gafchromic film for beam width assessment. CONCLUSION: The proposed approach to deconvolve the pencil chamber response demonstrates the potential of obtaining the CT beam width at high accuracy without the need of special hardware, software, or consumable films. This technique can improve workflow for routine performance evaluation of CT systems.

Artificial intelligence in medicine: mitigating risks and maximizing benefits via quality assurance, quality control, and acceptance testing.

The adoption of artificial intelligence (AI) tools in medicine poses challenges to existing clinical workflows. This commentary discusses the necessity of context-specific quality assurance (QA), emphasizing the need for robust QA measures with quality control (QC) procedures that encompass (1) acceptance testing (AT) before clinical use, (2) continuous QC monitoring, and (3) adequate user training. The discussion also covers essential components of AT and QA, illustrated with real-world examples. We also highlight what we see as the shared responsibility of manufacturers or vendors, regulators, healthcare systems, medical physicists, and clinicians to enact appropriate testing and oversight to ensure a safe and equitable transformation of medicine through AI.

Multicenter Quantification of Radiation Exposure and Associated Risks for Prostatic Artery Embolization in 1476 Patients.

Background Prostatic artery embolization (PAE) is a safe, minimally invasive angiographic procedure that effectively treats benign prostatic hyperplasia; however, PAE-related patient radiation exposure and associated risks are not completely understood. Purpose To quantify radiation dose and assess radiation-related adverse events in patients who underwent PAE at multiple centers. Materials and Methods This retrospective study included patients undergoing PAE for any indication performed by experienced operators at 10 high-volume international centers from January 2014 to May 2021. Patient characteristics, procedural and radiation dose data, and radiation-related adverse events were collected. Procedural radiation effective doses were calculated by multiplying kerma-area product values by an established conversion factor for abdominopelvic fluoroscopy-guided procedures. Relationships between cumulative air kerma (CAK) or effective dose and patient body mass index (BMI), fluoroscopy time, or radiation field area were assessed with linear regression. Differences in radiation dose stemming from radiopaque prostheses or fluoroscopy unit type were assessed using two-sample t tests and Wilcoxon rank sum tests. Results A total of 1476 patients (mean age, 69.9 years ± 9.0 [SD]) were included, of whom 1345 (91.1%) and 131 (8.9%) underwent the procedure with fixed interventional or mobile fluoroscopy units, respectively. Median procedure effective dose was 17.8 mSv for fixed interventional units and 12.3 mSv for mobile units. CAK and effective dose both correlated positively with BMI (R2 = 0.15 and 0.17; P < .001) and fluoroscopy time (R2 = 0.16 and 0.08; P < .001). No radiation-related 90-day adverse events were reported. Patients with radiopaque implants versus those without implants had higher median CAK (1452 mGy [range, 900-2685 mGy] vs 1177 mGy [range, 700-1959 mGy], respectively; P = .01). Median effective dose was lower for mobile than for fixed interventional systems (12.3 mSv [range, 8.5-22.0 mSv] vs 20.4 mSv [range, 13.8-30.6 mSv], respectively; P < .001). Conclusion Patients who underwent PAE performed with fixed interventional or mobile fluoroscopy units were exposed to a median effective radiation dose of 17.8 mSv or 12.3 mSv, respectively. No radiation-related adverse events at 90 days were reported. © RSNA, 2024 See also the editorial by Mahesh in this issue.

Method of determining technique from weight and height to achieve targeted detector exposures in portable chest and abdominal digital radiography.

This study presents a methodology to develop an X-ray technique chart for portable chest and abdomen imaging which utilizes patient data available in the modality worklist (MWL) to reliably achieve a predetermined exposure index (EI) at the detector for any patient size. The method assumes a correlation between the patients' tissue equivalent thickness and the square root of the ratio of the patient's weight to height. To assess variability in detector exposures, the EI statistics for 75 chest examinations and 99 abdominal portable X-ray images acquired with the new technique chart were compared to those from a single portable unit (chest: 3877 images; abdomen: 200 images) using a conventional technique chart with three patient sizes, and to a stationary radiography room utilizing automatic exposure control (AEC) (chest: 360 images; abdomen: 112 images). The results showed that when using the new technique chart on a group of portable units, the variability in EI was significantly reduced (p < 0.01) for both AP chest and AP abdomen images compared to the single portable using a standard technique chart with three patient sizes. The variability in EI for the images acquired with the new chart was comparable to the stationary X-ray room with an AEC system (p > 0.05). This method could be used to streamline the entire imaging chain by automatically selecting an X-ray technique based on patient demographic information contained in the MWL to provide higher quality examinations to clinicians by eliminating outliers. In addition, patient height and weight can be used to estimate the patients' tissue equivalent thickness.