[Scatter Radiation Intensities during Transforaminal Lumbar Interbody Fusion Using a Mobile C-arm System].

The purpose of this study was to measure the scatter radiation intensity during transforaminal lumbar interbody fusion using a mobile C-arm system (Arcadis Orbic 3D; Siemens) and minimize radiation exposure. Dosimetry was performed with anterior-posterior and lateral continuous fluoroscopy, and cone beam computed tomography (CT). A scaffold tower (L: 300 cm×W: 200 cm×H: 150 cm) was built with radiation-resistant paper cylinders at intervals of 50 cm and plastic joints over the bed, and 100 optically stimulated luminescence dosimeters (nanoDot; Nagase Landauer) were placed on each joint. A human torso phantom from head to pelvis (Kyoto Kagaku) was positioned on the bed in a prone position. The scatter radiation dose in a lateral view was highest on the X-ray tube side at the height of 100 cm (170.5 µGy/min). The scatter radiation dose increased significantly on the X-ray tube side during lateral continuous fluoroscopy. Continuous change of surgeons' standing positions is important to minimize radiation exposure received by a specific surgeon.

[Analysis of Myocardial T1 Value for Japanese Healthy Subjects with Non-contrast Myocardium T1 Mapping].

The purpose of this study was to analyze the native T1 value of myocardium and the relationship between myocardial native T1 value and gender, age and myocardial areas in Japanese. The subject of this study was 145 Japanese healthy subjects who underwent cardiac magnetic resonance imaging (MRI) at medical examination. MRI scanner was Ingenia 1.5T (Philips Healthcare, Best, The Netherlands). T1 mapping was acquired with modified look-locker inversion recovery method using IR pulse. The native T1 value of all subjects was 983.5±34.8 ms, and we were able to acquire the reference value of the native T1 value at our hospital. The native T1 value was significantly higher in females than in males. There was variation in native T1 value among the myocardial areas, and the native T1 value was significantly higher in the septum than in the lateral region. In the future, collaborative research in multicenter is necessary to obtain the reference value of Japanese.

Verification of the Injection Pressure Reduction Effect Using the Novel Indwelling Needle for Contrast-enhanced CT.

PURPOSE: The purpose of this study was to investigate the injection pressure reduction effect of the novel indwelling needle (Becton, Dickinson and Company). METHOD: We evaluated the period of 651 patients who underwent dynamic computed tomography. We compared the maximum injection pressure. The contrast medium was administered at 320, 350, and 370 mgI/ml. RESULT: The maximum injection pressure of the novel indwelling needle in 22 G was decreased 10% compared with SC5 in all contrast media. The maximum injection pressure of BDN in 20 G decreases 8% compared with SC5 at 370 mgI/ml, but there was no reduction at 320 mgI/ml and 350 mgI/ml. CONCLUSION: Our analysis demonstrated that BDN significantly reduced the injection pressure especially in 22 G and using high concentration contrast medium in 20 G.

The Effect of Metal Artifact Reduction at Different Calibrated and Display Field of Views in Computed Tomography.

PURPOSE: The purpose of this study was to investigate the effects of the metal artifact reduction using single energy metal artifact reduction (SEMAR) with a prosthetic hip joint in different field of view (FOV). METHODS: A prosthetic hip joint was arranged at the center of the phantom. The phantom images were scanned by changing calibrated-FOV (C-FOV) of 240, 320, 400, and 500 mm. Those images were reconstructed by changing the display-FOV (D-FOV) of 120, 180, 240, and 320 mm. The metal artifact reduction with the SEMAR was evaluated by calculating the artifact index (AI) and its decrease ratio. RESULTS: The AI of C-FOV (500 mm) and D-FOV (120, 180, 240, or 320 mm) were 15.8, 15.8, 15.7, and 14.4 with SEMAR. For changed C-FOV, the AI of C-FOV (240 mm) was significantly higher than any other C-FOVs. The AI of C-FOV (240 mm) was 29.8-30.0 and that of the other C-FOV were 12.4-15.8 with SEMAR. In addition, the decrease ratio of AI was 52.2-54.1% for C-FOV (240 mm) and 58.9-73.2% for the other C-FOVs. CONCLUSION: Although the SEMAR decreased the metal artifact, the effect of reducing the metal artifact was affected by C-FOV.

The Advantage of 80-row Non-helical Scan Method for Head Computed Tomography: In Basal Ganglia and Parietal.

PURPOSE: The purpose of this study was to evaluate the advantage of 80-row non-helical scan methods (NH) for the head computed tomography (CT). METHODS: We calculated the noise power spectrum (NPS), contrast-to-noise ratio (CNR), CT values and standard deviation (SD) at slice position, and coefficient of variation (CV) value in head phantom. This study compared the NH method with the helical scan method (HE). RESULTS: The NPS and CNR of NH were improved compared to the HE in equivalent volume-CT dose index (CTDIvol). However, the NH was inferior to the HE in CT values and the SD at slice position. The CV values of NH were increased than the HE in the skull base. On the other hand, the CV values of NH were decreased than the HE in basal ganglia and parietal. CONCLUSIONS: The non-helical scan method in head CT have advantage for the detection of lesion in basal ganglia and parietal.

[Accuracy of Modulation Transfer Function for Target Size and Field of View in a Circular Edge Strategy Using the CT Image Measurement Program].

PURPOSE: The purpose of this study was to evaluate the effects of target diameter and display-field of view (D-FOV) in modulation transfer function (MTF) by circular edge strategy using the computed tomography (CT) image measurement program "CTmeasure". METHODS: We calculated the MTF (MTF(edge)) using the circular edge strategy applied to cylindrical phantom (200 mmφ) that inserted with cylinders have 10, 20, 30, and 40 mm diameters. The phantom images were reconstructed using filtered back projection method varied with D-FOV (240, 320, 400, and 500 mm). The study compared both MTF(edge) and MTF(wire) at MTF50% and MTF(10%) for target diameter and D-FOV, respectively. RESULTS: The MTF(edge) by the different of target diameter indicated in rough compatibility. However, MTF(edge) of D-FOV diameters (320, 400, and 500 mm) decreased in the high frequency range. CONCLUSIONS: The circular edge strategy for MTF depended on the D-FOV, however, it was little dependent on target diameter using the CT image measurement program "CTmeasure".

[Validation of dark band artifact reduction using artifact reduction processing methods with low-dose CT images: phantom study].

PURPOSE: The purpose of this study was to validate the reduction of dark band (DB) artifact using iterative reconstruction (IR) of abdomen CT. METHODS: Phantoms were arranged with and without small phantom assuming arm position at the body side (Phantom-A, -B). Image reconstruction methods were derived by the following four methods: filtered back projection (FBP), IR [adaptive iterative dose reduction using three-dimensional processing: AIDR-3D (MILD)], organ specific reconstruction (OSR), and Boost-3D (Boost). We evaluated DB artifact with CT values, standard deviation (SD) values, and profile curves using the four reconstruction methods. RESULTS: CT values of artifact decreased with low tube current in Phantom-A. CT values of artifact were significantly increased (15-23 HU) in OSR and Boost compared to FBP and MILD (Phantom-A). SD values of artifact improved by IR method. However, IR method was not improved to CT values decreased by artifact (Phantom-A). CT values were not changed by the difference in image reconstruction methods in Phantom-B. CONCLUSION: IR method has an effect to reduce statistical noise, but reduced the CT value for DB artifact. On the other hand, the OSR and Boost methods are effective for the improvement of CT value in the DB artifact.

Improving the depiction of small intracranial vessels in head computed tomography angiography: a comparative analysis of deep learning reconstruction and hybrid iterative reconstruction.

This study aimed to evaluate the ability of deep learning reconstruction (DLR) compared to that of hybrid iterative reconstruction (IR) to depict small vessels on computed tomography (CT). DLR and two types of hybrid IRs were used for image reconstruction. The target vessels were the basilar artery (BA), superior cerebellar artery (SCA), anterior inferior cerebellar artery (AICA), and posterior inferior cerebellar artery (PICA). The peak value, ΔCT values defined as the difference between the peak value and background, and full width at half maximum (FWHM), were obtained from the profile curves. In all target vessels, the peak and ΔCT values of DLR were significantly higher than those of the two types of hybrid IR (p < 0.001). Compared to that associated with hybrid IR, the FWHM of DLR was significantly lower in the SCA (p < 0.001), AICA (p < 0.001), and PICA (p < 0.001). In conclusion, DLR has the potential to improve visualization of small vessels.

[Survey on the Number and Percentage of MR Safety Labeling Changed for Implantable Medical Devices].

PURPOSE: The purposes of this study were to investigate the number and percentage of items that changed magnetic resonance (MR) safety information labeling for implantable medical devices (IMDs) and to confirm the importance of checking the latest MR safety information database (117 types and 10031 items). METHODS: We investigated the number and percentage of MR safety labeling changed for IMDs in the MR safety information database as of December 2021 and August 2022. RESULTS: IMDs of MR Safety Unlabeled decreased from 4116 items (41.1%) to 859 items (8.6%). IMDs of MR Conditional increased from 4141 items (41.3%) to 5896 items (58.8%). CONCLUSIONS: Since there have been changes in the MR safety labeling for many IMDs, this study shows that it is important to confirm the latest MR safety information for IMDs.

[Organ and Effective Doses Using Automation Organ Dose Estimation Software for Lung Cancer Screening Using Low-dose Computed Tomography].

PURPOSE: The purpose of this study was to evaluate the differences in the organ doses and the effective doses using three types of automated organ dose estimation software for low-dose computed tomography (CT) screening for lung cancer and to evaluate the correlations between each dose and size-specific dose estimates (SSDEs). METHODS: Seventy-two adults who underwent low-dose CT screening for lung cancer were included, and the organ doses and the effective doses were calculated using each of automated organ dose estimation software. We evaluated differences between software for the organ doses and the effective doses and the correlations between each dose and SSDEs. RESULTS: Differences in organ doses and effective doses were observed among the software. The organ doses showed a strong correlation (r=0.833-0.995) with SSDEs for organs within the scan range. The effective doses showed a strong correlation (r=0.830-0.970) with SSDEs, although there were significant differences among the software. CONCLUSION: Although the organ doses and the effective doses differed between software, it may be possible to estimate them from SSDEs by using linear regression equations.

[Restructuring Torso CT Protocol for Radiation Dose Management].

PURPOSE: There are problems with dose management in X-ray computed tomography (CT) because the protocol used for any examination is not always in the same scan range. The purpose of this study was to investigate the usefulness of setting the CT protocol based on the scan range. METHODS: We evaluated the examination data of patients who underwent plain CT based on a scan range of chest to pelvis and abdomen to pelvis. The previous protocol [Chest-Abdomen Routine] was changed to the current protocols [Chest_Abdomen] and [Chest_Pelvis], and the previous protocol of [Abdomen Routine] was changed to the current protocols [Abdomen] and [Abdomen_Pelvis]. Examination data of height, scan length, volume CT dose index (CTDIvol), and dose length product (DLP) were obtained from digital imaging and communications in medicine, and radiation dose structured report using Radimetrics. The relationship between patient height and scan range, and CTDIvol and DLP was indicated in a scatter plot. Standard deviation (SD) of scan length and DLP were compared between current and previous protocols. Outliers were defined as the data exceeding average ±2SD. RESULTS: The SD of scan length decreased by 77.1% on abdomen to pelvis, and the SD of DLP decreased by 65.2% on abdomen to pelvis. The causes of the outliers were CT scan range, scan parameter, arm position, metal implants, and body thickness of patients. CONCLUSION: Setting CT protocols based on the scan range reduced SD of scan length and DLP. It was helpful for reducing the number of scan range outliers and analyzing the cause of outliers.

[Scientific Research Group Report: Nationwide Survey on Radiation Exposure of Pediatric CT Examination in Japan (2018)].

PURPOSE: To understand the latest pediatric computed tomography (CT) exposure required for the revision of national DRLs. METHODS: A questionnaire was sent to 409 facilities where the members of the Japanese Society of Radiological Technology and the Japanese Society of Pediatric Radiology are enrolled. We investigated the imaging conditions, CTDIvol, and DLP of the pediatric head, chest, and abdominal CT examinations. RESULTS: In all, 43 facilities (11%) responded to our survey. multi detector-row CT (MDCT) systems were available in all surveyed facilities. More than 98% of the MDCT systems had more than 64 detector rows. The CTDIvol of all CT protocols was lower than the NDRL due to the progress of updating to MDCTs with radiation exposure reduction functions such as an iterative reconstruction, but the DLP of head and abdominal CT protocols of some age group were higher than NDRL. CONCLUSION: It is necessary to review the imaging protocol with the attending physician and radiologist and consider further optimization of medical exposure.

CT dose management of adult patients with unknown body weight using an effective diameter.

PURPOSE: To assess the usefulness of effective diameter (Deff) for CT dose management of adult patients with unknown body weight. METHODS: A total of 642 adult patients whose height and weight had been measured before CT examination (chest CT using Aquilion Prime SP, 428 patients; chest CT using Biograph mCT, 100 patients; and abdominal CT using Aquilion Prime SP, 114 patients) were retrospectively examined between April 2018 and September 2019. The Deff was automatically calculated from the lateral diameter on a CT localizer radiograph by a dose management software (Radimetrics). In order to determine the correlation between body weight and Deff, we compared volume CT dose index and dose length product between patients with body weight between 50 and 70 kg and those with Deff equivalent to body weight between 50 and 70 kg. Correlation analysis was performed by Pearson's product-moment correlation, and statistical analyses were performed by using t-test. RESULTS: The correlation coefficient values between body weight and Deff were 0.920 for chest CT using Aquilion Prime SP, 0.929 for chest CT using Biograph mCT, and 0.805 for abdominal CT using Aquilion Prime SP. In both chest and abdominal CT scans, there were no significant differences in volume CT dose index and dose length product between patients with body weight between 50 and 70 kg and those with Deff equivalent to body weight between 50 and 70 kg. CONCLUSIONS: The Deff may be useful as a somatometric parameter for CT dose management of adult patients with unknown body weight.

Pulmonary Artery/Vein Separation Using Single-Phase Computed Tomography: Feasibility and the Influence of Patient Characteristics on Vessel Enhancement.

PURPOSE: The purpose of this article was to verify the usefulness and feasibility of a single-phase scan for pulmonary artery/vein separation using a bolus-tracking technique and to evaluate the influence of patient characteristics on differentiation of computed tomography (CT) values between arteries and veins. MATERIAL AND METHODS: A total of 79 patients (60 male individuals and 19 female individuals, mean age 70 y) with suspected lung cancers or metastasis underwent contrast-enhanced chest CT and ultrasonic echocardiography. The CT values of the pulmonary arteries and veins were measured, and the difference in CT values was calculated. The relationships between the difference in CT values and age, weight, height, body surface area, body mass index, cardiac output, cardiac index, trigger time, trigger CT value, and pulmonary transit time were investigated using univariate linear regression analysis. RESULTS: The CT values were 352.8±87.3 HU and 494.6±76.5 HU for the pulmonary arteries and veins, respectively (P<0.001). A significant but weak correlation was seen between the difference in CT values and the height (r=0.24), trigger time (r=0.35), cardiac index (r=-0.25), and pulmonary transit time (r=0.53) (P<0.05). There was no significant correlation between the difference in CT values and the remaining values. CONCLUSION: The single-phase scan protocol using a bolus-tracking technique is feasible to differentiate CT values between pulmonary arteries and veins. The influence of patient characteristics on the differentiation of CT values lacks impact. Thus, the suggested protocol may be suitable independent of these factors after further validation.

Corneal Dose Reduction Using a Bismuth-Coated Latex Shield over the Eyes During Brain SPECT/CT.

This study aimed to determine whether a bismuth-coated latex shield (B-shield) could protect the eyes during brain SPECT/CT. Methods: A shield containing the heavy metal bismuth (equivalent to a 0.15-mm-thick lead shield) was placed over a cylindric phantom and the eyes of a 3-dimensional brain phantom filled with 99mTc solution. Subsequently, phantoms with and without the B-shield were compared using SPECT/CT. The CT parameters were 30-200 mA and 130 kV. The dose reduction achieved by the B-shield was measured using a pencil-shaped ionization chamber. The protective effects of the B-shield were determined by evaluating relative radioactivity concentration as well as artifacts (changes in CT number), linear attenuation coefficients, and coefficients of variation on SPECT images. Results: The radiation doses with and without the B-shield were 0.14-0.77 and 0.36-1.93 mGy, respectively, and the B-shield decreased the average radiation dose by about 60%. The B-shield also increased the mean CT number, but only at locations just beneath the surface of the phantom. Streaks of higher density near the underside of the B-shield indicated beam hardening. Linear attenuation coefficients and the coefficients of variation did not significantly differ between phantoms with and without the B-shield, and the relative 99mTc radioactivity concentrations were not affected. Conclusion: The B-shield decreased the radiation dose without affecting estimated attenuation correction or radioactivity concentrations. Although surface artifacts increased with the B-shield, the quality of the SPECT images was acceptable. B-shields can help protect pediatric patients and patients with eye diseases who undergo SPECT imaging.