Local clinical diagnostic reference levels for chest and abdomen CT examinations in adults as a function of body mass index and clinical indication: a prospective multicenter study.
Objectives: To compare institutional dose levels based on clinical indication and BMI class to anatomy-based national DRLs (NDRLs) in chest and abdomen CT examinations and to assess local clinical diagnostic reference levels (LCDRLs).Methods: From February 2017 to June 2018, after protocol optimizat...
| Publicado en: | European Radiology Vol. 29; no. 12; pp. 6794 - 6805 |
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| Autores principales: | , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Dec2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139479354&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139479354 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Dec2019 vid: 29 iid: 12 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 139479354 139479354 NLM31144074 139479354 10.1007/s00330-019-06257-x NLM31144074 139479354 ppf: 6794 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Local clinical diagnostic reference levels for chest and abdomen CT examinations in adults as a function of body mass index and clinical indication: a prospective multicenter study. aug: au: Brat, Hugues Zanca, Federica Montandon, Stéphane Racine, Damien Rizk, Benoit Meicher, Eric Fournier, Dominique affil: Institut de Radiologie de Sion, Groupe 3R, Sion, Switzerland sug: subj: Radiography, Abdominal Methods Radiation Dosage Body Mass Index Radiography, Thoracic Methods Tomography, X-Ray Computed Methods Human Adolescence Adult Reference Values Prospective Studies Aged, 80 and Over Thorax Middle Age Young Adult Physical Examination Aged Male Female Abdomen Validation Studies Comparative Studies Evaluation Research Multicenter Studies Scales Adolescent: 13-18 years Adult: 19-44 years Aged, 80 & over Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Objectives: To compare institutional dose levels based on clinical indication and BMI class to anatomy-based national DRLs (NDRLs) in chest and abdomen CT examinations and to assess local clinical diagnostic reference levels (LCDRLs).Methods: From February 2017 to June 2018, after protocol optimization according to clinical indication and body mass index (BMI) class (< 25; ≥ 25), 5310 abdomen and 1058 chest CT series were collected from 5 CT scanners in a Swiss multicenter group. Clinical indication-based institutional dose levels were compared to the Swiss anatomy-based NDRLs. Statistical significance was assessed (p < 0.05). LCDRLs were calculated as the third quartile of the median dose values for each CT scanner.Results: For chest examinations, dose metrics based on clinical indication were always below P75 NDRL for CTDIvol (range 3.9-6.4 vs. 7.0 mGy) and DLP (164.0-211.2 vs. 250 mGycm) in all BMI classes except for DLP in BMI ≥ 25 (248.8-255.4 vs. 250.0 mGycm). For abdomen examinations, they were significantly lower or not different than P50 NDRLs for all BMI classes (3.8-9.0 vs. 10.0 mGy and 192.9-446.8 vs. 470mGycm). The estimated LCDRLs show a drop in CTDIvol (21% for chest and 32% for abdomen, on average) with respect to current DRLs. When considering BMI stratification, the largest LCDRL difference within the same clinical indication is for renal tumor (4.6 mGy for BMI < 25 vs. 10.0 mGy for BMI ≥ 25; - 117%).Conclusion: The results suggest the necessity of estimating clinical indication-based DRLs, especially for abdomen examinations. Stratifying per BMI class allows further optimization of the CT doses.Key Points: • Our data show that clinical indication-based DRLs might be more appropriate than anatomy-based DRLs and might help in reducing large variations in dose levels for the same type of examinations. • Stratifying the data per patient-size subgroups (non-overweight, overweight) allows a better optimization of CT doses and therefore the possibility to set LCDRLs based on BMI class. • Institutions who are fostering continuous dose optimization and LDRLs should consider defining protocols based on clinical indication and BMI group, to achieve ALARA. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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