In this study, we present the measurements of effective dose from CT of head & neck region. A series of dose measurements in anthropomorphic Rando phantom was conducted using a radio photoluminescent glass rod dosimeter to evaluate effective doses of organs of head and neck region from the patient. The experiments were performed with respect to four anatomic regions of head & neck: optic nerve, pons, cerebellum, and thyroid gland. The head & neck CT protocol was used in the single scan (Brain, 3D Facial, Temporal, Brain Angiography and 3D Cervical Spine) and the multiple scan (Brain+Brain Angiography, Brain+3D Facial, Brain+Temporal, Brain+3D Cervical spine, Brain+3D Facial+Temporal, Brain+3D Cervical Spine+Brain Angiography). The largest effective dose was measured at optic nerve in Brain CT and Brain Angiography. The largest effective dose was delivered to the thyroid grand in 3D faical CT and 3D cervical spine, and to the pons in Temporal CT. In multiple scans, the higher effective dose was measured in the thyroid grand in Brain+3D Facial, Brain+3D Cervical Spine, Brain+3D Facial+Temporal and Brain+3D Cervical Spine+Brain Angiography. In addition, the largest effective dose was delivered to the cerebellum in Brain CT+Brain Angiography CT and higher effective dose was delivered to the pons in Brain+Temporal CT. The results indicate that in multiple scan of Brain+3D Cervical Spine+Brain Angiography, effective dose was 2.52 mSv. This is significantly higher dose than the limitation of annual effective dose of 1 mSv. The effective dose to the optic nerve was 0.31 mSv in Brain CT, which shows a possibility of surpassing the limitation of 1 mSv by furthre examination. Therefore, special efforts should be made in clinical practice to reduce dose to the patients.
Jo, Ho jun;Lim, Yong Su;Kim, Jin Joo;Cho, Jin Seong;Hyun, Sung Youl;Yang, Hyuk Jun;Lee, Gun
Journal of Trauma and Injury
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제28권3호
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pp.149-157
/
2015
Purpose: Traumatic brain injury (TBI) is the most common cause of pediatric trauma patients came to the emergency department. Without guidelines, many of these children underwent repeat brain computed tomography (CT). The purpose of this study was to evaluate the value of repeat brain CT in children with TBI. Methods: We conducted a retrospective study of TBI in children younger than 19 years of age who visited the emergency department (ED) from January 2011 to December 2012. According to the Glasgow Coma Scale (GCS) and Pediatric Glasgow Coma Scale score of the patients, study population divided in three groups. Clinical data collected included age, mechanism of injury, type of TBI, and outcome. Results: A Total 83 children with TBI received repeat brain CT. There were no need for neurosurgical intervention in mild TBI (GCS score 13-15) group who underwent routine repeat CT. 4 patients of mild TBI group, received repeat brain CT due to neurological deterioration, and one patient underwent neurosurgical intervention. Routine repeat CT identified 12 patients with radiographic progression. One patient underwent neurosurgical intervention based on the second brain CT finding, who belonged to the moderate TBI (GCS score 9-12) group. Conclusion: Our study showed that children with mild TBI can be observed without repeat brain CT when there is no evidence of neurologic deterioration. Further study is needed for establish indication for repetition of CT scan in order to avoid unnecessary radiation exposure of children.
Kim, Hae-Suk;Kim, Jang-Oh;Lee, Yoon-Ji;Heo, Sung-Hoe;Lee, Chang-Ho;Min, Byung-In
Journal of the Korean Society of Radiology
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제14권4호
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pp.345-351
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2020
In this study, a dose assessment was conducted on the exposure dose of thyroid, breast and sexual gland using a personal dosimeter in multiple CT examinations currently being conducted in health examinations. The dose assessment was measured by attaching TLD and EPD to the locations of the thyroid, breast and sexual gland during CT examinations of Brain, Brain + C-S, Brain + Low lung, Brain + L-S among CT items. The generated dose of equipment, CTDIvol and DLP, was measured. The study found that effective doses were rated 41.7% higher for thyroid TLD in Brain + C-S CT examinations than for the general public, 156% higher for EPD, 10% for breast EPD in Brain + Low Lung CT examinations, 124.4% higher for reproductive TLD and 339.8% higher for Brain + L-S CT examinations. The CTDIvol and DLP analysis results showed that C-S CTDIvol values were higher than the diagnostic reference levels at 0.6%, Low Lung CTDIvol values at 5.7%, DLP values at 11.8% and L-S CTDIvol values at 1.2%. In order to reduce the exposure dose of patients, indiscriminate examination is reduced and dose limit setting is needed in health examination.
Three dogs (7-year-old, neutered male Chihuahua; case 1, 1-year-old, spayed female mixed breed; case 2, 10-month-old, female Maltese; case 3) were referred to Jeju Veterinary Medicine Teaching Hospital for traumatic brain injury. All three patients exhibited abnormal neurological symptoms. The patients were diagnosed through medical history obtained from their caregivers and through computed tomography (CT) or magnetic resonance imaging (MRI) scans. Structural brain abnormalities were observed in two dogs through CT scans and in one dog through MRI. Decompression therapy with mannitol was administered to all three dogs. Case 1, which showed CT findings of pulmonary hemorrhage but no significant brain injury, and case 2, which had mild brain damage on CT imaging, showed improvement in neurological symptoms and gait abnormalities after decompression therapy. However, case 3, which showed suspected brain hemorrhage and brain edema on MRI, did not respond to decompression therapy and was euthanized one month later. Imaging evaluation through CT or MRI in dogs with traumatic brain injury can assist clinical veterinarians in assessing the prognosis of patients.
Kim, Du Su;Kong, Min Ho;Jang, Se Youn;Kim, Jung Hee;Kang, Dong Soo;Song, Kwan Young
Journal of Korean Neurosurgical Society
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제54권2호
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pp.100-106
/
2013
Objective : To investigate the cases of intracranial abnormal brain MRI findings even in the negative brain CT scan after mild head injury. Methods : During a 2-year period (January 2009-December 2010), we prospectively evaluated both brain CT and brain MRI of 180 patients with mild head injury. Patients were classified into two groups according to presence or absence of abnormal brain MRI finding even in the negative brain CT scan after mild head injury. Two neurosurgeons and one neuroradiologist validated the images from both brain CT scan and brain MRI double blindly. Results : Intracranial injury with negative brain CT scan after mild head injury occurred in 18 patients (10.0%). Headache (51.7%) without neurologic signs was the most common symptom. Locations of intracranial lesions showing abnormal brain MRI were as follows; temporal base (n=8), frontal pole (n=5), falx cerebri (n=2), basal ganglia (n=1), tentorium (n=1), and sylvian fissure (n=1). Intracranial injury was common in patients with a loss of consciousness, symptom duration >2 weeks, or in cases of patients with linear skull fracture (p=0.00013), and also more frequent in multiple associated injury than simple one (35.7%>8.6%) (p=0.105). Conclusion : Our investigation showed that patients with mild head injury even in the negative brain CT scan had a few cases of intracranial injury. These findings indicate that even though the brain CT does not show abnormal findings, they should be thoroughly watched in further study including brain MRI in cases of multiple injuries and when their complaints are sustained.
This paper explores CT findings of a rabbit brain infection model injected with Escherichia coli and investigates the changes in Hounsfield unit (HU) of arterial blood over time. The brain infection model was produced by injecting E. coli $1{\times}10^7$ CFU/ml, 0.1 ml through the burr hole in the calvarium; 2~3 mm in depth from the dura mater, and contrast-enhanced CT, dynamic CT and arterial blood CT images were gained. It was found that various brain infections such as brain abscess, ventriculitis and meningitis. The CT image of brain abscess showed a typical pattern which the peripheral area was strongly contrast-enhanced while the center was weakly contrast-enhanced. The CT image of ventriculitis showed a strong contrast-enhancement along the lateral ventricle wall, and the CT image of meningitis showed a strong contrast-enhancement in the area between the telencephalon and the diencephalon. In dynamic CT images, the HU value of the infection core before injecting contrast medium was $31.01{\pm}3.55$. By 10 minutes after the injection, the value increased gradually to $40.36{\pm}3.76$. The HU value in the areas of the marginal rim where was hyper-enhanced showed $47.23{\pm}3.12$ before contrast injection, and it increased to $63.59{\pm}3.31$ about 45 seconds after the injection. In addition, the HU value of the normal brain tissue opposite to the E. coli. injected brain was $39.01{\pm}3.24$ before the injection, but after the contrast injection, the value increased to $49.01{\pm}4.29$ in about 30 seconds, and then it showed a gradual decline. In the arterial blood CT, the HU value before the contrast injection was $87.78{\pm}6.88$, and it increased dramatically between 10 to 30 seconds until it reached a maximum value of $749.13{\pm}98.48$. Then it fell sharply to $467.85{\pm}62.98$ between 30 seconds to 45 seconds and reached a plateau by 60 seconds. Later, the value showed a steady decrease and indicated $188.28{\pm}25.03$ at 20 minutes. Through this experiment, it was demonstrated that the brain infection model can be produced by injecting E. coli., and the characteristic of the infection model can be well observed with contrast-enhanced CT scan. The dynamic CT scan showed that the center of the infection was gradually contrast-enhanced, whereases the peripheral area was rapidly contrast-enhanced and then slowly decreased. As for arterial blood, it increased significantly between 10 seconds to 30 seconds after the contrast medium injection and decreased gradually after reaching a plateau.
A dog (Chihuahua, 2-year-old, intact female) was referred to us because of cluster seizure. She had history of falling from height few days before presentation. Brain computed tomography (CT) results demonstrated fracture line on right temporal bone and hypodense, edematous changes of the adjacent brain parenchyma on right cerebral parenchyma. Based on history, clinical signs, and diagnostic imaging findings, this patient was diagnosed to traumatic brain injury. After diagnosis, the patient was well controlled with anti-inflammatory drug and anti-epileptic drugs. When 30, 480, and 1260 days after initial brain CT examination, we performed serial brain CT rechecks. This case report describes serial clinical and brain CT findings after traumatic brain injury.
Purpose The purpose of this study was to evaluate image quality change by truncated region in field of view (FOV) of attenuation correction computed tomography (AC-CT) in brain PET/CT. Materials and Methods Biograph Truepoint 40 with TrueV (Siemens) was used as a scanner. $^{68}Ge$ phantom scan was performed with and without applying brain holder using brain PET/CT protocol. PET attenuation correction factor (ACF) was evaluated according to existence of pallet in FOV of AC-CT. FBP, OSEM-3D and PSF methods were applied for PET reconstruction. Parameters of iteration 4, subsets 21 and gaussian 2 mm filter were applied for iterative reconstruction methods. Window level 2900, width 6000 and level 4, 200, width 1000 were set for visual evaluation of PET AC images. Vertical profiles of 5 slices and 20 slices summation images applied gaussian 5 mm filter were produced for evaluating integral uniformity. Results Patient pallet was not covered in FOV of AC-CT when without applying brain holder because of small size of FOV. It resulted in defect of ACF sinogram by truncated region in ACF evaluation. When without applying brain holder, defect was appeared in lower part of transverse image on condition of window level 4200, width 1000 in PET AC image evaluation. With and without applying brain holder, integral uniformities of 5 slices and 20 slices summation images were 7.2%, 6.7% and 11.7%, 6.7%. Conclusion Truncated region by small FOV results in count defect in occipital lobe of brain in clinical or research studies. It is necessary to understand effect of truncated region and apply appropriate accessory for brain PET/CT.
Seo, Kang rok;Lee, Jeong eun;Ko, Hyun soo;Ryu, Jae kwang;Nam, Ki pyo
The Korean Journal of Nuclear Medicine Technology
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제23권1호
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pp.69-74
/
2019
Purpose $^{18}F$-FDOPA using amino acid is particularly attractive for imaging of brain tumors because of the high uptake in tumor tissue and the low uptake in normal brain tissue. But, on the other hand, $^{18}F$-FDG is highly uptake in both tumor tissue and normal brain tissue. The purpose of study is to evaluate comparison of contrasts in $^{18}F$-FDOPA Brain PET/CT and $^{18}F$-FDG Brain PET/CT and to find out optimal scan time by analysis of variation in SUV with the passage of uptake time. Materials and Methods A region of interest of approximately $350mm^2$ at the center of the tumor and cerebellum in 12 patients ($51.4{\pm}12.8yrs$) who $^{18}F$-FDG Brain PET/CT and $^{18}F$-FDOPA Brain PET/CT were examined more than once each. The $SUV_{max}$ was measured, and the $SUV_{max}$ ratio (T/C ratio) of the tumor cerebellum was calculated. In the analysis of SUV, T/C ratio was calculated for each frame after dividing into 15 frames of 2 minutes each using List mode data in 25 patients ($49.{\pm}10.3yrs$). SPSS 21 was used to compare T/C ratio of $^{18}F$-FDOPA and T/C ratio of $^{18}F$-FDG. Results The T/C ratio of $^{18}F$-FDOPA Brain PET/CT was higher than the T/C ratio of $^{18}F$-FDG Brain, and show a significant difference according to a paired t-test(t=-5.214, p=0.000). As a result of analyzing changes in $SUV_{max}$ and T/C ratio, the peak point of $SUV_{max}$ was $5.6{\pm}2.9$ and appeared in the fourth frame (6 to 8 minutes), and the peak of T/C ratio also appeared in the fourth frame (6 to 8 minutes). Taking this into consideration and comparing the existing 10 to 30 minutes image and 6 to 26 minutes image, the $SUV_{max}$ and T/C ratio increased by 0.2 and 0.1 each, compared to the 10 to 30 minutes image for 6 to 26 minutes image. Conclusion From this study, $^{18}F$-FDOPA Brain PET/CT is effective when reading the image, because the T/C ratio of $^{18}F$-FDOPA Brain PET/CT was higher than T/C ratio of $^{18}F$-FDG Brain PET/CT. In addition, in the case of $^{18}F$-FDOPA Brain PET/CT, there was no difference between the existing 10 to 30 minutes image and 6 to 26 minutes image. Through continuous research, we can find possibility of shortening examination time in $^{18}F$-FDOPA Brain PET/CT. Also, we can help physician to accurate reading using additional scan data.
The study is to produced a brain phantom simulating corpus striatum, which can evaluate the progression of parkinson's disease, to investigate possibility of reducing the brain exposure dose to CT while maintaining optimal image quality during PET-CT examinations. CT scans were performed by varying tube voltage (100, 120 kVp) and tube current (80, 140, 200 mAs) with $^{18}F$ FP-CIT injected into the phantom's hot sphere and background (radioactivity ratio 3:1)(reference condition; 120 kVp, 140 mAs). Estimated effective dose was calculated by using conversion factor according to each condition, and image quality was evaluated by setting SNR and CRChot image evaluation factors. Experimental results showed that the predicted effective dose below the CT imaging reference condition was reduced by at least 10% and by up to 60%, and the predicted effective dose beyond the reference condition was increased by 40%. In addition, there was no significant difference between SNR and CRChot of PET images, and it was confirmed that brain dose decreased with decrease of tube voltage and tube current. At the same time, there was no significant change in the quality of the image in terms of SNR and CRChot despite the change in scan conditions. This fact suggests that the quality of the images acquired under the existing dose conditions can be obtained even at low dose conditions and it is expected that it will be possible to use the brain PET-CT scan as a basic data for the research on reduction of dose and improvement of image quality.
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