• Title/Summary/Keyword: Diagnostic reference levels

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A Study of Diagnostic Reference Levels for Coronary Angiography and Percutaneous Coronary Intervention in Gyeongsang Area (관상동맥 조영술 및 경피적 관상동맥 중재술에 대한 진단참고준위에 관한 연구; 경상도지역중심)

  • Si-Wang Lim;Jung-Su Kim;Pyong-Kon Cho
    • Journal of radiological science and technology
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    • v.46 no.2
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    • pp.123-129
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    • 2023
  • Interventional cardiology procedures can involve relatively high radiation doses compared to conventional radiography. During CAG, CAG + PCI and PCI the same area is exposed to radiation for a long period. In this study, radiation exposure data of 421 examinations in Gyeongsang area were collected, and the DRLs and ADs in actual medical practice for three types of interventional cardiology procedures in Korea were established. In CAG 286 case, 75th percentile DRLs and ADs of the total DAP were 55.89 Gy·cm2 and 37.47 Gy·cm2 , respectively. In CAG + PCI 92 case, those values were 222.84 Gy·cm2 and 117.51 Gy·cm2 respectively. In PCI 43 case, those values were 198.73 Gy·cm2 and 120.13 Gy·cm2 respectively. In this study, for the first time, the diagnostic reference level of interventional cardiology procedures in Gyeongsang area were established. Using the diagnostic reference level of interventional cardiology procedures derived from this study, it will help to identify and improve the level of exposure dose in the region and country.

Production and Application of the Dose Calculation Program which used MS EXCEL and Bit System (MS EXCEL 및 Bit system을 이용한 피부선량 계산 프로그램의 제작 및 응용)

  • Kim, Sung-Chul;Kim, Chong-Yeal
    • Journal of radiological science and technology
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    • v.32 no.1
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    • pp.39-43
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    • 2009
  • The medical diagnostic examination using ionizing radiation has improved the patients' life and brought revolution in medical examination along with the mechanical development. However, the development of medical imaging systems has also been the reason to increase the patients' exposure for ionizing radiation. ICRP recommends that each country adopts diagnostic reference levels depending on regional and national situations. The Korea Food & Drug Administration suggested the dosimetry measurement guideline for patients in 2007. Nonetheless, in reality, it is hard to know the skin dose of the patients when applying a x-ray since there is no radiation dosimeter in most of clinical situation. Therefore, this study sets a program based on the bit system to figure out easily the skin dose of a patients using MS Excel program in the PC setting. The results showed 10% better outcome.

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Proposed Institutional Diagnostic Reference Levels in Computed and Direct Digital Radiography Examinations in Two Teaching Hospitals

  • Emmanuel Gyan;George Amoako;Stephen Inkoom;Christiana Subaar;Barry Rahman Maamah
    • Journal of Radiation Protection and Research
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    • v.48 no.1
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    • pp.9-14
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    • 2023
  • Background: The detectors of both computed radiography (CR) and direct digital radiography (DR) have a wide dynamic range that could tolerate high values of exposure factors without an adverse effect on image quality. Therefore, this study aims to assess patient radiation dose and proposes institutional diagnostic reference levels (DRLs) for two teaching hospitals in Ghana. Materials and Methods: CR and DR systems were utilized in this study from two teaching hospitals. The CR system was manufactured by Philips Medical Systems DMC GmbH, while the DR system was manufactured by General Electric. The entrance skin doses (ESDs) were calculated using the standard equation and the tube output measurements. Free-in-air kerma (µGy) was measured using a calibrated radiation dosimeter. The proposed institutional DRLs were estimated using 75th percentiles values of the estimated ESDs for nine radiographic projections. Results and Discussion: The calculated DRLs were 0.4, 1.6, 3.4, 0.5, 0.4, 1.1, 1.0, 1.2, and 1.7 mGy for chest posteroanterior (PA), lumbar spine anteroposterior (AP), lumbar spine lateral (LAT), cervical spine AP, cervical spine LAT, skull PA, pelvis AP, and abdomen AP, respectively in CR system. In the DR system, the values were 0.3, 1.6, 3.1, 0.4, 0.3, 0.7, 0.6, 0.9, and 1.3 for chest PA, lumbar spine AP, lumbar spine LAT, cervical spine AP, cervical spine LAT, skull PA, pelvis AP, and abdomen AP, respectively. Conclusion: Institutional DRLs in nine radiographic projections have been proposed for two teaching hospitals in Ghana for the first time. The proposed DRLs will serve as baseline data for establishing local DRLs in the hospitals and will be a valuable tool in optimizing patient doses.

Review of National Diagnostic Reference Levels for Interventional Procedures

  • Lee, Min Young;Kwon, Jae;Ryu, Gang Woo;Kim, Ki Hoon;Nam, Hyung Woo;Kim, Kwang Pyo
    • Progress in Medical Physics
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    • v.30 no.4
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    • pp.75-88
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    • 2019
  • Diagnostic reference level (DRL) is employed to optimize the radiation doses of patients. The objective of this study is to review the DRLs for interventional procedures in Korea and abroad. Literature review was performed to investigate radiation dose index and measurement methodology commonly used in DRL determination. Dose area product (DAP) and fluoroscopy time within each major procedure category were systematically abstracted and analyzed. A wide variation was found in the radiation dose. The DAP values and fluoroscopy times ranged 0.01-3,081 Gy·㎠ and 2-16,878 seconds for all the interventional procedures, 8.5-1,679 Gy·㎠ and 32-5,775 seconds for the transcatheter arterial chemoembolization (TACE), and 0.1-686 Gy·㎠ and 16-6,636 seconds for the transfemoral cerebral angiography (TFCA), respectively. The DRL values of the DAP and fluoroscopy time were 238 Gy·㎠ and 1,224 seconds for the TACE and 189 Gy·㎠ and 686 seconds for the TFCA, respectively. Generally, the DRLs of Korea were lower than those of other developed countries, except for the percutaneous transluminal angioplasty with stent in arteries of the lower extremity (LE PTA and stent), aneurysm coil embolization, and Hickman insertion procedures. The wide variation in the radiation doses of the different procedures suggests that more attention must be paid to reduce unnecessary radiation exposure from medical imaging. Furthermore, periodic nationwide survey of medical radiation exposures is necessary to optimize the patient dose for radiation protection, which will ultimately contribute to patient dose reduction and radiological safety.

Correlation Analysis of between Patient and Equipment Factors and Radiation Dose in Chest Low Dose and Abdominal Non-contrast CT (흉부 저선량 및 복부 비조영 CT 검사에서 환자 및 장비 인자와 선량과의 상관관계 분석)

  • Shim, Jina;Lee, Youngjin
    • Journal of the Korean Society of Radiology
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    • v.15 no.2
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    • pp.117-123
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    • 2021
  • This paper is to establish a basis for a dose reduction strategy by confirming correlations with the factors that may affect the radiation dose based on the dose records in low-dose chest CT and abdominal non-contrast CT. In order to find out the causes of unnecessary exposure, the correlation between seven factors (age, gender, height, weight, BMI, patient status [inpatient and outpatient], and use of dose modulation) and CT dose were identified. Logistic regression was used as the statistical analysis for correlation verification. In the low dose chest CT, as the higher values of height and BMI and dose modulation off were associated with lowering the risk exceeding Diagnostic Reference Levels(DRL) (odds ration<1, p<0.05). However, as woman compared to man and the higher values of weight were associated with highering the risk exceeding DRL (odds ration>1, p<0.05). In the abdomen CT, as dose modulation off were associated with lowering the risk exceeding DRL (odds ration<1, p<0.05). Therefore It is necessary to conduct research on the relationship between various factors affecting radiation exposure and patient radiation dose for reducing the dose.

Analysis and Evaluation of Computed Tomography Dose Index (CTDI) of Pediatric Brain by Hospital Size (병원규모별 소아 두부 CT 검사 선량지표 분석 평가)

  • Kim, Hyeonjin;Lee, Hyoyeong;Im, Inchul
    • Journal of the Korean Society of Radiology
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    • v.10 no.7
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    • pp.503-510
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    • 2016
  • Even though children are exposed to the same amount of radiation, their effective dose amount is higher than those of adults. Therefore, it is very important to reduce the amount of unnecessary radiation exposure because children have a higher radiosensitivity and a smaller body size than adults. In this study, the proposal to seek ways to reduce the amount of radiation is drawn by comparing and analyzing CT Dose Index(CTDI) on the pediatric head CT which was performed at the Busan regional hospitals, to the national diagnostic reference levels. For this, the pediatric head CT scan was conducted among the CT equipments that were installed in downtown Busan. From 2,043 children 10 years old or less who were referred to the pediatric head CT scan, targeting the 28 CT equipments in the 24 hospitals that transmit dose reports to PACS, were examined retrospectively. As a result, the average value of CTDIvol, computed tomography dose index (CTDI) of infant brain, across the hospital, was 31.18 mGy, with DLP of $444.73mGy{\cdot}cm$, which exceeded the diagnostic reference level. The lower the age, the more management is needed for radiation. However, the reality is that the CT examinations are being conducted with a dose that exceeds the reference level as the age of the aged is exceeded. For this purpose, the study seeks to determine the degree of doses of doses outside the diagnostic reference level and analyze the cause of the excess dose and devise measures to reduce the dose reduction.

Analysis of Patient Exposure dose with Glass Dosimeter (Glass Dosimeter를 이용한 환자피폭선량에 관한 분석)

  • Kim, Jae-In;Choi, Won-Keun;Chang, Sung-Won;Oh, Chang-Seop;Lee, Kwan-Sup;Ha, Dong-Yoon
    • Korean Journal of Digital Imaging in Medicine
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    • v.11 no.1
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    • pp.15-20
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    • 2009
  • Far reducing medical radiation exposure and managing patient doses, Entrance surface doses(ESDs) were measured at Diagnostic Radiology Department in ASAN medical center, also we determined and compared with the Diagnostic Reference Level(DRL) of some other countries. ESDs were measured far the most common types of X-ray procedures, such as chest PA, lumbar spine AP, lumbar spine lateral, Pelvis AP, Skull PA. ESDs were measured by Glass dosimeter and Unfors Xi meter. Those were applied collimation center of phantom's entrance skin surface. The results of ESDs were compared Glass dosimeter with Unfors Xi meter. Those were measured within 5% statistical difference. It seemed well agreement at two devices. In most cases ESDs measured far the different types of X ray procedures were found to be lower than the DRL of IAEA, but ESDs on chest PA, lumbar spine AP, lumbar spine lateral, Pelvis AP, Skull PA were proximity ar excesses at DRL of advanced country. Through this study, we need an investigation and improvement at present diagnostic radiology exam system. Also, radiologists make an effort to reduce patient dose and having a technical skill.

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A Review Study on National Diagnostic Reference Levels for Computed Tomography Examinations (국내·외 전산화단층촬영 진단참고준위 설정 현황 리뷰)

  • Kim, Jong Hwa;Kim, Woo Jin;Lee, Min Young;Park, Il;Lee, Bo Haeng;Kim, Kwang Pyo
    • Journal of Radiation Industry
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    • v.12 no.4
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    • pp.365-372
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    • 2018
  • The use of CT examinations is increasing rapidly and radiation dose from CT examinations is much higher than other diagnostic radiography examinations including general radiography and mammography. DRLs used to optimize the radiation dose of patients by diagnostic radiology in each country. The objective of this study was to investigate and to analyze the status of DRLs from CT examinations in domestic and other countries. In other countries, DRLs were set for each age group and each examination considering the medical situation of each country. In Korea, DRLs were set for adults and children in 2017. For adults, DRLs were set for 13 examinations. Reported DLP values were 1119, 297, $472mGy{\cdot}cm$ for head, chest and abdomen pelvis examination, respectively. For children, DRLs were set for head examinations. Reported DLP values were 298 (0~1 years), 404 (2~5 years), 494 (6~10 years), 1,088 (11~15 years) $mGy{\cdot}cm$. DRLs of Korea were similar to other countries for head examinations. For chest examinations and abdomen pelvis examinations were relatively lower than other countries. As a major reason for relatively low radiation dose, it is considered to contribute the activity and management of medical radiation safety at national level.

Reference values for pulp oxygen saturation as a diagnostic tool in endodontics: a systematic review and meta-analysis

  • Paula Lambert;Sergio Augusto Quevedo Miguens Jr;Caroline Solda;Juliana Tomaz Sganzerla;Leandro Azambuja Reichert;Carlos Estrela;Fernando Branco Barletta
    • Restorative Dentistry and Endodontics
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    • v.45 no.4
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    • pp.48.1-48.11
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    • 2020
  • Objectives: This systematic review aimed to identify mean oxygen saturation values (SpO2) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods: The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of "oximetry" AND "dental pulp test" were used as search terms. Studies reporting means and standard deviations of SpO2 values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I2 statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results: Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO2 values were 84.94% (95% confidence interval [CI], 84.85%-85.04%) for the central incisors, 89.29% (95% CI, 89.22%-89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%-89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions: Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.

Reference value of serum amyloid P : a systematic review (혈청 아밀로이드 P (SAP)의 정상 참고치 탐색을 위한 문헌 고찰)

  • Park, Sunju;Jung, Jeeyoun;Jang, Soobin
    • Journal of Society of Preventive Korean Medicine
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    • v.23 no.2
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    • pp.91-99
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    • 2019
  • Objectives : The aim of this study was to examine the reference value of biomarker serum amyloid p (SAP) to diagnose blood stasis objectively. Methods : Pubmed-Medline, Cochrane library, EMBASE were searched using the key words 'SAP' and 'serum amyloid p' in June 2018. Original articles of human adults that published in English, studies that recruited from the clinical research settings or well defined population based cohorts were only included. Results : A total of 12 studies were selected to extract the reference value of SAP. It was between 8.5 ng/mL (0.0085 mg/L) to 57.5 mg/L. Although the disease varied, most of them showed elevated SAP levels in the disease group (1.1-1.5 times). Conclusions : This study is meaningful in that it summarizes the results of previous researches of SAP, which has the potential to be diagnostic index of blood stasis.