Cardiovascular calcifications can occur in various cardiovascular diseases and can serve as a biomarker for cardiovascular event prediction. Advances in CT have enabled evaluation of calcifications in cardiovascular structures not only on ECG-gated CT but also on non-ECG-gated CT. Therefore, many studies have been conducted on the clinical relevance of cardiovascular calcifications in patients. In this study, we divided cardiovascular calcifications into three classes, i.e., coronary artery, thoracic aorta, and cardiac valve calcifications, which are closely associated with cardiovascular events. Further, we briefly described pericardial calcifications, which can be found incidentally. Since the start of lung cancer screening in Korea in the second half of 2019, the number of non-enhanced, non-ECG-gated, low-dose chest CT has been increasing, and the number of incidentally found cardiovascular calcifications has also been increasing. Therefore, understanding the relevance of cardiovascular calcifications on non-enhanced, non-ECG-gated, low-dose chest CT and their proper reporting are important for radiologists.
In the field of imaging medicine, computed tomography is one of the most common test methods and one of the most frequently used test methods in hospitals. However, it is accompanied by a very high radiation exposure compared to other test methods. In order to reduce exposure, CT scans should be performed only when absolutely necessary, and even if the tests are performed because they are absolutely necessary, a protocol that serves the purpose of the test and allows the test to be performed in a small dose should be used. In this study, we wanted to learn about the most up-to-date radiation dose usage information used by the region's leading general hospitals and develop a diagnostic reference level (DRL). In the experimental results, the Head CT and Abdomen CT tests showed that DLP was higher than the NRPB (U.K) and Korean DRL. The DLP values used by Chest CT were low for all 3 types of CT devices. The hospital found that efforts to reduce exposure should be made during CT examinations, and in particular, Head CT and Abdomen CT determined that efforts to reduce exposure were necessary.
Choi Jin Yeong;Kang Hwa Won;Lee Kang Woo;Lee Woo Sik
Journal of The Korean Radiological Technologist Association
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v.28
no.1
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pp.112-119
/
2002
Purpose : The purpose of this study is to evaluate the usefulness, after we compare and analyze the difference about the location of a lesion and the result of diagnosis on chest radiographs(CR) and low dose computed tomography(LDCT) in subjects for healt
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
/
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.
The use of tin filters as a way to reduce the medical radiation in computed tomography (CT). However, due to the changed X-ray spectrum with the use of tin filters, disease diagnosis could be affected because it appears as images of different impressions from previous images. Therefore, this study evaluates the changes in images when using tin filter and high pitch in chest low-dose CT. In this study, images were acquired in groups of three for comparison. Group 1 did not apply to tin filter, and used the existing pitch 0.8. Group 2 used a tin filter, pitch 0.8, Group 3 used a tin filter, and pitch 2.5. To compare the image quality, the natural image quality evaluator (NIQE) and the blind/referenceless image quality evaluator (BRISQUE) were used among the blind quality evaluation factors depended on a no-reference basis. As a result, the NIQE values were low in the order of Group 1, Group 3, and Group 2. BRISQUE values were low in the order of Group 3, Group 2 and Group 1. This study confirms the superiority of images of tin filter and high pitch techniques in chest low-dose CT, which is considered to be a fundamental study for acquiring accurate images of patients with difficult breathing control.
To compare between calcium scoring CT (CSCT) and Low-dose CT (LDCT) image finding for coronary artery calcification (CAC) in screening of lung disease by MDCT. A total of 61 subjects who retired-workers exposed to inorganic dust were performed LDCT and CSCT by using a MDCT scanner on the same day, after be approved by the institutional review board, and obtaining the written informed consent from all subjects. LDCT images were read for detecting lung diseases as well as CAC by a experienced chest radiologist, then the subjects were divided either the positive group with CAC or the negative group without it. The CSCT was used to quantify and detect the presence of calcification in the coronary artery, and score of CAC calculated by using a Rapidia software (ver 2.8). In all coronary arteries, calcium score of positive group was higher better than that in negative group, especially in the total calcium (13.7 vs. 582.9, p=0.008) and the left anterior descending artery (3.2 vs. 249.0, p=0.006). CAC findings between CSCT and LDCT image were showed excellent agreement in cut-off point 100(K-value=0.80, 95% CI=0.69-0.91) from total calcium score. CAC findings on LDCT images showed the higher relation with CSCT. Therefore, the obstructive coronary artery disease could be predicted by CAC on LDCT images for screening of lung diseases.
The difference of radiation dose of MDCT due to different protocols between hospitals was analyzed by CTDI, DLP, the number of Slice and the number of DLP/Slice in 30 cases of the head, the abdomen and the chest that have 10 cases each from MDCT examination of the department of diagnostic imaging of three general hospitals in Gyeongsangbuk-do. The difference of image quality, CTDI, DLP, radiation dose in the eye and radiation dose in thyroid was analyzed after both helical scan and normal scan for head CT were performed because a protocol of head CT is relatively simple and head CT is the most frequent case. Head CT was significantly higher in two-thirds of hospitals compared to A hospital that does not exceed a CTDI diagnostic reference level (IAEA 50mGy, Korea 60mGy) (p<0.001). DLP was higher in one-third of hospitals than a diagnostic reference level of IAEA 1,050mGy.cm and Korea 1,000mGy.cm and two-thirds exceeded the recommendation of Korea and those were significantly higher than A hospital that does not exceed a diagnostic reference level (p<0.001). Abdomen CT showed 119mGy that was higher than a diagnostic reference level of IAEA 25mGy and Korea 20mGy in one-third. DLP in all hospitals was higher that Korea recommendation of 700mGy.cm. Among target hospitals, C hospital showed high radiation dose in all tests because MPR and 3D were of great importance due to low pitch and high Tube Curren. To analyze the difference of radiation dose by scan methods, normal scan and helical scan for head CT of the same patient were performed. In the result, CTDI and DLP of helical CT were higher 63.4% and 93.7% than normal scan (p<0.05, p<0.01). However, normal scan of radiation dose in thyroid was higher 87.26% (p<0.01). Beam of helical CT looked like a bell in the deep part and the marginal part so thyroid was exposed with low radiation dose deviated from central beam. In addition, helical scan used Gantry angle perpendicularly and normal scan used it parallel to the orbitomeatal line. Therefore, radiation dose in thyroid decreased in helical scan. However, a protocol in this study showed higher radiation dose than diagnostic reference level of KFDA. To obey the recommendation of KFDA, low Tube Curren and high pitch were demanded. In this study, the difference of image quality between normal scan and helical scan was not significant. Therefore, a standardized protocol of normal scan was generally used and protective gear for thyroid was needed except a special case. We studied a part of CT cases in the local area. Therefore, the result could not represent the entire cases. However, we confirmed that patient's radiation dose in some cases exceeded the recommendation and the deviation between hospitals was observed. To improve this issue, doctors of diagnostic imaging or technologists of radiology should perform CT by the optimized protocol to decrease a level of CT radiation and also reveal radiation dose for the right to know of patients. However, they had little understanding of the situation. Therefore, the effort of relevant agencies with education program for CT radiation dose, release of radiation dose from CT examination and addition of radiation dose control and open CT contents into evaluation for hospital services and certification, and also the effort of health professionals with the best protocol to realize optimized CT examination.
Do, Yong Ho;Song, Ho Jun;Lee, Hyung Jin;Lee, Hong Jae;Kim, Jin Eui
The Korean Journal of Nuclear Medicine Technology
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v.16
no.2
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pp.29-34
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2012
Purpose : Presently, hardwares and softwares for reducing radiation exposure are continually developed for PET/CT examination. Purpose of this study is to evaluate effectiveness of reducing radiation exposure dose of CT and SUV changes of PET when applied each kernel to ACCT (Attenuation Correction Computed Tomography) according to adopted IRIS (Iterative Reconstruction in Image Space) software. Materials and Methods : Biograph mCT (Siemens, Germany) was used as a PET/CT scanner. Using AAPM CT performance phantom, from standard (120 kVp, 100 mAs), 7 scans were conducted by reducing 15 mAs each. After image reconstruction by FBP (Filtered Back Projection) and IRIS, noise and spatial resolution were evaluated. The same method was applied to anthropomorphic chest phantom and acquired images were compared. NEMA IEC body phantom was used for SUV evaluation. Injected dose rate for hot sphere (hot) and background cylinder (BKG) were 1:8. CT dose condition (120 kVp, 50 mAs) was the same for each scan and PET scan durations were 1, 2, 3 and 4min. After scanning, each kernel of IRIS was applied to ACCT. And PET images were reconstructed by ACCT adopted IRIS for comparing SUV changes. Results : AAPM phantom test for noise evaluation, SD for FBP 100 mAs, IRIS 55 mAs were 8.8 and 8.9. FBP 85 mAs, IRIS 40 mAs were 9.5 and 9.7. FBP 70 mAs, IRIS 25 mAs were 11.9 and 11.1. Above mAs condition for FBP and IRIS, SD showed similar values. And for spatial resolution test, there was no significant difference. For chest phantom test, when applied the same mAs and kernel to both of FBP and IRIS, every applied kernels showed reduced noise. Lower mAs and higher kernel value showed higher noise reduction. There was no considerable difference only except for I70 very sharp kernel for SUV comparison using NEMA IEC body phantom. Conclusion : In this study, low mAs (55 mAs) applied IRIS and standard mAs (100 mAs) applied FBP showed similar noise. And only except for I70 kernel, there was no significant SUV changes. It is possible to reduce needless radiation exposure and acquire better image quality than FBP's through applying appropriate kernel of IRIS to PET/CT.
To In this study, we sought to evaluate related factors affecting lung volume and their significance in pulmonary function and ventilation disorders. As experimental subjects, 206 normal adult men and women who underwent a low-dose chest CT scan and a spirometry test were selected at the same time. The experimental method was to measure lung volume using lung CT images obtained through a low-dose chest CT scan using deep learning-based AVIEW. Measurements were made using the LCS automatic diagnosis program. In addition, the results of measuring lung function were obtained using a spirometer, and gender and BMI were selected as related factors that affect lung volume, and significance was evaluated through an independent sample T-test with lung volume. As a result of the experiment, it was confirmed that in evaluating lung volume according to gender, all lung volumes of men were larger than all lung volumes of women. he result of an independent samples T-test using the respective average values for gender and lung volume showed that all lung volumes were larger in men than in women, which was significant (p<0.001). And in the evaluation of lung volume according to BMI index, it was confirmed that all lung volumes of adults with a BMI index of 24 or higher were larger than all lung volumes of adults with a BMI index of less than 24. However, the independent samples T-test using the respective average values for BMI index and lung volume did not show a significant result that all lung volumes were larger in BMI index 24 or higher than in BMI index less than 24 (p<0.055). In the evaluation of lung volume according to the presence or absence of pulmonary ventilation impairment, it was confirmed that all lung volumes of adults with normal pulmonary function ventilation were larger than all lung volumes of adults with pulmonary ventilation impairment. And as a result of the independent sample T-test using the respective average values for the presence or absence of pulmonary ventilation disorder and lung volume, the result was significant that all lung volumes were larger in adults with normal pulmonary function ventilation than in adults with pulmonary function ventilation disorder (p <0.001). Lung volume and spirometry test results are the most important indicators in evaluating lung health, and using these two indicators together to evaluate lung function is the most accurate evaluation method. Therefore, it is expected that this study will be used as basic data by presenting the average lung volume for adults with normal ventilation and adults with impaired lung function and ventilation in similar future studies on lung volume and vital capacity testing.
In this study, standard model of medical radiation dosage quality control system will be suggested and the useful of this system in clinical field will be reviewed. Radiation dosage information of modalities are gathered from digital imaging and communications in medicine(DICOM) standard data(such as DICOM dose SR and DICOM header) and stored in database. One CT scan, two digital radiography modalities and two mammography modalities in one health promotion center in Seoul are used to derive clinical data for one month. After 1 months research with 703 CT scans, the study shows CT $357.9mGy{\cdot}cm$ in abdomen and pelvic CT, $572.4mGy{\cdot}cm$ in brain without CT, $55.9mGy{\cdot}cm$ in calcium score/heart CT, screening CT at $54mGy{\cdot}cm$ in chest screening CT(low dose screening CT scan), $284.99mGy{\cdot}cm$ in C-spine CT and $341.85mGy{\cdot}cm$ in L-spine CT as health promotion center reference level of each exam. And with 1955 digital radiography cases, it shows $274.0mGy{\cdot}cm2$ and for mammography 6.09 mGy is shown based on 536 cases. The use of medical radiation shall comply with the principles of justification and optimization. This quality management of medical radiation exposure must be performed in order to follow the principle. And the procedure to reduce the radiation exposure of patients and staff can be achieved through this. The results of this study can be applied as a useful tool to perform the quality control of medical radiation exposure.
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