Skip to main content

Clinical Expansion of CT and Radiation Dose

  • Chapter
Radiation Dose from Multidetector CT

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

The principles of protecting the patient undergoing clinical investigation using radiation are clear and well established: it is the responsibility of all radiological services to ensure the information required for the clinical management of the patient is obtained with the lowest practicable exposure to radiation. Within this clear objective, however, medical investigation operates in a constantly changing scenario influenced by increasing knowledge of disease processes and advancing technological development. This syndrome ensures that as time passes differing objectives and concerns come to the fore. With the now widespread adoption of multidetector computed tomography (MDCT), for a broad range of examinations, MDCT continues to be the dominant source of dose from medical X-ray examinations, thereby posing significant challenges in radiological protection to the extent that some now claim that this represents today’s greatest single challenge in radiation protection in diagnostic use. This book expounds the challenges posed by MDCT to scientists and physicians and in this chapter we provide an introduction to the main themes which are of concern.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • AAPM Dose Check Guidelines (2011) Version1.0, 04/27/2011. Available from: http://www.aapm.org/pubs/CTProtocols/documents/NotificationLevelsStatement_2011-04-27.pdf

  • Abul-Kasim K, Strömbeck A, Sahlstrand-Johnson P (2011) Low-dose computed tomography of the paranasal sinuses: radiation doses and reliability analysis. Am J Otolaryngol 32(1):47–51 [Epub 2009 Oct 12]

    Article  PubMed  Google Scholar 

  • American Association of Physicists in Medicine (AAPM) (2011) AAPM Government Affairs. Available from http://www.aapm.org/government_affairs/default.asp

  • Anderson K, Cowan NC (2004) Multidetector CT urography. Radiol Now 21:4–6

    Google Scholar 

  • Benjamin MS, Drucker EA, McLoud TC, Shepherd J (2003) Small pulmonary nodules: detection at chest CT and outcome. Radiology 226:489–493

    Article  PubMed  Google Scholar 

  • Berland LL, Smith JK (1998) Multidetector-array CT: once again, technology creates new opportunities. Radiology 209:327–329

    PubMed  CAS  Google Scholar 

  • BMU (1996) (Bundesministerium fur Umwelt, Naturschutz und Reaktorsicher-heit). Umweltradioaktivitat und Strahlenbelastung im Jahre. Deutscher Bundestag 13. Wahlperiode; Drucksache 13/8630

    Google Scholar 

  • Brix G, Nagel HD, Stamm G et al (2003) Radiation exposure in multi-slice versus single slice spiral CT: results of a nationwide survey. Eur Radiol 13:1979–1991

    Article  PubMed  CAS  Google Scholar 

  • Caramella D, Bartolozzi C (eds) (2002) 3D image processing: techniques and applications. Springer, Brelin

    Google Scholar 

  • Cohnen M, Fischer H, Hamacher J et al (2000) CT of the head by use of reduced current and kilovoltage: relationship between image quality and dose reduction. Am J Neuradiol 21(1654):1660

    Google Scholar 

  • Computed Tomography Dose Check (NEMA Standards Publication XR 25-2010) (2010) http://www.nema.org/stds/xr25.cfm)

  • European Commission (2000) European guidelines on quality criteria for computed tomography. EUR 16262EN. EC, Luxembourg

    Google Scholar 

  • European Commission (2004) MSCT quality criteria. European guidelines for multislice computed tomography. Contract number FIGM-CT2000-20078-CT-TIP. Bongartz G, Golding SJ, Jurik AG, Leonardi M, van Persijn van Meerten E, Rodríguez R, Schneider K, Calzado A, Geleijns J, Jessen KA, Panzer W, Shrimpton PC, Tosi G. Available from http://www.drs.dk/guidelines/ct/quality/index.htm

  • European commission (2008) Safety and efficacy of computed tomography: a broad perspective (CT safety and efficacy). European commission Euratom research and training programme on nuclear energy (area: radiation protection) report. Contract FI6R-CT2004-002388. Geleijns J (Koos), Kalender W, Krispijn W, Schneider K, Shrimpton P. Available from ftp://ftp.cordis.europa.eu/pub/fp6-euratom/docs/ct_safety_efficacy_projrep_en.pdf

  • Garney CJ, Hanlon R (2002) Computed tomography in clinical practice. BMJ 324:1077–1080

    Article  Google Scholar 

  • Gervaise A, Osemont B, Lecocq S, Noel A, Micard E, Felblinger J, Blum A (2011) CT image quality improvement using adaptive iterative dose reduction with wide-volume acquisition on 320-detector CT. Eur Radiol 17 Sep 2011 [Epub ahead of print]

    Google Scholar 

  • Golding SJ, Shrimpton PC (2002) Radiation dose in CT: are we meeting the challenge? Br J Radiol 75:1–4

    PubMed  CAS  Google Scholar 

  • Hart D, Wall BF, Hillier MC, Shrimpton PC (2010) Frequency and collective dose for medical and dental X-ray examinations in the UK, 2008. Chilton HPA-CRCE-012, 2010. Available from http://www.hpa.org.uk/radiation/

  • Henzler T, Barraza JM Jr, Nance JW Jr, Costello P, Krissak R, Fink C, Schoepf UJ (2011) CT imaging of acute pulmonary embolism. J Cardiovasc Comput Tomogr. 5(1):3–11 [Epub 29 Oct 2010]

    Google Scholar 

  • Hounsfield GN (1973) Computerised transverse axial scanning (tomography). Br J Radiol 46:1016

    Article  PubMed  CAS  Google Scholar 

  • Hu H, He HD, Foley WD, Fox SH (2000) Four multidetector-row helical CT: image quality and volume coverage speed. Radiology 215:55–62

    PubMed  CAS  Google Scholar 

  • Iannaccone R, Laghi A, Catalano C et al (2003) Feasibility of ultra-low dose multislice CT colography for the detection of colorectal lesions: preliminary experience. Eur Radiol 13:1297–1302

    PubMed  Google Scholar 

  • Ichikawa T, Erturk SM, Araki T (2006) Multiphasic contrast-enhanced multidetector-row CT of liver: contrast-enhancement theory and practical scan protocol with a combination of fixed injection duration and patients’ body-weight-tailored dose of contrast material. Eur J Radiol 58(2):165–176 [Epub 18 Jan 2006]

    Article  PubMed  Google Scholar 

  • Irie T, Kajitani M, Itai Y (2001) CT fluoroscopy-guided intervention: marked reduction of scattered radiation dose to the physicians hand by use of a lead plate and an improved I–I device. J Vasc Interv Radiol 12:1417–1421

    Article  PubMed  CAS  Google Scholar 

  • Jackson A, Whitehouse RW (1993) Low-dose computed tomographic imaging in orbital trauma. Br J Radiol 66:655–661

    Article  PubMed  CAS  Google Scholar 

  • Johnson CD (2001) Pancreatic carcinoma: developing a protocol for multidetector row CT. Radiology 220:3–4

    PubMed  CAS  Google Scholar 

  • Kalendar W (2004) Dose management in multislice spiral computed tomography. Eur Radiol Syllabus 14:40–49

    Article  Google Scholar 

  • Kalender WA (2000) Computed tomography, Publicis MCD Verlag, Munich

    Google Scholar 

  • Kalender WA, Seissler W, Klotz E, Vock P (1990) Spiral volumetric CT with single-breath-hold technique, continuous transport, and continuous scanner rotation. Radiology 176:181–183

    PubMed  CAS  Google Scholar 

  • Kalra KM, Maher M, Toth TL et al (2004) Techniques and applications of automatic tube current modulation. Radiology 233:649–657

    Article  PubMed  Google Scholar 

  • Kawashima A, Vrtiska TJ, LeRoy AJ et al (2004) CT urography. RadioGr 24:S35–S54

    Article  Google Scholar 

  • Kröpil P, Cohnen M, Andersen K, Heinen W, Stegmann V, Mödder U (2010) Image quality in multidetector CT of paranasal sinuses: potential of dose reduction using an adaptive post-processing filter. Rofo 182(11):973–978 [Epub 18 Aug 2010. German]

    Article  PubMed  Google Scholar 

  • Landeras LA, Aslam R, Yee J (2007) Virtual colonoscopy: technique and accuracy. Radiol Clin North Am 45(2):333–345

    Article  PubMed  Google Scholar 

  • Lauenstein TC, Goehde SC, Herborn CU et al (2004) Whole-body MR imaging: evaluation of patients for metastases. Radiology 233:139–148

    Article  PubMed  Google Scholar 

  • Lederlin M, Thambo JB, Latrabe V, Corneloup O, Cochet H, Montaudon M, Laurent F (2011) Coronary imaging techniques with emphasis on CT and MRI. Pediatr Radiol 41(12):1516–1525 [Epub 30 Nov 2011]

    Article  PubMed  Google Scholar 

  • Lehmkuhl L, Gosch D, Nagel HD, Stumpp P, Kahn T, Gutberlet M (2010) Quantification of radiation dose savings in cardiac computed tomography using prospectively triggered mode and ECG pulsing: a phantom study. Eur Radiol 20(9):2116–2125 [Epub 9 Apr 2010]

    Article  PubMed  Google Scholar 

  • Lewis MA, Edyvean S (2005) Patient dose reduction in CT. Br J Radiol 78:880–883

    Article  PubMed  CAS  Google Scholar 

  • Makayama Y, Yamashita Y and Takahahi M (2001) CT of the aorta and its major branches. In: Multislice CT. Reiser M, Takahashi M, Modic M and Bruening R (eds) Multislice CT, Springer, Berlin

    Google Scholar 

  • Mayo JR (1997) Opinion response to acute pulmonary embolism: the role of computed tomographic imaging. J Thoracic Imaging 12:95–97

    Article  Google Scholar 

  • Meeson S, Alvey CM, Golding SJ (2009) Justifying multidetector CT in abdominal sepsis: time for review? Br J Radiol 82:190–197 [Epub 27 Oct 2008]

    Article  PubMed  CAS  Google Scholar 

  • Meeson S, Shrimpton PC, MacLachlan SA, Golding SJ (2011) Update on radiation exposure from CT: early progress in the third UK CT dose survey. In: (e103) Proceedings of UK radiological congress 2011, BJR Congress Series, pp 55–56

    Google Scholar 

  • Mettler FA, Wiest PW, Locken JA, Kelsey CA (2000) CT scanning: patterns of use and dose. J Radiol Prot 20:353–359

    Article  PubMed  Google Scholar 

  • Mini RL, Vock P, Mury R, Schneeberger PP (1995) Radiation exposure of patients who undergo CT of the Trunk. Radiology 195:557–562

    PubMed  CAS  Google Scholar 

  • Morhard D, Fink C, Graser A, Reiser MF, Becker C, Johnson TR (2009) Cervical and cranial computed tomographic angiography with automated bone removal: dual energy computed tomography versus standard computed tomography. Invest Radiol 44(5):293–297

    Article  PubMed  Google Scholar 

  • Mori S, Endo M, Nishizawa K et al (2006) Comparison of patient doses in 256-slice CT and 16-slice CT scanners. Br J Radiol 79:56–61

    Article  PubMed  CAS  Google Scholar 

  • McCollough CH, Bruesewitz MR, Kofler JM Jr (2006) CT dose reduction and dose management tools: overview of available options. Radiographics 26:503–512 (review)

    Article  PubMed  Google Scholar 

  • NCRP (2009) Ionizing radiation exposure of the population of the United States. NCRP report 160. National Council on Radiation Protection and Measurements, Bethesda

    Google Scholar 

  • Nicholson R, Fetherston S (2002) Primary radiation outside the imaged volume. Br J Radiol 75:518–522

    PubMed  CAS  Google Scholar 

  • Olerud HM (1997) Analysis of factors influencing patient doses from CT in Norway. Radiat Prot Dosim 71:123–133

    Article  Google Scholar 

  • Olerud HM, Obberg S, Widmark A, Hauser M (2002) Physician and patient radiation dose in various CT guided biopsy protocols. In: Sixth European ALARA network on “occupational exposure optimisation in the medical field and radiopharmaceutical industry”. Madrid, Spain, 23–25 Oct 2002

    Google Scholar 

  • Poll LW, Cohnen M, Brachten S, Ewen K, Modder U (2002) Dose reduction in multi-slice CT of the heart by use of ECG-controlled tube current modulation (“ECG pulsing”): phantom measurements. Rofo 174:1500–1505

    Article  PubMed  CAS  Google Scholar 

  • Prokop (2005) New challenges in MDCT. Eur Radiol 15(suppl 5):E35–E45

    Google Scholar 

  • Raptopoulos V, Katson G, Rosen P et al (2003) Acute appendicitis: effect of increased use of CT on selecting patients earlier. Radiology 226:521–526

    Article  PubMed  Google Scholar 

  • Rathburn SW, Raskob GE, Whitsett TL (2000) Sensitivity and specificity of helical computed tomography in the diagnosis of pulmonary embolism: a systematic review. Ann Int Med 132:227–232

    Google Scholar 

  • Scheck RJ, Coppenrath EM, Kellner MW et al (1998) Radiation dose and image quality in spiral computed tomography: multicentre evaluation at six institutions. Br J Radiol 71:734–744

    PubMed  CAS  Google Scholar 

  • Semelka RC (2005) Radiation risks from CT scans: a call for patient-focused imaging. Medscape Radiol 6(1) http://www.medscape.com/article/496297

  • Shrimpton PC, Edyvean S (1998) CT scanner dosimetry. Br J Radiol 71:1–3

    PubMed  CAS  Google Scholar 

  • Shrimpton PC, Hillier MC, Lewis MA, Dunn M (2005) Doses from computed tomography (CT). Examinations in the UK—2003 Review. NRPB-W67

    Google Scholar 

  • Shrimpton PC, Jones DG, Hillier MC et al (1991) Survey of CT practice in the UK. Part 2: dosimetric aspects. NRPB Report R249. NRPB, Chilton

    Google Scholar 

  • Smith A, Shah GA, Kron T (1998) Variation of patient dose in head CT. Br J Radiol 71:1296–1301

    PubMed  CAS  Google Scholar 

  • Smith RC, Verga M, McCarthy S, Rosenfield AT (1996) Diagnosis of acute flank pain: value of unenhanced helical CT. Am J Roentgenol 166:97–101

    CAS  Google Scholar 

  • Starck G, Lonn L, Cederblad A et al (1998) Radiation dose reduction in CT: application to tissue area and volume determination. Radiology 209:397–403

    PubMed  CAS  Google Scholar 

  • Summers RM (2010) Polyp size measurement at CT colonography: what do we know and what do we need to know? Radiology 255(3):707–720

    Article  PubMed  Google Scholar 

  • Theocharopoulos N, Chatzakis G, Damilakis J (2009) Is radiography justified for the evaluation of patients presenting with cervical spine trauma? Med Phys 36(10):4461–4470

    Article  PubMed  Google Scholar 

  • United Nations Scientific Committee on the Effects of Atomic Radiation (2000) Sources and effects of ionising radiation, vol 1. UNSCEAR, New York

    Google Scholar 

  • UNSCEAR (2010) United Nations scientific committee on the effects of atomic radiation 2008 report: sources and effects of ionizing radiation, vol 1. Annex A: Medical radiation exposures. Available from www.unscear.org

  • Vining DJ (1997) Virtual colonoscopy. Gastrointest Endosc Clin N Amer 7:285–291

    CAS  Google Scholar 

  • Wells ES et al (1998) Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med 129:997–1005

    PubMed  CAS  Google Scholar 

  • Wittram C, Maher MM, Yoo AJ et al (2004) CT angiography of pulmonary embolism: diagnosis criteria and causes of misdiagnosis. RadioGraphics 24:1219–1238

    Article  PubMed  Google Scholar 

  • Yates SJ, Pike LC, Goldstone KE (2004a) Effect of multislice scanners on patient dose from routine CT examinations in East Anglia. Br J Radiol 77:472–478

    Article  PubMed  CAS  Google Scholar 

  • Yates SJ, Pike LC, Golstone KE (2004b) Effect of multislice scanners on patient dose from routine CT examinations in East Anglia. Br J Radiol 77:472–478

    Article  PubMed  CAS  Google Scholar 

  • Zoetelief J, Geleijns J (1998) Patient dose in spiral CT. Br J Radiol 71:584–586

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephen Golding .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Meeson, S., Patel, R., Golding, S. (2012). Clinical Expansion of CT and Radiation Dose. In: Tack, D., Kalra, M., Gevenois, P. (eds) Radiation Dose from Multidetector CT. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_541

Download citation

  • DOI: https://doi.org/10.1007/174_2012_541

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-24534-3

  • Online ISBN: 978-3-642-24535-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics