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204 records · Page 12
All sourcesNASA NTRSDOE OSTI
DOE OSTI2016

SU-F-I-40: Impact of Scan Length On Patient Dose in Abdomen/pelvis CT Diagnosis

Purpose: To analysis the impact of scan length on patient doses in abdomen/pelvis CT diagnosis of each hospital. Methods: Scan length of 7 hospitals from abdomen/pelvis CT diagnosis was surveyed in Korea. Surveyed scan lengths were additional distance above diaphragm and distance below pubic symphysis except for standard scan range between diaphragm and pubic symphysis. Patient dose was estimated for adult male and female according to scan length of each hospital. CT-Expo was used to estimate the patient dose under identical equipment settings (120 kVp, 100 mAs, 10 mm collimation width, etc.) except scan length. Effective dose was calculated by using tissue weighting factor of ICRP 103 recommendation. Increase rate of effective dose was calculated comparing with effective dose of standard scan range Results: Scan lengths of abdomen/pelvis CT diagnosis of each hospital were different. Also effective dose was increased with increasing the scan length. Generally increasing the distance above diaphragm caused increase of effective dose of male and female, but increasing the distance below pubic symphysis caused increase of effective dose of male. Conclusion: We estimated the patient dose according to scan length of each hospital in abdomen/pelvis CT diagnosis. Effective dose was increased by increasing the scan length because dose of organs with high tissue weighting factor such as lung, breast, testis were increased. Scan length is important factor on patient dose in CT diagnosis. If radiologic technologist interested in patient dose, decreasing the unnecessary scan length will decrease the risk of patients from radiation. This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI13C0004).

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-91: Development of Real Time Abdominal Compression Force (ACF) Monitoring System

Purpose: Hard-plate based abdominal compression is known to be effective, but no explicit method exists to quantify abdominal compression force (ACF) and maintain the proper ACF through the whole procedure. In addition, even with compression, it is necessary to do 4D CT to manage residual motion but, 4D CT is often not possible due to reduced surrogating sensitivity. In this study, we developed and evaluated a system that both monitors ACF in real time and provides surrogating signal even under compression. The system can also provide visual-biofeedback. Methods: The system developed consists of a compression plate, an ACF monitoring unit and a visual-biofeedback device. The ACF monitoring unit contains a thin air balloon in the size of compression plate and a gas pressure sensor. The unit is attached to the bottom of the plate thus, placed between the plate and the patient when compression is applied, and detects compression pressure. For reliability test, 3 volunteers were directed to take several different breathing patterns and the ACF variation was compared with the respiratory flow and external respiratory signal to assure that the system provides corresponding behavior. In addition, guiding waveform were generated based on free breathing, and then applied for evaluating the effectiveness of visual-biofeedback. Results: We could monitor ACF variation in real time and confirmed that the data was correlated with both respiratory flow data and external respiratory signal. Even under abdominal compression, in addition, it was possible to make the subjects successfully follow the guide patterns using the visual biofeedback system. Conclusion: The developed real time ACF monitoring system was found to be functional as intended and consistent. With the capability of both providing real time surrogating signal under compression and enabling visual-biofeedback, it is considered that the system would improve the quality of respiratory motion management in radiation therapy. This research was supported by the Mid-career Researcher Program through NRF funded by the Ministry of Science, ICT & Future Planning of Korea (NRF-2014R1A2A1A10050270) and by the Radiation Technology R&D program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (No. 2013M2A2A7038291)

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2016

Sci-Fri AM: MRI and Diagnostic Imaging - 02: Quality Improvement: Diagnostic Reference Levels for Interior Health CT exams – L-Spine, Chest/Abdomen/pelvis, Abdomen/Pelvis, Head

Diagnostic Reference Levels are used to optimize patient dose and image quality in the clinical setting. It is assumed that the majority of exams are of diagnostic quality, or the radiologists would request protocol adjustments. By investigating the dose indicator distributions from all scanners, the upper DRL can be set to the 75th percentile of the distribution and a lower DRL can be set to the 10th percentile. Scanners using doses consistently outside the upper/lower DRL range can be adjusted accordingly. 11 CT scanners, all contributing to the American College of Radiology Dose Index Registry (ACR DIR) were used in this study. Dose indicator data were compiled from the ACR DIR data and local DRLs established. Scanners with median doses outside the upper/lower DRL were followed-up with. Using effective dose and exam volumes, collective dose was determined before and after protocol adjustments to evaluate the effect of this quality improvement effort. The quality initiative is complete for L-spine and Chest/Abdomen/Pelvis exams and only initial surveys were completed for Head and Abdomen/Pelvis examsg. Median Scanner Dose reductions were 8.8 and 4.9 % for L-spine and Chest/Abdomen/Pelvis exams, respectively, resulting with collective dose reductions of 0.7 and 3.2 person•Sv/yr. Follow-up is ongoing for Abdomen/Pelvis and Head exams.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Gallbladder Volvulus: A Rare Emergent Cause of Acute Cholecystitis, if Untreated, Progresses to Necrosis and Perforation

An 86 year-old woman with a past medical history significant for abdominal hernia and Alzheimer dementia presented to the Emergency Department with a 24 hour history of acute right upper quadrant pain associated with nausea and non-bilious emesis. Physical exam revealed right sided abdominal tenderness with associated mass. All laboratory values were within normal ranges. Both abdominal ultrasound and computed tomography of the abdomen/pelvis revealed a large distended gallbladder with wall thickening and gallstones. Based on presentation and radiologic findings, the emergency general surgery service was consulted for suspected acute cholecystitis. The patient was then admitted for intravenous antibiotics and scheduled for laparoscopic cholecystectomy the following day. Intra-operative findings revealed volvulus with acute necrosis of the entire gallbladder. The gallbladder had a long pedunculated cystic duct and artery that was detorsed before proceeding with resection. Postoperatively, the patient did well and was discharged a few days later tolerating a regular diet.

62 RADIOLOGY AND NUCLEAR MEDICINE↗