Jakob Weiss1,2, Andreas Pomschar3, Carsten Rist3, Klement Neumaier4, Minglun Li4, Wilhelm Flatz3, Kolja Thierfelder3, Mike Notohamiprodjo5,3. 1. Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, University of Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany. Jakob.Weiss@med.uni-tuebingen.de. 2. Department of Diagnostic and Interventional Radiology, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany. Jakob.Weiss@med.uni-tuebingen.de. 3. Department of Diagnostic and Interventional Radiology, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany. 4. Department of Radiooncology and Radiotherapy, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany. 5. Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, University of Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.
Abstract
PURPOSE: To establish an optimized ultralow-dose digital pulsed fluoroscopy (FP) protocol for upper gastrointestinal tract examinations and to investigate the radiation dose and image quality. MATERIALS AND METHODS: An Alderson-Rando-Phantom with 60 thermoluminescent dosimeters was used for dose measurements to systematically evaluate the dose-area product (DAP) and organ doses of the optimized FP protocol with the following acquisition parameters: 86.7 kV; 77 mA; 0.9 mm3, automatic image noise and contrast adaption. Subjective image quality, depiction of contrast agent and image noise (5-point Likert scale; 5 = excellent) were assessed in 41 patients, who underwent contrast-enhanced FP with the aforementioned optimized protocol by two radiologists in consensus. A conventional digital radiograph (DR) acquisition protocol served as the reference standard for radiation dose and image quality analyses. RESULTS: Phantom measurements revealed a general dose reduction of approximately 96% per image for the FP protocol as compared to the DR standard. DAP could be reduced by 97%. Significant dose reductions were also found for organ doses, both in the direct and scattered radiation beam with negligible orbital (FP 5.6 × 10-3 vs. DR 0.11; p = 0.02) and gonadal dose exposure (female FP 2.4 × 10-3 vs. DR 0.05; male FP 8 × 10-4 vs. DR 0.03; p ≤ 0.0004). FP provided diagnostic image quality in all patients, although reading scores were significantly lower for all evaluated parameters as compared to the DR standard (p < 0.05). CONCLUSION: Ultralow-dose FP is feasible for clinical routine allowing a significant reduction of direct and scattered dose exposure while providing sufficient diagnostic image quality for reliable diagnosis.
PURPOSE: To establish an optimized ultralow-dose digital pulsed fluoroscopy (FP) protocol for upper gastrointestinal tract examinations and to investigate the radiation dose and image quality. MATERIALS AND METHODS: An Alderson-Rando-Phantom with 60 thermoluminescent dosimeters was used for dose measurements to systematically evaluate the dose-area product (DAP) and organ doses of the optimized FP protocol with the following acquisition parameters: 86.7 kV; 77 mA; 0.9 mm3, automatic image noise and contrast adaption. Subjective image quality, depiction of contrast agent and image noise (5-point Likert scale; 5 = excellent) were assessed in 41 patients, who underwent contrast-enhanced FP with the aforementioned optimized protocol by two radiologists in consensus. A conventional digital radiograph (DR) acquisition protocol served as the reference standard for radiation dose and image quality analyses. RESULTS: Phantom measurements revealed a general dose reduction of approximately 96% per image for the FP protocol as compared to the DR standard. DAP could be reduced by 97%. Significant dose reductions were also found for organ doses, both in the direct and scattered radiation beam with negligible orbital (FP 5.6 × 10-3 vs. DR 0.11; p = 0.02) and gonadal dose exposure (female FP 2.4 × 10-3 vs. DR 0.05; male FP 8 × 10-4 vs. DR 0.03; p ≤ 0.0004). FP provided diagnostic image quality in all patients, although reading scores were significantly lower for all evaluated parameters as compared to the DR standard (p < 0.05). CONCLUSION: Ultralow-dose FP is feasible for clinical routine allowing a significant reduction of direct and scattered dose exposure while providing sufficient diagnostic image quality for reliable diagnosis.
Authors: Robert C Chandler; Gujjarrapa Srinivas; Kedar N Chintapalli; Wayne H Schwesinger; Srinivasa R Prasad Journal: AJR Am J Roentgenol Date: 2008-01 Impact factor: 3.959
Authors: Sara Y S Linke; Ilias Tsiflikas; Klaus Herz; Phillipp Szavay; Sergios Gatidis; Jürgen F Schäfer Journal: Eur Radiol Date: 2015-09-18 Impact factor: 5.315
Authors: David J Brenner; Richard Doll; Dudley T Goodhead; Eric J Hall; Charles E Land; John B Little; Jay H Lubin; Dale L Preston; R Julian Preston; Jerome S Puskin; Elaine Ron; Rainer K Sachs; Jonathan M Samet; Richard B Setlow; Marco Zaider Journal: Proc Natl Acad Sci U S A Date: 2003-11-10 Impact factor: 11.205