Radiation Dose from Multidetector CT PDF
Preview Radiation Dose from Multidetector CT
Medical Radiology Diagnostic Imaging Series Editors Maximilian F. Reiser Hedvig Hricak Michael Knauth Editorial Board Andy Adam, London Fred Avni, Brussels Richard L. Baron, Chicago Carlo Bartolozzi, Pisa George S. Bisset, Durham A. Mark Davies, Birmingham William P. Dillon, San Francisco D. David Dershaw, New York Sam Sanjiv Gambhir, Stanford Nicolas Grenier, Bordeaux Gertraud Heinz-Peer, Vienna Robert Hermans, Leuven Hans-Ulrich Kauczor, Heidelberg Theresa McLoud, Boston Konstantin Nikolaou, Munich Caroline Reinhold, Montreal Donald Resnick, San Diego Rüdiger Schulz-Wendtland, Erlangen Stephen Solomon, New York Richard D. White, Columbus For furthervolumes: http://www.springer.com/series/4354 Denis Tack Mannudeep K. Kalra • Pierre Alain Gevenois Editors Radiation Dose from Multidetector CT Second Edition Foreword by Maximilian F. Reiser 123 Editors Prof.Dr. DenisTack Prof.Dr.Pierre AlainGevenois Department of Radiology Department ofRadiology Réseau Hospitalierde Médecine Sociale Université librede BruxellesHôspital RueLouisCaty 136 Erasme 7331Baudour Routede Lennik808 Belgium 1070Brussels Belgium Asst.Prof.Dr. MannudeepK.Kalra Department of Radiology Harvard Medical School Massachusetts General Hospital 55Fruit Street 02114Boston MA USA Additionalmaterialtothisbookcanbedownloadedfromhttp://extras.springer.com/ ISSN 0942-5373 ISBN 978-3-642-24534-3 ISBN 978-3-642-24535-0 (eBook) DOI 10.1007/978-3-642-24535-0 SpringerHeidelbergNewYorkDordrechtLondon LibraryofCongressControlNumber:2012934251 (cid:2)Springer-VerlagBerlinHeidelberg2012 Thisworkissubjecttocopyright.Allrightsarereserved,whetherthewholeorpartofthematerialis concerned,specificallytherightsoftranslation,reprinting,reuseofillustrations,recitation,broadcasting, reproductiononmicrofilmorinanyotherway,andstorageindatabanks.Duplicationofthispublication orpartsthereofispermittedonlyundertheprovisionsoftheGermanCopyrightLawofSeptember9, 1965,initscurrentversion,andpermissionforusemustalwaysbeobtainedfromSpringer.Violationsare liabletoprosecutionundertheGermanCopyrightLaw. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protectivelawsandregulationsandthereforefreeforgeneraluse. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consultingtherelevantliterature. Printedonacid-freepaper SpringerispartofSpringerScience+BusinessMedia(www.springer.com) Foreword Theintroductionofspiralandmulti-detector-rowcomputedtomographyhasa profound impact on radiological practice. Within one and a half decades we witnessed a breathtaking technological development allowing for high quality imagingdatawithinaveryshortacquisitiontimeandprovidingexcellentimage qualityanddiagnosticaccuracy.Notsurprisingly,therewasalsoaconsiderable increaseinradiationexposuretothepatientsandthepopulation.Thisresulted in concerns about potential health hazards as well as various initiatives and actionsof governmental and non-governmental bodies. At thesame timegreat effortsweremadeinordertoreducetheradiationexposuretopatientswithout compromising image quality and diagnostic efficacy. The high actuality of this topic isunderlined by the fact,that within a short period of time a second edition of the book ‘‘Radiation dose in CT’’ became necessary.ItisthegreatmeritoftheeditorsDenisTack,MannudeepK.Kalra and Pierre Alain Gevenois and the authors contributing to this book, to compose a second edition which covers many important issues such as CT technology and use, general aspects of CT radiation, practical approaches to dose reduction, radiation risk management in low dose MDCT screening programmes, initiatives for dose reduction and the vendor perspective on CT radiation dose. The editors as well as the authors are internationally distin- guished scientists inthefield. Thisbook gives acomprehensive overview on all aspects of radiation dose in CT. I would like to express my great appreciation and thanks forthis magnificentwork which I amconfident will be of great use not only for radiologists and CT practitioners but also for those interested in radiation protection as well as for political decision makers. Prof. Dr. Maximilian F. Reiser Munich v Preface RadiationdoseinCTisthesecondeditionofourtextbooktitledRadiationDose from Adult and Pediatric Multidetector Computed Tomography. The second edition of this textbook was necessitated by continued technologic advances in multidetector-rowcomputedtomography(MDCT)sincethefirsteditionaswell asbydevelopmentofnewandpromisingradiationdosereductiontechnologies. Despite these developments, MDCT still poses challenges in radiological protection to the extent that CT radiation dose has been labelled by some as one of the topmost patient safety concerns. Applications and use of MDCT continuetoproliferatewithemergenceofnewerclinicalindications;requestsof clinicians for high diagnostic confidence as provided by MDCT are factors contributing to a continuous increase in the collective radiation dose from diagnostic CT imaging. The first edition of the textbook dealt with radiation issues with MDCT in two parts. The first part was preceded with detailed discussions on the clinical use and expansion of CT in modern medical practice. In Part I, the book provided a comprehensive approach to perceived and potential risks of low radiation dose, influence of CT technical factors on the radiation dose, and technologicdevelopmentsforoptimization andreductionoftheradiation dose peracquisition.InPartII,acomprehensiveclinicalapproachofradiationdose justification, optimization, and reduction was provided, covering the fields of pediatric, head and neck, chest, abdomen, cardiovascular, bone and joint, and interventionalMDCT.Finally,adetaileddiscussiononthebalancebetweenthe risksandbenefitsofscreeningforcancerusinglow-doseMDCTwaspresented in the field of lung cancer and colon cancer. Thesecondeditionofthetextbookhasrecentandupdatedinformationabout thetwopartspresentedinthefirstedition.Severalnewchaptersfromrenowned internationalradiationexpertshavebeenaddedtoembellishthesecondedition, which now boasts seven parts including an online only Interactive Atlas-based teachingpartwhichhasfouradditionalchaptersforunderstandingtheeffectof CTradiationdoseonimagequalityandlesiondetectionandappearance.Inthe secondedition,PartIdealswithtechnologicadvancesinMDCTandupdateson clinical expansion in useof MDCT.PartIIdeals withrisk issueswith CT, and severaltechnicalaspectsofCTradiationdosemanagementwithnewchapterson iterative reconstruction techniques, noise reduction filters, hardware develop- mentsfordoseoptimization,tubepotentialadjustmentsfordosereduction,and anunbiasedperspectiveontheuseofshieldingdevicesinCT.Anewchapteron radiationdoserecordingand auditing has also been added tothis part. vii viii Preface Practicalandclinicalapproaches todoseoptimization indifferentradiology subspecialties are presented in Part III of the second edition, which has been enhanced by addition of a chapter based on issues with CT scanning in preg- nant patients. Part IV deals with radiation issues and dose reduction strategies forlungandcoloncancerscreeningCTprotocols.PartVpresentsperspectives of several regulatory bodies, organizations, and campaigns on CT radiation dose including the IAEA, FDA, ICRP, Image Gently, and Image Wisely. This part also includes two chapters on software for estimating CT dose and risks, and on discussion of guidelines for appropriate use of CT. Part VI brings entirely new content to the second chapter with four new chapters from major CT vendors outlining their CT radiation dose reduction and optimization technologies. Several international experts, from Europe and North America, selected for theirimportantcontributionstothescientificliterature,havecontributedtothis bookwithacommonobjectiveofprovidingreaderswithacomprehensive,up- to-date, practical, clinical, and well-documented approach on radiation dose optimization and reduction, suitable for daily MDCT practice. Among thethree editors, Denis Tack,isa general radiologist subspecialized in MDCT, and Pierre Alain Gevenois is Chest radiologist and Professor of medicalimagingattheFacultyofMedicineandtheSchoolofPublicHealthof the University of Brussels, Belgium. Their researches deal with radiation dose reduction with MDCT, and quantification of pulmonary emphysema and pulmonary edema by computed tomography. The new editor, Mannudeep K. KalraisaChestandCardiacradiologistattheMassachusettsGeneralHospital and an Assistant Professor at Harvard Medical School in Boston with key interest in CT radiation dose research and education. Denis Tack Mannudeep K. Kalra Pierre Alain Gevenois Contents Part I CT Technology and Use Multi-Detector Row CT–Recent Developments, Radiation Dose and Dose Reduction Technologies . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Thomas Flohr Clinical Expansion of CT and Radiation Dose . . . . . . . . . . . . . . . . . . . 21 Stuart Meeson, Rajesh Patel, and Stephen Golding Part II General Aspects of CT Radiation Risks from Ionising Radiation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Kenneth H. Chadwick and Hendrik P. Leenhouts The Cancer Risk from Low Level Radiation . . . . . . . . . . . . . . . . . . . . 61 Bernard L. Cohen Image Quality in CT: Challenges and Perspectives. . . . . . . . . . . . . . . . 81 Thomas L. Toth Radiation Dose Metrics and the Effect of CT Scan Protocol Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Sue Edyvean, Maria Lewis, and Alan Britten Scan Parameters and CT Radiation Dose. . . . . . . . . . . . . . . . . . . . . . . 119 Sarabjeet Singh and Mannudeep K. Kalra Optimization of Tube Potential for Radiation Dose Reduction in CT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Lifeng Yu, Joel G. Fletcher, and Cynthia H. McCollough Conventional and Newer Reconstruction Techniques in CT . . . . . . . . . 143 Homer Pien, Synho Do, Sarabjeet Singh, and Mannudeep K. Kalra ix x Contents Image Noise Reduction Filters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 Sarabjeet Singh and Mannudeep K. Kalra Hardware Developments for Radiation Dose Reduction . . . . . . . . . . . . 175 Rich Mather Application of Shielding in CT Radiation Dose Reduction. . . . . . . . . . . 183 Shima Aran, Sarabjeet Singh, and Mannudeep K. Kalra Radiation Dose: Records and Audits . . . . . . . . . . . . . . . . . . . . . . . . . . 195 Tessa S. Cook, William W. Boonn, and Woojin Kim Collective Radiation Dose from MDCT: Critical Review of Surveys Studies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209 Georg Stamm ALARA Concept for MDCT Optimization: What is Reasonable, What is Achievable? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231 Denis Tack Automatic Exposure Control in Multidetector-row CT. . . . . . . . . . . . . 259 Mannudeep K. Kalra Patient Centering in MDCT: Dose Effects . . . . . . . . . . . . . . . . . . . . . . 273 Mannudeep K. Kalra and Thomas L. Toth Part III Practical Approaches to Dose Reduction Dose Optimization and Reduction in CT of the Brain and Head and Neck Region. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281 Tom Mulkens, Rodrigo Salgado, and Patrick Bellinck Dose Reduction and Optimization in Computed Tomography of the Chest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307 Pierre Alain Gevenois and Denis Tack Dose Optimization and Reduction in MDCT of the Abdomen. . . . . . . . 317 Caroline Keyzer and Denis Tack Radiation Dose Optimisation of Cardiac and Vascular MDCT in Adults and Paediatric Patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339 Jean François Paul, Caroline Keyzer, Michelle Williams, and Denis Tack Dose Optimization and Reduction in Musculoskeletal CT Including the Spine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369 A. Gervaise, P. Teixeira, N. Villani, S. Lecocq, M. Louis, and A. Blum Contents xi Dose Reduction in CT Fluoroscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . 389 N. Buls, F. Vandenbroucke, and J. de Mey Dose Optimization and Reduction in CT of Children . . . . . . . . . . . . . . 419 Peter Vock, Enno Stranzinger, and Rainer Wolf CT Scanning in Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 437 D. E. Litmanovich and A. A. Bankier Part IV Radiation Risk Management in Low Dose MDCT Screening Programs Radiation Risk Associated with Lung Cancer Screening. . . . . . . . . . . . 455 Cornelia Schaefer-Prokop, Krijn van Muiswinkel, and Mathias Prokop Dose Reduction in Screening Programs: Colon Cancer Screening. . . . . 469 Thierry N. Boellaard, Henk W. Venema, and Jaap Stoker Part V Initiatives for Dose Reduction CT Dose Perspectives and Initiatives of the IAEA . . . . . . . . . . . . . . . . 495 Madan M. Rehani and Olivera Ciraj-Bjelac The Image Gently Campaign: Championing Radiation Protection for Children Through Awareness, Educational Resources and Advocacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 509 Marilyn J. Goske, Michael J. Callahan, Donald P. Frush, Sue C. Kaste, Gregory Morrison, and Keith J. Strauss CT Radiation Dose and Safety: Perspectives at the U.S. Food and Drug Administration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 537 Stanley H. Stern, Sean Boyd, Kish Chakrabarti, Iacovos S. Kyprianou, Thalia T. Mills, and David C. Spelic ICRP’s Role in Patient Dose Management in CT . . . . . . . . . . . . . . . . . 557 Madan M. Rehani Software for Calculating Dose and Risk. . . . . . . . . . . . . . . . . . . . . . . . 563 Georg Stamm Image Wisely . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 569 James A. Brink and E. Stephen Amis Guidelines for Appropriate CT Imaging. . . . . . . . . . . . . . . . . . . . . . . . 575 Kristie M. Guite, J. Louis Hinshaw, Frank N. Ranallo, and Fred T. Lee
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