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H D Nagel

Publications and source records attributed to H D Nagel.

11 recordsLinked to original sources
PubMed2004

[Diagnostic imaging in polytrauma: comparison of radiation exposure from whole-body MSCT and conventional radiography with organ-specific CT].

PURPOSE: To compare the radiation dose of whole-body multislice CT (MSCT) and conventional radiography with organ-specific CT in polytrauma. MATERIALS AND METHODS: The whole-body MSCT encompassing brain, neck and midface, chest, abdomen and pelvis was performed on a Somatom Volume Zoom (Siemens). Conventional radiography consisted of chest and cervical, thoracic and lumbar spine in two views as well as pelvis (Polymat, Siemens). Three combinations of organ specific CT were chosen: CT examination of (1) head and cervical spine, (2) head, cervical spine and chest, (3) head, cervical spine and abdomen. The effective doses of whole-body MSCT and conventional radiography with organ-specific CT were calculated. RESULTS: Effective doses were 20 mSv for whole-body MSCT, 2 mSv for conventional x-ray, and 5 mSv for combination (1), 8 mSv for combination (2) and (3) 16 mSv for combination (3) of the organ-specific CT. The ratio of radiation dose between whole-body MSCT and radiography was 10 : 1. This ratio was reduced to 3 : 1, 2 : 1 and 1 : 1 when a combination of radiography and CT was performed. CONCLUSIONS: Whole-body MSCT in polytrauma compared to conventional radiography with organ-specific CT induces a threefold increased dose in unfavorable situations and no increased dose in favorable situations. Nevertheless, routine use of whole-body MSCT should be critically evaluated and should be adapted to the clinical benefit.

Humans↗
PubMed2004

[Image quality of thin- and thick-slice MSCT reconstructions in low-contrast objects (liver lesions) with equal doses].

PURPOSE: To evaluate the image quality of thin-section MSCT examinations of low-contrast objects such as liver lesions, and to find out whether a thin slice technique requires an increase in radiation dose. MATERIALS AND METHODS: MSCT examinations of the liver were performed in the portal venous phase on a Volume Zoom Scanner (Siemens, Erlangen) with a collimation of 4 x 2.5 mm, 120 kV, 125 mAs and table speed of 12.5 mm. Forty small hypodense liver lesions with a mean size of 3 mm (1 to 8 mm) were reconstructed using a slice thickness of 3, 5, 7, and 10 mm. All lesions were evaluated for each slice thickness by 3 independent radiologists using a 5-point scale (excellent to poor) for the following 7 criteria: contrast, demarcation and contour of the lesion, image noise and quality, demarcation of liver veins and liver contour. The mean values of the reviewers' scores were calculated. The correlation of the three observers in the evaluation of the criteria was determined using the Kendall's Tau coefficient. RESULTS: The 3-mm thin sections were excellent in the evaluation of lesion detection, lesion contrast and lesion contour with a mean score of 1.4 compared to 4.1 for 10-mm sections. Concerning the criteria image quality and liver contour, thin sections achieved the best results in our series. Image noise was pronounced in thin sections but did not affect negatively the image analysis. Interrater agreement was 0.53 for the criterium image noise. CONCLUSION: Thin sections in MSCT examinations of low contrast objects such as liver lesions do not require an increase in radiation dose because the increase in image noise is compensated by improved lesion contrast.

Contrast Media↗
PubMed2004

[5 years of "concerted action dose reduction in CT" -- what has been achieved and what remains to be done?].

In May 1998, the German "Concerted Action Dose Reduction in CT" was founded by all parties involved in CT. Its intention was to achieve a significant reduction of the radiation exposure caused by CT, a matter that has increasingly been considered a major challenge since the early nineties. As a result of a number of joint efforts, the essential preconditions have been established by now. The fifth anniversary of the Concerted Action gave rise for both retrospection and outlook on the tasks that have already been accomplished and those that still need to be done. For this purpose, a one-day symposium took place in Berlin on November 4, 2003. The contents of a total of 18 contributions will be outlined here in brief.

Adult↗
PubMed2003

Radiation exposure in multi-slice versus single-slice spiral CT: results of a nationwide survey.

Multi-slice (MS) technology increases the efficacy of CT procedures and offers new promising applications. The expanding use of MSCT, however, may result in an increase in both frequency of procedures and levels of patient exposure. It was, therefore, the aim of this study to gain an overview of MSCT examinations conducted in Germany in 2001. All MSCT facilities were requested to provide information about 14 standard examinations with respect to scan parameters and frequency. Based on this data, dosimetric quantities were estimated using an experimentally validated formalism. Results are compared with those of a previous survey for single-slice (SS) spiral CT scanners. According to the data provided for 39 dual- and 73 quad-slice systems, the average annual number of patients examined at MSCT is markedly higher than that examined at SSCT scanners (5500 vs 3500). The average effective dose to patients was changed from 7.4 mSv at single-slice to 5.5 mSv and 8.1 mSv at dual- and quad-slice scanners, respectively. There is a considerable potential for dose reduction at quad-slice systems by an optimisation of scan protocols and better education of the personnel. To avoid an increase in the collective effective dose from CT procedures, a clear medical justification is required in each case.

Data Collection↗
PubMed2002

[CT-expo--a novel program for dose evaluation in CT].

CT-Expo is a novel MS Excel application for assessing the radiation doses delivered to patients undergoing CT examinations, based on computational methods that were used to analyze the data collected in the German survey on CT practice in 1999. The program enables the calculation of all dose quantities of practical value, such as axial dose free-in-air, weighted CTDI, dose-length product, effective dose and uterine dose. In contrast to existing programs for CT dose assessment, CT-Expo offers a number of unique features, such as gender-specific dose calculation for all age groups (adults, children, newborns), applicability to all existing scanner models including correction of scanner-specific influences, and the possibility of comparison with the results from the German CT survey on CT practice. Three different application modules offer free and standardized dose calculations as well as a comprehensive benchmarking section including guidance on dose optimization. The program is available as shareware in both German and English version. Additional information and a demo version free of charge can be requested via e-mail from the author's address stamm.georg@mh-hannover. de) or from the web page http://www.mh-hannover.de/kliniken/radiologie/str_04.html.

Adult↗
PubMed2001

Derivation and mapping of critical loads for nitrogen and trends in their exceedance in Germany.

The term "critical load" means a quantitative estimate of an exposure to one or more pollutants below which significant harmful effects on specified sensitive elements of the environment do not occur, according to present knowledge. In the case of nitrogen, both oxidised and reduced compounds contribute to the total deposition of acidity, which exceeds critical loads in many forest ecosystems. These also cause negative effects through eutrophication. Critical loads of nitrogen were derived for forest soils (deciduous and coniferous forest), natural grassland, acid fens, heathland, and mesotrophic peat bogs. In Germany, a decrease in sulphur emissions over the past 15 years resulted in a reduced exceedance of critical loads for acid deposition. In the same period it was noted that reduction in the emissions of nitrogen oxides and ammonia remained insignificant. Therefore, emissions of nitrogen compounds have become relatively more important and will continue to threaten ecosystem function and stability. The risk of environmental damage remains at an unacceptable level. The German maps show the degree to which the critical loads are exceeded, and they present current developments and an expected future trend. Results indicate that recovery from pollutant stress occurs only gradually.

Ecosystem↗
PubMed1999

[Optimization of beam filtering, kv-ma regulation curve and image intensifier entrance exposure rate to reduce radiation exposure in angiographic fluoroscopy].

AIM OF STUDY: Evaluation of radiation exposure and image quality during fluoroscopy using a new vascular X-ray system. MATERIAL AND METHODS: The measurements were made on an Integris V 3000 X-ray system with MRC tube and SpectraBeam technology (Philips Medical Systems, Hamburg). Entrance dose rates were measured with phantoms for the three fluoroscopy levels (1-3) which differed with regard to beam filtering and image intensiver entrance exposure rate. We evaluated 132 diagnostic and interventional angiographic studies. The angiographic investigators were asked to start with level 1 and to change to the next fluoroscopy level only in the case of insufficient image quality. RESULTS: Entrance dose rate is reduced by approx. 74% at fluoroscopy level 1 and by approx. 46% at level 2 relative to level 3 which is comparable to angiographic X-ray systems without MRC tube and SpectraBeam technology. Because level 1 ensured a sufficient image quality in 92% of the diagnostic and 60% of the interventional angiographic procedures a change to higher fluoroscopy levels was not necessary. CONCLUSION: Reduction of the intensifier exposure rate and the optimization of beam filtering enabled us to reduce the radiation exposure considerably. The procedure was well accepted by the angiographic investigators due to the diagnostically sufficient image quality of the fluoroscopy level 1.

Angiography, Digital Subtraction↗
PubMed1988

Limitations in the determination of total filtration of x-ray tube assemblies.

A brief introduction is given to various inferential methods for the determination of total filtration of x-ray tube assemblies. The HVL method, which is most commonly used, was investigated in detail. The influence of a number of parameters on the relationship between filtration and HVL was systematically studied. The results clearly show that the HVL method only provides a rough estimate for filtration with errors of typically +/- 30%. As a consequence, quality assurance checks on the acceptance and status test level must consider the limited accuracy of this method. Changing requirements from minimum filtration to minimum HVL permitted at particular kVp does not considerably improve the situation.

Humans↗
PubMed1986

Aluminum equivalence of materials used in diagnostic radiology and its dependence on beam quality.

A semi-empirical theory has been derived that relates the aluminum equivalence of various materials used in diagnostic radiology to their attenuation coefficients. The dependence of the aluminum hardness (AHE) and attenuation (AAE) equivalent on the beam quality is described in terms of effective energy. This 'aluminum equivalence approach' (ALEAP) gives estimates of the aluminum equivalent, regardless of spectral shape, that are usually within +/- 5% except when absorption edges are involved. A reasonable definition for the AHE of K-edge filters is offered. Suggestions are made for methods of testing for compliance with standards and regulations.

Aluminum↗