Biomedical subjects

Jo-Anne Shepard

Publications and source records attributed to Jo-Anne Shepard.

4 recordsLinked to original sources

PubMed2005

Scanning beyond anatomic limits of the thorax in chest CT: findings, radiation dose, and automatic tube current modulation.

OBJECTIVE: Our objective was to determine additional radiation dose associated with scanning beyond the anatomic limits of the thorax in chest CT protocol and to assess the effect of z-axis modulation on the additional radiation dose associated with the scanning protocol. MATERIALS AND METHODS: "Extra" images for routine chest CT were defined as those above lung apices (supraapical) and those caudal to the lowermost portion of lung parenchyma (infrapulmonary), including images obtained beyond the adrenal glands (infraadrenal). One hundred and forty-eight consecutive chest CT examinations (70 men, 78 women; age range, 15-90 years) performed September 13-25, 2003, were reviewed to determine the number of supraapical, infrapulmonary, and infraadrenal extra images. All examinations were performed using z-axis modulation (n = 70) or fixed tube current (n = 78). The CT dose index volume and dose-length product (DLP) values for the extra images were calculated. Two radiologists reviewed these extra images for pathologic findings. Student's t test was used to perform the statistical analysis. RESULTS: One hundred forty-four (97%) examinations had supraapical extra images and 145 (98%) had infrapulmonary extra images. A total of 31 additional findings were observed in extra images. Most clinically important findings were identified in patients with a history of malignancy. With z-axis modulation, the mean DLP for supraapical and infrapulmonary extra images was 39.98 mGy x cm and 132.59 mGy x cm, respectively. With fixed tube current, the mean DLP for supraapical and infrapulmonary extra images was 30.31 mGy x cm and 95.91 mGy x cm, respectively. CONCLUSION: A substantial number of extra images are acquired during chest CT that do not add clinically important information in patients with nonmalignant indications. The use of z-axis modulation increased radiation dose for the extra images.

Adolescent↗

PubMed2004

Strategies for CT radiation dose optimization.

Recent technologic advances have markedly enhanced the clinical applications of computed tomography (CT). While the benefits of CT exceed the harmful effects of radiation exposure in patients, increasing radiation doses to the population have raised a compelling case for reduction of radiation exposure from CT. Strategies for radiation dose reduction are difficult to devise, however, because of a lack of guidelines regarding CT examination and scanning techniques. Various methods and strategies based on individual patient attributes and CT technology have been explored for dose optimization. It is the purpose of this review article to outline basic principles of CT radiation exposure and emphasize the need for CT radiation dose optimization based on modification of scanning parameters and application of recent technologic innovations.

Adult↗

PubMed2003

Can noise reduction filters improve low-radiation-dose chest CT images? Pilot study.

Effect of noise reduction filters on chest computed tomographic (CT) images acquired with 50% radiation dose reduction was evaluated. Two sets of images were acquired with multi-detector row CT at standard (220-280 mA) and 50% reduced (110-140 mA) tube current at the level of the carina. After postprocessing with six noise reduction filters, images were compared with baseline standard-dose images for noise, sharpness, and contrast in lungs, mediastinum, and chest wall. Quantitative image noise was measured in descending thoracic aorta. Modulation transfer functions were calculated from CT images of 50-microm wire. Noise reduction filters reduced image noise on low-radiation-dose chest CT images, with some compromise in image sharpness and contrast assessed qualitatively, and slightly altered modulation transfer function at higher spatial frequencies.

Aged↗

PubMed2002

Standard-dose and 50%-reduced-dose chest CT: comparing the effect on image quality.

OBJECTIVE: CT accounts for considerable population-based radiation dose from radiographic diagnostic studies. The technical factors for CT examinations are not appropriately adjusted on the basis of patient size and anatomy. We hypothesized that radiation doses for routine chest CT can be reduced by 50% for the evaluation of normal structures without seriously jeopardizing image quality. SUBJECTS AND METHODS: After receiving institutional review board approval, we prospectively studied 24 patients with cancer who were 65 years old and older on a multidetector CT scanner. Each patient underwent imaging with four slices (centered at the carina) at the standard dose (220-280 mAs) and at 50%-reduced dose (110-140 mAs) at a constant 140 kVp. Single breath-hold scanning was performed with a 2.5-mm detector configuration, a tube rotation time of 0.8 sec, and a pitch of 6:1. Contiguous images were reconstructed at 5-mm intervals. Two subspecialty-trained chest radiologists who were unaware of the CT technique reviewed randomized images for overall image quality and anatomic detail of the structures in the lung, airway, mediastinum, and chest wall using a 5-point scale (1, worst; 2, suboptimal; 3, adequate; 4, very good; 5, excellent). The data were analyzed using the Wilcoxon's signed rank test. RESULTS: Although overall image quality was better with standard-dose CT, the quality of reduced-dose CT was acceptable. The differences in mean scores were statistically significant. There was a correlation of 0.59 between observers. The mean scores of standard-dose CT were always greater than or equivalent to those of low-dose CT for both observers. The assessment of great vessels and soft tissue of the chest wall contributed mainly to the differences in image quality. Both the central and peripheral lung parenchyma and the airway were adequately visualized on low-dose CT. Radiation doses (based on weighted-CT-dose index) from standard-dose CT and 50%-reduced-dose CT were 15.6-21.4 mSv and 7.8-10.7 mSv, respectively (from the manufacturer's data). CONCLUSION: Chest CT image quality appears to be acceptable for evaluating normal anatomic structures even with a 50% reduction in radiation dose.

Aged↗