Authors : Piyush Kant; Arshad Alam Khan; Komal Priya

Volume/Issue : Volume 9 - 2024, Issue 5 - May

Google Scholar : https://tinyurl.com/yzptt39a

Scribd : https://tinyurl.com/yxsjry6e

DOI : https://doi.org/10.38124/ijisrt/IJISRT24MAY839

Abstract : The primary objective of this investigation is to comprehensively evaluate potential strategies to mitigate the risk of radiation-induced ailments stemming from the excessive exposure of radiosensitive organs such as the eyes, thyroid, breast, and gonads during CT scans, without compromising diagnostic image quality. In the methodology, a thorough examination and synthesis of existing literature were conducted, encompassing various studies and their respective findings. By scrutinizing the results and conclusions of these studies, the aim was to identify optimal approaches for minimizing the risk of radiation-related diseases associated with the overexposure of radiosensitive organs. The culmination of this analysis revealed a range of methods tailored to protect specific radiosensitive organs. Notably, for safeguarding the eye lens, gantry tilting emerged as the most efficacious technique. However, circumstances may arise where gantry tilting is impractical; in such cases, the utilization of silicon rubber shielding combined with tube current modulation was deemed viable. Furthermore, for other radiosensitive organs, such as the thyroid, breast, and gonads, the implementation of tube current modulation, supplemented by ADMIRE 3, was identified as a significantly effective measure. In conclusion, this study underscores the importance of adopting targeted strategies to mitigate radiation risks while preserving diagnostic image quality during CT scans. By leveraging techniques such as gantry tilting, silicon rubber shielding, and tube current modulation with ADMIRE 3, healthcare practitioners can enhance patient safety and minimize the likelihood of radiation- induced health complications. Additionally, ensuring the authenticity of these findings, plagiarism was rigorously checked to maintain the integrity of the research.

Keywords : SODAR, Gantry Tilting, Radiological Staff Training, Tube Current Modulation, ADMIRE.

References :

1. History of computed tomography - Wikipedia. (2007, May 7). History of Computed Tomography - Wikipedia. Retrieved November 20, 2022, from https://en.wikipedia.org/w/index.php?title=History_of_computed_tomography&oldid=1048274109
2. Half A Century In CT: How Computed Tomography Has Evolved — ISCT. (2016, October 7). ISCT. Retrieved November 20, 2022, from https://www.isct.org/computed-tomography-blog/2017/2/10/half-a-century-in-ct-how-computed-tomography-has-evolved
3. Costello, J. E., Cecava, N. D., Tucker, J. E., & Bau, J. L. (2013). Ct radiation dose: Current controversies and dose reduction strategies. American Journal of Roentgenology, 201(6), 1283–1290. https://doi.org/10.2214/AJR.12.9720.
4. Pearce, M. S., Salotti, J. A., Little, M. P., McHugh, K., Lee, C., Kim, K. P., Howe, N. L., Ronckers, C. M., Rajaraman, P., Craft, A. W., Parker, L., & Berrington De González, A. (2012). Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: A retrospective cohort study. The Lancet, 380(9840), 499–505. https://doi.org/10.1016/S0140-6736(12)60815-0
5. [No authors listed]. The 2007 Recommendations of the International Commission on Radiological Protection: ICRP publication 103. Ann ICRP
6. Poon, R., & Badawy, M. K. (2019). Radiation dose and risk to the lens of the eye during CT examinations of the brain. Journal of Medical Imaging and Radiation Oncology, 63(6), 786–794. https://doi.org/10.1111/1754-9485.12950
7. Nikupaavo, U., Kaasalainen, T., Reijonen, V., Ahonen, S.-M., & Kortesniemi, M. (2015). Lens dose in routine head ct: Comparison of different optimization methods with anthropomorphic phantoms. American Journal of Roentgenology, 204(1), 117–123. https://doi.org/10.2214/AJR.14.12763
8. Yuan, M.-K., Tsai, D.-C., Chang, S.-C., Yuan, M.-C., Chang, S.-J., Chen, H.-W., & Leu, H.-B. (2013). The risk of cataract associated with repeated head and neck ct studies: A nationwide population-based study. American Journal of Roentgenology, 201(3), 626–630. https://doi.org/10.2214/AJR.12.9652
9. Lai, C. W.-K., Cheung, H.-Y., Chan, T.-P., & Wong, T. H. (2015). Reducing the radiation dose to the eye lens region during CT brain examination: The potential beneficial effect of the combined use of bolus and a bismuth shield. Radioprotection, 50(3), 195–201. https://doi.org/10.1051/radiopro/2015003
10. Wang, J., Duan, X., Christner, J. A., Leng, S., Grant, K. L., & McCollough, C. H. (2012). Bismuth shielding, organ-based tube current modulation, and global reduction of tube current for dose reduction to the eye at head ct. Radiology, 262(1), 191–198. https://doi.org/10.1148/radiol.11110470
11. Kosaka, H., Monzen, H., Amano, M., Tamura, M., Hattori, S., Kono, Y., & Nishimura, Y. (2020). Radiation dose reduction to the eye lens in head CT using tungsten functional paper and organ-based tube current modulation. European Journal of Radiology, 124, 108814. https://doi.org/10.1016/j.ejrad.2020.108814
12. Irdawati, Y., Sutanto, H., Anam, C., Fujibuchi, T., Zahroh, F., & Dougherty, G. (2019). Development of a novel artifact-free eye shield based on silicon rubber-lead composition in the CT examination of the head. Journal of Radiological Protection, 39(4), 991–1005. https://doi.org/10.1088/1361-6498/ab2f3e
13. Saba, V., Valizadeh, A., Barkhordari, M., Shuraki, J. K., & Zahedinia, M. (2021). In-plane Saba shielding for dose reduction to the eye at head CT. Physica Medica, 92, S128. https://doi.org/10.1016/S1120-1797(22)00274-5
14. Merzan, D., Nowik, P., Poludniowski, G., & Bujila, R. (2017). Evaluating the impact of scan settings on automatic tube current modulation in CT using a novel phantom. The British Journal of Radiology, 90(1069), 20160308. https://doi.org/10.1259/bjr.20160308
15. Haji-Momenian, S., Ellenbogen, A., Khati, N., Taffel, M., Earls, J., Miller, G., & Zeman, R. K. (2018). Comparing dose-length product–based and monte carlo simulation organ–based calculations of effective dose in 16- and 64-mdct examinations using automatic tube current modulation. American Journal of Roentgenology, 210(3), 583–592. https://doi.org/10.2214/AJR.17.18294
16. Sookpeng, S., Butdee, C. Signal-to-noise ratio and dose to the lens of the eye for computed tomography examination of the brain using an automatic tube current modulation system. Emerg Radiol 24, 233–239 (2017). https://doi.org/10.1007/s10140-016-1470-6
17. Duan, X., Wang, J., Christner, J. A., Leng, S., Grant, K. L., & McCollough, C. H. (2011). Dose reduction to anterior surfaces with organ-based tube-current modulation: Evaluation of performance in a phantom study. American Journal of Roentgenology, 197(3), 689–695. https://doi.org/10.2214/AJR.10.6061
18. Reimann, A. J., Davison, C., Bjarnason, T., Yogesh, T., Kryzmyk, K., Mayo, J., & Nicolaou, S. (2012). Organ-based computed tomographic (Ct) radiation dose reduction to the lenses: Impact on image quality for ct of the head. Journal of Computer Assisted Tomography, 36(3), 334–338. https://doi.org/10.1097/RCT.0b013e318251ec61
19. Karmazyn, B., Ai, H., Liang, Y., Klahr, P., Eckert, G. J., & Jennings, S. G. (2015). Effect of body size on dose reduction with longitudinal tube current modulation in pediatric patients. American Journal of Roentgenology, 204(4), 861–864. https://doi.org/10.2214/AJR.14.12762
20. Mayer, C., Meyer, M., Fink, C., Schmidt, B., Sedlmair, M., Schoenberg, S. O., & Henzler, T. (2014). Potential for radiation dose savings in abdominal and chest ct using automatic tube voltage selection in combination with automatic tube current modulation. American Journal of Roentgenology, 203(2), 292–299. https://doi.org/10.2214/AJR.13.11628
21. Lin, M.-F., Chen, C.-Y., Lee, Y.-H., Li, C.-W., Gerweck, L. E., Wang, H., & Chan, W. P. (2019). Topogram-based tube current modulation of head computed tomography for optimizing image quality while protecting the eye lens with shielding. Acta Radiologica, 60(1), 61–67. https://doi.org/10.1177/0284185118770894
22. Li, C., Qi, L., Zhang, Y., Gao, F., Jin, X., Zhang, L., Tang, H., & Li, M. (2020). Image quality and clinical usefulness of automatic tube current modulation technology in female chest computed tomography screening. Medicine, 99(33), e21719. https://doi.org/10.1097/MD.0000000000021719
23. Gervaise, A., Naulet, P., Beuret, F., Henry, C., Pernin, M., Portron, Y., & Lapierre-Combes, M. (2014). Low-dose ct with automatic tube current modulation, adaptive statistical iterative reconstruction, and low tube voltage for the diagnosis of renal colic: Impact of body mass index. American Journal of Roentgenology, 202(3), 553–560. https://doi.org/10.2214/AJR.13.11350
24. Israel, G. M., Cicchiello, L., Brink, J., & Huda, W. (2010). Patient size and radiation exposure in thoracic, pelvic, and abdominal ct examinations performed with automatic exposure control. American Journal of Roentgenology, 195(6), 1342–1346. https://doi.org/10.2214/AJR.09.3331
25. Spampinato, S., Gueli, A. M., Milone, P., & Raffaele, L. A. (2018). Dosimetric changes with computed tomography automatic tube-current modulation techniques. Radiological Physics and Technology, 11(2), 184–191. https://doi.org/10.1007/s12194-018-0454-5
26. Schmid, A. I., Uder, M., & Lell, M. M. (2017). Reaching for better image quality and lower radiation dose in head and neck CT: Advanced modeled and sinogram-affirmed iterative reconstruction in combination with tube voltage adaptation. Dentomaxillofacial Radiology, 46(1), 20160131. https://doi.org/10.1259/dmfr.20160131
27. Ellmann, S., Kammerer, F., Allmendinger, T., Hammon, M., Janka, R., Lell, M., Uder, M., & Kramer, M. (2018). Advanced modeled iterative reconstruction (Admire) facilitates radiation dose reduction in abdominal ct. Academic Radiology, 25(10),1277–1284. https://doi.org/10.1016/j.acra.2018.01.014
28. Higaki, T., Nakamura, Y., Fukumoto, W., Honda, Y., Tatsugami, F., & Awai, K. (2019). Clinical application of radiation dose reduction at abdominal CT. European Journal of Radiology, 111, 68–75. https://doi.org/10.1016/j.ejrad.2018.12.018
29. Brodoefel, H., Bender, B., Schabel, C., Fenchel, M., Ernemann, U., & Korn, A. (2015). Potential of combining iterative reconstruction with noise efficient detector design: Aggressive dose reduction in head CT. The British Journal of Radiology, 88(1050), 20140404. https://doi.org/10.1259/bjr.20140404
30. Takakuwa, K. M., Estepa, A. T., & Shofer, F. S. (2010). Knowledge and attitudes of emergency department patients regarding radiation risk of ct: Effects of age, sex, race, education, insurance, body mass index, pain, and seriousness of illness. American Journal of Roentgenology, 195(5), 1151–1158. https://doi.org/10.2214/AJR.09.3847
31. Paolicchi, F., Faggioni, L., Bastiani, L., Molinaro, S., Puglioli, M., Caramella, D., & Bartolozzi, C. (2014). Optimizing the balance between radiation dose and image quality in pediatric head ct: Findings before and after intensive radiologic staff training. American Journal of Roentgenology, 202(6), 1309–1315. https://doi.org/10.2214/AJR.13.11741
32. Hricak, H., Brenner, D. J., Adelstein, S. J., Frush, D. P., Hall, E. J., Howell, R. W., McCollough, C. H., Mettler, F. A., Pearce, M. S., Suleiman, O. H., Thrall, J. H., & Wagner, L. K. (2011). Managing radiation use in medical imaging: A multifaceted challenge. Radiology, 258(3), 889–905. https://doi.org/10.1148/radiol.10101157
33. Mosher, E. G., Butman, J. A., Folio, L. R., Biassou, N. M., & Lee, C. (2018). Lens dose reduction by patient posture modification during neck ct. American Journal of Roentgenology, 210(5), 1111–1117. https://doi.org/10.2214/AJR.17.18261