Mr Liang Chong Ri, Ms Tang Penny Hie Mein, Ms Cantiriga Subramaniam
{"title":"确定计算机断层扫描冠状动脉造影的机构诊断参考水平","authors":"Mr Liang Chong Ri, Ms Tang Penny Hie Mein, Ms Cantiriga Subramaniam","doi":"10.1016/j.jmir.2024.101535","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Computed Tomography Coronary Angiogram (CTCA) can be routinely performed using prospective or high-pitch ECG gating, acting as valuable diagnostic imaging tool for cardiovascular disease. However, one of the concerns associated with CTCA is the ionizing radiation. Establishing an institutional diagnostic reference level (DRL) for CTCA in adults is a valuable initiative to optimize radiation dose and ensure patient safety. The aim of the study is to establish institutional diagnostic reference level in CTCA for adult 16 years old and above.</div></div><div><h3>Methods</h3><div>One-year CT dose data of 232 patients above 16 years old regarding CTCA from 01 Jan 2022 to 31 Dec 2022 were retrospectively collected for analysis from existing dose-tracking software. CTCA comprises two parts of scans: calcium score and angiogram. Calcium score was performed with high-pitch ECG gated protocol while angiogram was performed with either prospective sequence protocol or high-pitch protocol based on the patient's heart rate. The data extracted included information on scan protocols, patient demographics and radiation dose parameters. Excel version 2016 was used to calculate the mean, 75th percentile, and 90th percentile of CT dose index (CTDIvol) and dose length product (DLP) distribution according to calcium score, prospective ECG-gated and high-pitch scanning protocols.</div></div><div><h3>Result</h3><div>The institutional DRL for CTCA for our CT units were established as mean (50<sup>th</sup> percentile) of CTDIvol (mGy), DLP (mGy.cm) for CT calcium score exam, prospective ECG-gated exam and high-pitch ECG-gated exam. Calcium score exam: (1.35 mGy), (25.15mGy.cm) respectively; Prospective ECG-gated exam: (18.43mGy), (251.55mGy.cm) respectively; High-pitch ECG-gated exam: (2.98mGy), (58.9 mGy.cm) respectively.</div></div><div><h3>Conclusion</h3><div>The study indicates that CTCA using High-pitch ECG-gated protocol results in much lower radiation exposure compared to the prospective ECG-gated protocol. The reported matrix offers a variety of dose information for quality improvement activities.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Establishment of Institutional Diagnostic Reference Level for Computed Tomography Coronary Angiogram\",\"authors\":\"Mr Liang Chong Ri, Ms Tang Penny Hie Mein, Ms Cantiriga Subramaniam\",\"doi\":\"10.1016/j.jmir.2024.101535\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Computed Tomography Coronary Angiogram (CTCA) can be routinely performed using prospective or high-pitch ECG gating, acting as valuable diagnostic imaging tool for cardiovascular disease. However, one of the concerns associated with CTCA is the ionizing radiation. Establishing an institutional diagnostic reference level (DRL) for CTCA in adults is a valuable initiative to optimize radiation dose and ensure patient safety. The aim of the study is to establish institutional diagnostic reference level in CTCA for adult 16 years old and above.</div></div><div><h3>Methods</h3><div>One-year CT dose data of 232 patients above 16 years old regarding CTCA from 01 Jan 2022 to 31 Dec 2022 were retrospectively collected for analysis from existing dose-tracking software. CTCA comprises two parts of scans: calcium score and angiogram. Calcium score was performed with high-pitch ECG gated protocol while angiogram was performed with either prospective sequence protocol or high-pitch protocol based on the patient's heart rate. The data extracted included information on scan protocols, patient demographics and radiation dose parameters. Excel version 2016 was used to calculate the mean, 75th percentile, and 90th percentile of CT dose index (CTDIvol) and dose length product (DLP) distribution according to calcium score, prospective ECG-gated and high-pitch scanning protocols.</div></div><div><h3>Result</h3><div>The institutional DRL for CTCA for our CT units were established as mean (50<sup>th</sup> percentile) of CTDIvol (mGy), DLP (mGy.cm) for CT calcium score exam, prospective ECG-gated exam and high-pitch ECG-gated exam. Calcium score exam: (1.35 mGy), (25.15mGy.cm) respectively; Prospective ECG-gated exam: (18.43mGy), (251.55mGy.cm) respectively; High-pitch ECG-gated exam: (2.98mGy), (58.9 mGy.cm) respectively.</div></div><div><h3>Conclusion</h3><div>The study indicates that CTCA using High-pitch ECG-gated protocol results in much lower radiation exposure compared to the prospective ECG-gated protocol. The reported matrix offers a variety of dose information for quality improvement activities.</div></div>\",\"PeriodicalId\":46420,\"journal\":{\"name\":\"Journal of Medical Imaging and Radiation Sciences\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Medical Imaging and Radiation Sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1939865424002662\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medical Imaging and Radiation Sciences","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1939865424002662","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Establishment of Institutional Diagnostic Reference Level for Computed Tomography Coronary Angiogram
Introduction
Computed Tomography Coronary Angiogram (CTCA) can be routinely performed using prospective or high-pitch ECG gating, acting as valuable diagnostic imaging tool for cardiovascular disease. However, one of the concerns associated with CTCA is the ionizing radiation. Establishing an institutional diagnostic reference level (DRL) for CTCA in adults is a valuable initiative to optimize radiation dose and ensure patient safety. The aim of the study is to establish institutional diagnostic reference level in CTCA for adult 16 years old and above.
Methods
One-year CT dose data of 232 patients above 16 years old regarding CTCA from 01 Jan 2022 to 31 Dec 2022 were retrospectively collected for analysis from existing dose-tracking software. CTCA comprises two parts of scans: calcium score and angiogram. Calcium score was performed with high-pitch ECG gated protocol while angiogram was performed with either prospective sequence protocol or high-pitch protocol based on the patient's heart rate. The data extracted included information on scan protocols, patient demographics and radiation dose parameters. Excel version 2016 was used to calculate the mean, 75th percentile, and 90th percentile of CT dose index (CTDIvol) and dose length product (DLP) distribution according to calcium score, prospective ECG-gated and high-pitch scanning protocols.
Result
The institutional DRL for CTCA for our CT units were established as mean (50th percentile) of CTDIvol (mGy), DLP (mGy.cm) for CT calcium score exam, prospective ECG-gated exam and high-pitch ECG-gated exam. Calcium score exam: (1.35 mGy), (25.15mGy.cm) respectively; Prospective ECG-gated exam: (18.43mGy), (251.55mGy.cm) respectively; High-pitch ECG-gated exam: (2.98mGy), (58.9 mGy.cm) respectively.
Conclusion
The study indicates that CTCA using High-pitch ECG-gated protocol results in much lower radiation exposure compared to the prospective ECG-gated protocol. The reported matrix offers a variety of dose information for quality improvement activities.
期刊介绍：
Journal of Medical Imaging and Radiation Sciences is the official peer-reviewed journal of the Canadian Association of Medical Radiation Technologists. This journal is published four times a year and is circulated to approximately 11,000 medical radiation technologists, libraries and radiology departments throughout Canada, the United States and overseas. The Journal publishes articles on recent research, new technology and techniques, professional practices, technologists viewpoints as well as relevant book reviews.
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