Radiation Dose Reduction in CT Torsion Measurement of the Lower Limb: Introduction of a New Ultra-Low Dose Protocol
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Estimation of the Effective Radiation Dose
2.3. Technical Parameters of the HQ Protocol for CT Torsion Measurement of the Lower Limb
2.4. Technical Parameters of the New ULD Protocol for CT Torsion Measurement of the Lower Limb
2.5. Measurement of Body Volume Parameters, CNR and DC
2.6. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations and Acronyms
ALARA | “as low as reasonably achievable-principle” |
AP | anterior-posterior |
BMI | body mass index |
CNR | contrast-to-noise ratio |
CTDIvol | computed tomography dose index |
DC | subjectively rated diagnostic confidence |
DLP | dose length product |
HQ | high-quality |
RL | right-left |
ROI | region of interest |
SL | scan length |
SOP | standard operating procedure |
ULD | ultra-low dose |
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HQ Protocol | ULD Protocol | p-Value | |
---|---|---|---|
N | 30 | 30 | - |
Age at time of CT (yrs.) # | 40.4 ± 15.9 | 38.8 ±15.8 | 0.784 |
Gender (male/female) | 17/13 | 16/14 | 0.795 |
BMI (kg/m2) # | 29.1 ± 5.4 | 28.7 ± 6.0 | 0.777 |
Body area at femoral head level; (cm2) # | 738.8 ± 130.2 | 723.6 ± 131.8 | 0.515 |
Ratio area/distance femoral heads # | 4.1 ± 0.7 | 4.1 ± 0.7 | 0.819 |
Max. RL body diameter at femoral head level (mm) # | 388.8 ± 36.5 | 393.6 ± 31.4 | 0.344 |
Ratio max. RL diameter/distance femoral heads # | 2.2 ± 0.3 | 2.2 ± 0.2 | 0.762 |
max. AP body diameter at femoral head level (mm) # | 219.4 ± 28.8 | 219.3 ± 30.6 | 0.923 |
Ratio max. AP diameter/distance femoral heads # | 1.2 ± 0.2 | 1.2 ± 0.2 | 0.900 |
BMI (p-Value; Equational Fit) | Correlation Coefficient (r2) | |
---|---|---|
Body area | <0.001 (linear fit) | 0.73 |
Ratio area/distance femoral heads | <0.001 (linear fit) | 0.74 |
Max. RL body diameter | <0.001 (linear fit) | 0.48 |
Ratio max. RL diameter/distance femoral heads | <0.001 (linear fit) | 0.33 |
Max. AP body diameter | <0.001 (linear fit) | 0.77 |
Ratio max. AP diameter/distance femoral heads | <0.001 (linear fit) | 0.67 |
HQ Protocol | ULD Protocol | p-Value | |
---|---|---|---|
CNR # | 19.8 ± 3.6 | 17.6 ± 4.1 | 0.033 |
CTDIvol hip (mGy) * | 17.1 (9.5–35.7) | 0.8 (0.6–1.5) | <0.001 |
CTDIvol knee (mGy) * | 6.2 (3.6–13.5) | 0.2 (0.2–0.4) | <0.001 |
CTDIvol ankle (mGy) * | 6.4 (3.8–6.5) | 0.2 (0.2–0.2) | <0.001 |
DLP hip (mGycm) * | 279.5 (125–596) | 10 (7–20) | <0.001 |
DLP knee (mGycm) * | 98.5 (48–219) | 2.5 (2–5) | <0.001 |
DLP ankle (mGycm) * | 78 (43–104) | 2 (1–2) | <0.001 |
DLP total (mGycm) * | 457 (251–851) | 15 (11–26) | <0.001 |
mSv hip * | 3.79 (1.44–11.7) | 0.15 (0.08–0.69) | <0.001 |
mSv knee * | 0.90 (0.03–2.76) | 0.03 (<0.01–0.11) | <0.001 |
mSv ankle * | 0.05 (0.01–0.07) | <0.01 (<0.01–<0.01) | <0.001 |
mSv total * | 4.37 (2.09–13.15) | 0.17 (0.08–0.80) | <0.001 |
Tube Voltage HQ Protocol | Tube Voltage ULD Protocol | Tube Current HQ Protocol | Tube Current ULD Protocol | |
---|---|---|---|---|
Hip | 120 kV | 26 × 100 kV 4 × 120 kV | 292.4 ± 110.6 mAs | 100 kV: 20 (14–27) mAs 120 kV: 21 (19–24) mAs |
Knee | 120 kV | 80 kV | 95.0 mAs | 9 (9–20) mAs |
Ankle | 120 kV | 80 kV | 95.0 mAs | 10 (10–10) mAs |
HQ Protocol | ULD Protocol | p-Value | |
---|---|---|---|
SL hip * | 14.9 (12.8–24.6) | 13.5 (10.8–17.0) | <0.001 |
SL knee * | 16.1 (11.5–26.3) | 12.0 (11.1–22.2) | 0.019 |
SL ankle * | 12.2 (9.4–16.3) | 11.1 (5.6–11.1) | <0.001 |
SL total * | 42.9 (35.5–57.4) | 36.4 (27.5–44.6) | <0.001 |
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Keller, G.; Götz, S.; Kraus, M.S.; Grünwald, L.; Springer, F.; Afat, S. Radiation Dose Reduction in CT Torsion Measurement of the Lower Limb: Introduction of a New Ultra-Low Dose Protocol. Diagnostics 2021, 11, 1209. https://doi.org/10.3390/diagnostics11071209
Keller G, Götz S, Kraus MS, Grünwald L, Springer F, Afat S. Radiation Dose Reduction in CT Torsion Measurement of the Lower Limb: Introduction of a New Ultra-Low Dose Protocol. Diagnostics. 2021; 11(7):1209. https://doi.org/10.3390/diagnostics11071209
Chicago/Turabian StyleKeller, Gabriel, Simon Götz, Mareen Sarah Kraus, Leonard Grünwald, Fabian Springer, and Saif Afat. 2021. "Radiation Dose Reduction in CT Torsion Measurement of the Lower Limb: Introduction of a New Ultra-Low Dose Protocol" Diagnostics 11, no. 7: 1209. https://doi.org/10.3390/diagnostics11071209