Feasibility of optimized ultralow-dose pulsed fluoroscopy for upper gastrointestinal tract examinations: a phantom study with clinical correlation

Weiss, Jakob; Pomschar, Andreas; Rist, Carsten; Neumaier, Klement; Li, Minglun; Flatz, Wilhelm; Thierfelder, Kolja und Notohamiprodjo, Mike (2017): Feasibility of optimized ultralow-dose pulsed fluoroscopy for upper gastrointestinal tract examinations: a phantom study with clinical correlation. In: Radiologia Medica, Bd. 122, Nr. 11: S. 822-828

Abstract

To establish an optimized ultralow-dose digital pulsed fluoroscopy (FP) protocol for upper gastrointestinal tract examinations and to investigate the radiation dose and image quality. An Alderson-Rando-Phantom with 60 thermoluminescent dosimeters was used for dose measurements to systematically evaluate the dose-area product (DAP) and organ doses of the optimized FP protocol with the following acquisition parameters: 86.7 kV;77 mA;0.9 mm(3), automatic image noise and contrast adaption. Subjective image quality, depiction of contrast agent and image noise (5-point Likert scale;5 = excellent) were assessed in 41 patients, who underwent contrast-enhanced FP with the aforementioned optimized protocol by two radiologists in consensus. A conventional digital radiograph (DR) acquisition protocol served as the reference standard for radiation dose and image quality analyses. Phantom measurements revealed a general dose reduction of approximately 96% per image for the FP protocol as compared to the DR standard. DAP could be reduced by 97%. Significant dose reductions were also found for organ doses, both in the direct and scattered radiation beam with negligible orbital (FP 5.6 x 10(-3) vs. DR 0.11;p = 0.02) and gonadal dose exposure (female FP 2.4 x 10(-3) vs. DR 0.05;male FP 8 x 10(-4) vs. DR 0.03;p ae<currency> 0.0004). FP provided diagnostic image quality in all patients, although reading scores were significantly lower for all evaluated parameters as compared to the DR standard (p < 0.05). Ultralow-dose FP is feasible for clinical routine allowing a significant reduction of direct and scattered dose exposure while providing sufficient diagnostic image quality for reliable diagnosis.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0033-8362
• Sprache: Englisch