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Feasibility of optimized ultralow-dose pulsed fluoroscopy for upper gastrointestinal tract examinations: a phantom study with clinical correlation
Purpose 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. Materials and methods An Alderson-Rando-Phantom with 60 thermoluminescent dosimeters was used for dose measu...
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| Published in: | Radiologia medica 2017-11, Vol.122 (11), p.822-828 |
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| container_title | Radiologia medica |
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| creator | Weiss, Jakob Pomschar, Andreas Rist, Carsten Neumaier, Klement Li, Minglun Flatz, Wilhelm Thierfelder, Kolja Notohamiprodjo, Mike |
| description | Purpose
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.
Materials and methods
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.
Results
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 × 10
−3
vs. DR 0.11;
p
= 0.02) and gonadal dose exposure (female FP 2.4 × 10
−3
vs. DR 0.05; male FP 8 × 10
−4
vs. DR 0.03;
p
≤ 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
|
| doi_str_mv | 10.1007/s11547-017-0793-z |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1922508911</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1922508911</sourcerecordid><originalsourceid>FETCH-LOGICAL-c324t-26ab7ab9a844d65a6ad7b1c6449d887a7b605ce3cd6ffe6588935f813fc9500c3</originalsourceid><addsrcrecordid>eNp1kc1u3CAUhVHVqJmkfYBsKqRuunECxsaQXRQ1P1KkbNo1whgyjLBx-VHqeYw8cZlMUlWRskAI7nfO5XIAOMHoFCPUnUWM26arEC6r46TafgArzGpaUc7IR7BCiJCKEVofgqMYNwg1CCP-CRzWrCOEY7YCT1daRttbZ9MCvYF-Tna0Wz3A7FKQzj9Wg48aztnFcmlc9sFH5ecFGh9gnmcd4IOMKXg7JR2TnaSDRakS1H_kWI7J-imeQwnntZySH2FMeVjgo01rqJydrCoK5UPQ7pn9DA6MLN2-vOzH4NfVj5-XN9Xd_fXt5cVdpUjdpKqmsu9kzyVrmoG2ksqh67GiTcMHxjrZ9RS1ShM1UGM0bRnjpDUME6N4i5Aix-D73ncO_ncuTxejjUo7JyftcxSY13WLGMe4oN_eoBufQ5l0RxUz1lDKC4X3lCpfFIM2Yg52lGERGIldYGIfmCiBiV1gYls0X1-ccz_q4Z_iNaEC1HsgltL0oMN_rd91_QvFkaWq</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1950084669</pqid></control><display><type>article</type><title>Feasibility of optimized ultralow-dose pulsed fluoroscopy for upper gastrointestinal tract examinations: a phantom study with clinical correlation</title><source>Springer Nature</source><creator>Weiss, Jakob ; Pomschar, Andreas ; Rist, Carsten ; Neumaier, Klement ; Li, Minglun ; Flatz, Wilhelm ; Thierfelder, Kolja ; Notohamiprodjo, Mike</creator><creatorcontrib>Weiss, Jakob ; Pomschar, Andreas ; Rist, Carsten ; Neumaier, Klement ; Li, Minglun ; Flatz, Wilhelm ; Thierfelder, Kolja ; Notohamiprodjo, Mike</creatorcontrib><description>Purpose
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.
Materials and methods
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.
Results
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 × 10
−3
vs. DR 0.11;
p
= 0.02) and gonadal dose exposure (female FP 2.4 × 10
−3
vs. DR 0.05; male FP 8 × 10
−4
vs. DR 0.03;
p
≤ 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).
Conclusion
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.</description><identifier>ISSN: 0033-8362</identifier><identifier>EISSN: 1826-6983</identifier><identifier>DOI: 10.1007/s11547-017-0793-z</identifier><identifier>PMID: 28733918</identifier><language>eng</language><publisher>Milan: Springer Milan</publisher><subject>Abdominal Radiology ; Correlation analysis ; Diagnostic Radiology ; Diagnostic systems ; Dosimeters ; Feasibility ; Fluoroscopy ; Image acquisition ; Image contrast ; Image quality ; Imaging ; Interventional Radiology ; Medicine ; Medicine & Public Health ; Neuroradiology ; Patients ; Quality ; Radiation dosage ; Radiology ; Reduction ; Ultrasound</subject><ispartof>Radiologia medica, 2017-11, Vol.122 (11), p.822-828</ispartof><rights>Italian Society of Medical Radiology 2017</rights><rights>Copyright Springer Science & Business Media 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c324t-26ab7ab9a844d65a6ad7b1c6449d887a7b605ce3cd6ffe6588935f813fc9500c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28733918$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weiss, Jakob</creatorcontrib><creatorcontrib>Pomschar, Andreas</creatorcontrib><creatorcontrib>Rist, Carsten</creatorcontrib><creatorcontrib>Neumaier, Klement</creatorcontrib><creatorcontrib>Li, Minglun</creatorcontrib><creatorcontrib>Flatz, Wilhelm</creatorcontrib><creatorcontrib>Thierfelder, Kolja</creatorcontrib><creatorcontrib>Notohamiprodjo, Mike</creatorcontrib><title>Feasibility of optimized ultralow-dose pulsed fluoroscopy for upper gastrointestinal tract examinations: a phantom study with clinical correlation</title><title>Radiologia medica</title><addtitle>Radiol med</addtitle><addtitle>Radiol Med</addtitle><description>Purpose
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.
Materials and methods
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.
Results
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 × 10
−3
vs. DR 0.11;
p
= 0.02) and gonadal dose exposure (female FP 2.4 × 10
−3
vs. DR 0.05; male FP 8 × 10
−4
vs. DR 0.03;
p
≤ 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).
Conclusion
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.</description><subject>Abdominal Radiology</subject><subject>Correlation analysis</subject><subject>Diagnostic Radiology</subject><subject>Diagnostic systems</subject><subject>Dosimeters</subject><subject>Feasibility</subject><subject>Fluoroscopy</subject><subject>Image acquisition</subject><subject>Image contrast</subject><subject>Image quality</subject><subject>Imaging</subject><subject>Interventional Radiology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroradiology</subject><subject>Patients</subject><subject>Quality</subject><subject>Radiation dosage</subject><subject>Radiology</subject><subject>Reduction</subject><subject>Ultrasound</subject><issn>0033-8362</issn><issn>1826-6983</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp1kc1u3CAUhVHVqJmkfYBsKqRuunECxsaQXRQ1P1KkbNo1whgyjLBx-VHqeYw8cZlMUlWRskAI7nfO5XIAOMHoFCPUnUWM26arEC6r46TafgArzGpaUc7IR7BCiJCKEVofgqMYNwg1CCP-CRzWrCOEY7YCT1daRttbZ9MCvYF-Tna0Wz3A7FKQzj9Wg48aztnFcmlc9sFH5ecFGh9gnmcd4IOMKXg7JR2TnaSDRakS1H_kWI7J-imeQwnntZySH2FMeVjgo01rqJydrCoK5UPQ7pn9DA6MLN2-vOzH4NfVj5-XN9Xd_fXt5cVdpUjdpKqmsu9kzyVrmoG2ksqh67GiTcMHxjrZ9RS1ShM1UGM0bRnjpDUME6N4i5Aix-D73ncO_ncuTxejjUo7JyftcxSY13WLGMe4oN_eoBufQ5l0RxUz1lDKC4X3lCpfFIM2Yg52lGERGIldYGIfmCiBiV1gYls0X1-ccz_q4Z_iNaEC1HsgltL0oMN_rd91_QvFkaWq</recordid><startdate>20171101</startdate><enddate>20171101</enddate><creator>Weiss, Jakob</creator><creator>Pomschar, Andreas</creator><creator>Rist, Carsten</creator><creator>Neumaier, Klement</creator><creator>Li, Minglun</creator><creator>Flatz, Wilhelm</creator><creator>Thierfelder, Kolja</creator><creator>Notohamiprodjo, Mike</creator><general>Springer Milan</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20171101</creationdate><title>Feasibility of optimized ultralow-dose pulsed fluoroscopy for upper gastrointestinal tract examinations: a phantom study with clinical correlation</title><author>Weiss, Jakob ; Pomschar, Andreas ; Rist, Carsten ; Neumaier, Klement ; Li, Minglun ; Flatz, Wilhelm ; Thierfelder, Kolja ; Notohamiprodjo, Mike</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c324t-26ab7ab9a844d65a6ad7b1c6449d887a7b605ce3cd6ffe6588935f813fc9500c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdominal Radiology</topic><topic>Correlation analysis</topic><topic>Diagnostic Radiology</topic><topic>Diagnostic systems</topic><topic>Dosimeters</topic><topic>Feasibility</topic><topic>Fluoroscopy</topic><topic>Image acquisition</topic><topic>Image contrast</topic><topic>Image quality</topic><topic>Imaging</topic><topic>Interventional Radiology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroradiology</topic><topic>Patients</topic><topic>Quality</topic><topic>Radiation dosage</topic><topic>Radiology</topic><topic>Reduction</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Weiss, Jakob</creatorcontrib><creatorcontrib>Pomschar, Andreas</creatorcontrib><creatorcontrib>Rist, Carsten</creatorcontrib><creatorcontrib>Neumaier, Klement</creatorcontrib><creatorcontrib>Li, Minglun</creatorcontrib><creatorcontrib>Flatz, Wilhelm</creatorcontrib><creatorcontrib>Thierfelder, Kolja</creatorcontrib><creatorcontrib>Notohamiprodjo, Mike</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Radiologia medica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weiss, Jakob</au><au>Pomschar, Andreas</au><au>Rist, Carsten</au><au>Neumaier, Klement</au><au>Li, Minglun</au><au>Flatz, Wilhelm</au><au>Thierfelder, Kolja</au><au>Notohamiprodjo, Mike</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feasibility of optimized ultralow-dose pulsed fluoroscopy for upper gastrointestinal tract examinations: a phantom study with clinical correlation</atitle><jtitle>Radiologia medica</jtitle><stitle>Radiol med</stitle><addtitle>Radiol Med</addtitle><date>2017-11-01</date><risdate>2017</risdate><volume>122</volume><issue>11</issue><spage>822</spage><epage>828</epage><pages>822-828</pages><issn>0033-8362</issn><eissn>1826-6983</eissn><abstract>Purpose
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.
Materials and methods
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.
Results
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 × 10
−3
vs. DR 0.11;
p
= 0.02) and gonadal dose exposure (female FP 2.4 × 10
−3
vs. DR 0.05; male FP 8 × 10
−4
vs. DR 0.03;
p
≤ 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).
Conclusion
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.</abstract><cop>Milan</cop><pub>Springer Milan</pub><pmid>28733918</pmid><doi>10.1007/s11547-017-0793-z</doi><tpages>7</tpages></addata></record> |
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| ispartof | Radiologia medica, 2017-11, Vol.122 (11), p.822-828 |
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| language | eng |
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| source | Springer Nature |
| subjects | Abdominal Radiology Correlation analysis Diagnostic Radiology Diagnostic systems Dosimeters Feasibility Fluoroscopy Image acquisition Image contrast Image quality Imaging Interventional Radiology Medicine Medicine & Public Health Neuroradiology Patients Quality Radiation dosage Radiology Reduction Ultrasound |
| title | Feasibility of optimized ultralow-dose pulsed fluoroscopy for upper gastrointestinal tract examinations: a phantom study with clinical correlation |
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