Dose optimisation of double-contrast barium enema examinations

• Published in: Radiation protection dosimetry 2010-04, Vol.139 (1-3), p.388-392
• Main Authors: Berner, K., Båth, M., Jonasson, P., Cappelen-Smith, J., Fogelstam, P., Söderberg, J.
• Format: Article
• Language: English
• Subjects: Barium Sulfate - administration & dosage; Colon - diagnostic imaging; Colonography, Computed Tomographic - instrumentation; Colonography, Computed Tomographic - methods; Contrast Media; Dose-Response Relationship, Drug; Enema - methods; Humans; Phantoms, Imaging; Radiographic Image Enhancement - methods; Radiologi och bildbehandling; Radiology, Nuclear Medicine and Medical Imaging; Reproducibility of Results; Sensitivity and Specificity
• ISSN: 0144-8420; 1742-3406; 1742-3406
• DOI: 10.1093/rpd/ncq093

The purpose of the present work was to optimise the filtration and dose setting for double-contrast barium enema examinations using a Philips MultiDiagnost Eleva FD system. A phantom study was performed prior to a patient study. A CDRAD phantom was used in a study where copper and aluminium filtration, different detector doses and tube potentials were examined. The image quality was evaluated using the software CDRAD Analyser and the phantom dose was determined using the Monte Carlo-based software PCXMC. The original setting [100 % detector dose (660 nGy air kerma) and a total filtration of 3.5 mm Al, at 81 kVp] and two other settings identified by the phantom study (100 % detector dose and additional filtration of 1 mm Al and 0.2 mm Cu as well as 80 % detector dose and added filtration of 1 mm Al and 0.2 mm Cu) were included in the patient study. The patient study included 60 patients and up to 8 images from each patient. Six radiologists performed a visual grading characteristics study to evaluate the image quality. A four-step scale was used to judge the fulfilment of three image quality criteria. No overall statistical significant difference in image quality was found between the three settings (P > 0.05). The decrease in the effective dose for the settings in the patient study was 15 % when filtration was added and 34 % when both filtrartions was added and detector dose was reduced. The study indicates that additional filtration of 1 mm Al and 0.2 mm Cu and a decrease in detector dose by 20 % from the original setting can be used in colon examinations with Philips MultiDiagnost Eleva FD to reduce the patient dose by 30 % without significantly affecting the image quality. For 20 exposures, this corresponds to a decrease in the effective dose from 1.6 to 1.1 mSv.