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Computed tomography (CT) is a powerful technique providing precise and confident diagnoses. The burgeoning use of CT has resulted in an exponential increase in collective radiation dose to the population. Despite investigations supporting the use of lower radiation doses, surveys highlight the lack of proper understanding of CT parameters that affect radiation dose. Dynamic advances in CT technology also make it important to explain the latest dose-saving strategies in an easy-to-comprehend manner. This book aims to review all aspects of the radiation dose from CT and to provide simple rules and tricks for radiologists and radiographers that will assist in the appropriate use of CT technique. The second edition includes a number of new chapters on the most up-to-date strategies and technologies for radiation dose reduction while updating the outstanding contents of the first edition. Vendor perspectives are included, and an online image gallery will also be available to readers.
This book considers in depth all the factors that influence the radiation dose and the risk associated with MDCT in children and adults. Only a small proportion of referring clinicians, radiologists, and technologists are aware of both the radiation risks and their underlying mechanisms. The book proposes detailed guidelines for optimization of the radiation dose when using MDCT. It is written by experts of international standing.
This open access book focuses on diagnostic and interventional imaging of the chest, breast, heart, and vessels. It consists of a remarkable collection of contributions authored by internationally respected experts, featuring the most recent diagnostic developments and technological advances with a highly didactical approach. The chapters are disease-oriented and cover all the relevant imaging modalities, including standard radiography, CT, nuclear medicine with PET, ultrasound and magnetic resonance imaging, as well as imaging-guided interventions. As such, it presents a comprehensive review of current knowledge on imaging of the heart and chest, as well as thoracic interventions and a selection of "hot topics". The book is intended for radiologists, however, it is also of interest to clinicians in oncology, cardiology, and pulmonology.
Diagnostic reference levels (DRLs) are used in medical imaging to indicate whether the patient radiation dose or amount of administered activity from a specific procedure are unusually high or low for that procedure. DRLs are the first step in the optimization process to manage patient dose commensurate with the medical purpose of the procedure. Achievable dose is an optimization goal, based on survey data, and typically defined as the median value (50th percentile) of the dose distribution of standard techniques and technologies in widespread use. The overarching goal is to obtain image quality consistent with the clinical objective, while avoiding unnecessary radiation. Too low an exposure, however, is also to be avoided if it results in an inadequate image. This Report represents an important continuation of NCRP reports on radiation safety and health protection in medicine and lays the foundation for the development and application of DRLs and achievable doses for diagnostic x-ray examinations. The concept of DRLs is extended to procedures other than diagnostic x-ray examinations (e.g., for interventional radiology) by the use of reference levels (RLs), which represent radiation dose levels that if exceeded prompt an evaluation of the reasons why. This Report discusses the establishment and use of RLs for fluoroscopically-guided interventional (FGI) procedures and describes why a different approach from DRLs is required to account for the greater complexity of interventional radiology compared with standard medical imaging procedures. Phantoms are models of the human body used in radiation dosimetry studies to estimate exposures to patients. The use of phantom survey data in the United States is contrasted with the use of patient-based dose data in Europe for establishing DRLs, achievable doses, and RLs. The use of phantom survey data is reviewed for determining DRLs for imaging modalities such as projection radiography, fluoro
Clinical Medical Imaging Physics: Current and Emerging Practice is the first text of its kind--a comprehensive reference work covering all imaging modalities in use in clinical medicine today. Destined to become a classic in the field, this book provides state-of-practice descriptions for each imaging modality, followed by special sections on new and emerging applications, technologies, and practices. Authored by luminaries in the field of medical physics, this resource is a sophisticated, one-volume handbook to a fast-advancing field that is becoming ever more central to contemporary clinical medicine. Summarizes the current state of clinical medical imaging physics in one volume, with a focus on emerging technologies and applications Provides comprehensive coverage of all key clinical imaging modalities, taking into account the new realities in healthcare practice Features a strong focus on clinical application of principles and technology, now and in the future Contains authoritative text compiled by world-renowned editors and contributors responsible for guiding the development of the field Practicing radiologists and medical physicists will appreciate Clinical Medical Imaging Physics as a peerless everyday reference work. Additionally, graduate students and residents in medical physics and radiology will find this book essential as they study for their board exams.
Multidetector-row computed tomography (MDCT) has become a fundamental imaging technique for the study of many anatomical districts in different clinical situations, as it provides a fast, reliable, and accurate simultaneous evaluation of different organs, including parenchyma, hollow viscera, vessels, and bony structures. It has also equipped the radiologist with the ability to explore areas that in the last decade were largely ignored by CT, especially the coronary arteries and the colon, and to limit invasive diagnostic tests (e.g., catheter angiography) to those cases in which interventional procedures are required. The examination quality and the consequent diagnostic accuracy of MDCT are the results of an optimized study technique, which nonetheless needs to be adapted to the particular clinical situation of the patient, while bearing in mind the radiation exposure. Another fundamental parameter in the optimization of MDCT is the protocol for the intravenous injection of iodinated contrast material; in these studies, multiple variables, some modifiable by the operator and others patient-dependent, must be considered based on the aims of maximizing arterial and venous enhancements whilst minimizing the dose of iodine injected, saving money, and increasing patient safety. Through the presentation of cases addressing different anatomical regions and various clinical indications, including emergency and neuro-imaging, this volume seeks to provide the general radiologist and trainee specialist with a guide to the main study protocols to be implemented in order to optimize examination quality and, consequently, facilitate the diagnostic process.
This book is the seventh in a series of titles from the National Research Council that addresses the effects of exposure to low dose LET (Linear Energy Transfer) ionizing radiation and human health. Updating information previously presented in the 1990 publication, Health Effects of Exposure to Low Levels of Ionizing Radiation: BEIR V, this book draws upon new data in both epidemiologic and experimental research. Ionizing radiation arises from both natural and man-made sources and at very high doses can produce damaging effects in human tissue that can be evident within days after exposure. However, it is the low-dose exposures that are the focus of this book. So-called “late” effects, such as cancer, are produced many years after the initial exposure. This book is among the first of its kind to include detailed risk estimates for cancer incidence in addition to cancer mortality. BEIR VII offers a full review of the available biological, biophysical, and epidemiological literature since the last BEIR report on the subject and develops the most up-to-date and comprehensive risk estimates for cancer and other health effects from exposure to low-level ionizing radiation.
"MDCT: From Protocols to Practice" tackles contemporary and topical issues in MDCT technology and applications. As an updated edition of MDCT: A Practical Approach, this volume offers new content as well as revised chapters from the previous volume. New chapters discuss important topics such as imaging of children and obese subjects, the use of contrast medium in pregnant women, coronary MDCT angiography, and PET/CT in abdominal and pelvic malignancies. Furthermore an Appendix with over 50 updated MDCT scanning protocols completes this publication. The book emphasizes the practical aspects of MDCT, making it an invaluable source of information for radiologists, residents, medical physicists, and radiology technologists in everyday clinical practice.
Though overall cancer incidence and mortality have continued to decline in recent years, cancer continues to devastate the lives of far too many Americans. In 2009 alone, 1.5 million American men, women, and children were diagnosed with cancer, and 562,000 died from the disease. There is a growing body of evidence linking environmental exposures to cancer. The Pres. Cancer Panel dedicated its 2008¿2009 activities to examining the impact of environmental factors on cancer risk. The Panel considered industrial, occupational, and agricultural exposures as well as exposures related to medical practice, military activities, modern lifestyles, and natural sources. This report presents the Panel¿s recommend. to mitigate or eliminate these barriers. Illus.