Radiation dose management in thoracic CT: an international survey

PURPOSEWe aimed to examine current practice patterns of international thoracic radiologists regarding radiation dose management in adult thoracic computed tomography (CT) examinations. MATERIALS AND METHODSAn electronic questionnaire was sent to 800 members of five thoracic radiology societies in North America, Europe, Asia, and Latin America addressing radiation dose training and education, standard kVp and mAs settings for thoracic CT, dose reduction practices, clinical scenarios, and demographics. RESULTSOf the 800 radiologists, 146 responded to our survey. Nearly half (66/146, 45% [95% confidence interval, 37%–53%]) had no formal training in dose reduction, with “self-study of the literature” being the most common form of training (54/146, 37% [29%–45%]). One hundred and seventeen (80% [74%–87%]) had automatic exposure control, and 76 (65% [56%–74%]) used it in all patients. Notably, most respondents (89% [84%–94%]) used a 120 to 125 kVp standard setting, whereas none used 140 kVp. The most common average dose-length-product (DLP) value was 150 to 249 mGy.cm (75/146, 51% [43%–59%]), and 59% (51%–67%) delivered less than 250 mGy.cm in a 70 kg patient. There was a tendency towards higher DLP values with multidetector-row CT. Age, gender, and pregnancy were associated more with dose reduction than weight and clinical indication. CONCLUSIONEfforts for reducing patient radiation dose are highly prevalent among thoracic radiologists. Areas for improvement include reduction of default tube current settings, reduction of anatomical scan coverage, greater use of automatic exposure control, and eventually, reduction of current reference dose values. Our study emphasizes the need for international guidelines to foster greater conformity in dose reduction by thoracic radiologists

Reversed halo sign in pneumocystis pneumonia: a case report

<p>Abstract</p> <p>Background</p> <p>The reversed halo sign may sometimes be seen in patients with cryptogenic organizing pneumonia, but is rarely associated with other diseases.</p> <p>Case presentation</p> <p>We present a case study of a 32-year-old male patient with acquired immunodeficiency syndrome, who had previously been treated with chemotherapy for non-Hodgkin's lymphoma. A chest X-ray showed bilateral patchy infiltrates. High-resolution computed tomography revealed the reversed halo sign in both upper lobes. The patient was diagnosed with pneumocystis pneumonia, which was successfully treated with sulfamethoxazole trimethoprim; the reversed halo sign disappeared, leaving cystic lesions. Cases such as this one are rare, but show that the reversed halo sign may occur in patients who do not have cryptogenic organizing pneumonia.</p> <p>Conclusion</p> <p>Physicians can avoid making an incorrect diagnosis and prescribing the wrong treatment by carefully evaluating all clinical criteria rather than assuming that the reversed halo sign only occurs with cryptogenic organizing pneumonia.</p

Expert opinion: quantitative computed tomography anaylysis of chronic obstructive pulmonary disease

info:eu-repo/semantics/publishe

Congenital Absence of the Right Upper Lobe Bronchus With Double Segmental Tracheal Bronchi

A multidisciplinary approach revealed an absent right upper lobe bronchus and atretic bronchioles in a child with recurrent pulmonary infections. Use of a multidimensional computed tomographic scan and bronchoscopy clearly delineated the anatomical aberration. The child underwent an uncomplicated right upper anterior segmentectomy with an expedient recovery