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CARE Right

“Committed to ALARA“ VS. “Admitting to guesswork” – Second best is not an option.

Clinical Examples: Scanning with the Right Dose

CARE Right aims at finding the right dose for every individual patient. What matters is the right balance between image quality and radiation dose. All of CARE Right’s individual areas – right dose technology, right dose levels, and right dose management – come together in the following examples.

CARE Right. Committed to the right dose in CT.


Clinical cases:

Diagnosis: Coarctation of the aorta
(Image: Shandong Medical Imaging Research Institute / Shandong, P. R. China)


Used Iterative Reconstruction Method: SAFIRE

Collimation: 128 x 0.6 mm
Flash scan mode
Scan time: 0.32 s
Scan length: 144 mm
Rotation time: 0.28 s
70 kV, 130 mAs
CTDIvol: 0.37 mGy
DLP: 8 mGy cm
Eff. dose: 0.35 mSv

Diagnosis: A re-evaluation CTA using only 20 ml of contrast media confirmed a Stanford B aortic dissection, beginning behind the junction of the left subclavian artery and stretching to just below the diaphragm, with a new partially thrombotic occlusion of the false lumen.
(Image: University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University)

Used Iterative Reconstruction Method: ADMIRE

Collimation: 192 x 0.6 mm
Flash scan mode
Scan time: 0.91 s
Scan length: 673.6 mm
Rotation time: 0.25 s
80 kV, 140 mAs
CTDIvol: 2.09 mGy
DLP: 154.6 mGy cm
Eff. dose 2.3 mSv

 

Diagnosis: The radiologists found the right balance between applied radiation and image quality. As the habitus of the patient is larger than the reference patient, 5.6 mSv was the right effective dose to achieve this balance. CT images showed a cauliflower-like, broad-based soft tissue mass located on the left-posterior wall of the rectum. It measured 25 x 22 mm and was causing luminal narrowing.
(Image: Department of Radiology, Panshi City Hospital, Lilin, P. R. China)

Used Iterative Reconstruction Method: SAFIRE

Collimation: 64 x 0.6 mm
Scan time: 13 s
Scan length: 518 mm
Rotation time: 0.6 s
110 kV, 86 mAs
CTDIvol: 6.36 mGy
DLP: 374.27 mGy cm
Eff. dose: 5.6 mSv

Diagnosis: Septum defect with impact on lung perfusion?
(Image: Erasmus MC - University Medical Center Rotterdam / Rotterdam, the Netherlands)

   

 

Scan method: thorax dual energy scan and flash spiral scan

Thorax dual energy scan:
Collimation: 64 x 0.6 mm
Spatial resolution: 0.30 mm
Scan time: 2 s
Scan length: 118 mm
TI: 0.28 s
80/140 Sn kV, 26/16 mAs
DLP: 18 mGycm
CTDIvol: 1.28 mGy
Eff. dose: 1.58 mSv

Flash spiral scan:
Collimation: 128 x 0.6 mm
Spatial resolution: 0.30 mm
Scan time: 0.29 s
Scan length: 118 mm
TI: 0.28 s
70 kV, 14 mAs
DLP: 3 mGycm
CTDIvol: 0.15 mGy
Eff. dose: 0.26 mSv

Diagnosis: EVAR with persistent aortic endoleak
(Image: Clinique CIMOP Bizet / Paris, France)




Collimation: 128 x 0.6 mm
Spatial resolution: 0.30 mm
Scan time: 3 s
Scan length: 543 mm
TI: 0.28 s
100 kV, 83 mAs
DLP: 190 mGycm
CTDIvol: 3.29 mGy
Eff. dose: 2.85 mSv

Diagnosis: obese patient after cholecystectomy
(Image: C.I.M. Laennec / Cesson Sevigne, France)
 

 

 

Collimation: 64 x 0.6 mm
Spatial resolution: 0.30 mm
Scan time: 10 s
Scan length: 373 mm
TI: 0.5 s
100 kV, 300 mAs
DLP: 529 mGy/cm
CTDIvol: 13.55 mGy
Eff. dose: 7.9 mSv

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