RSNA Radiation Dose Exhibit Archive

This curated series from the annual meeting of the Radiological Society of North America highlights a selection of education exhibits dealing with radiation safety and patient dose. New exhibits are added monthly.

September 8, 2017 — Organ-based Tube-current Modulation Applied on Different MDCT Scanners: Reduction in the Radiation Dose to the Eye Lens at Head CT (from RSNA 2016)
Organ-based tube current modulation (OB-TCM) reduces the radiation dose to the lens of the eye during head CT by decreasing tube current when the x-ray tube passes over the anterior surface of the organ. CT scanners from three different manufactures with the OB-TCM feature are examined in this exhibit.
N. Kitera, C. Fujioka, K. Yokomachi, M. Kiguchi, E. Nishimaru, K. Awai 

August 14, 2017 — A Comprehensive Approach to Managing Patient Radiation Exposure in Nuclear Medicine Gamma Camera Imaging: Combining Expert-based Guidelines with Practical and Efficacious Gamma Camera Technique to Lower Radiopharmaceutical Administered Activity (from RSNA 2016)
This exhibit offers strategies for optimizing necessary nuclear radiography examinations. It offers information on the use of appropriateness criteria, society guidelines and accreditation, and optimizing techniques for choosing radiopharmaceutical dose along with gamma camera technique.
D. Eckstein, S. Shah, D. Muenzel, M. Becker 

July 13, 2017 — Emerging Concepts on Oral Contrast Media for CT (from RSNA 2016)
This exhibit reviews the current utilization of the different oral contrast media (OCM) in diverse clinical settings. The authors describe new CT technologies and their impact on OCM, discuss strategies for optimizing use of OCM when using the new technologies, and examine alternative contrast media in abdominal CT.
M. Patino, A. Parakh, D. Muenzel, D. Murcia, A. Kambadakone, D. Sahani 

June 23, 2017 — Potential Exposure Dose Reductions in Digital Breast Tomosynthesis and Synthetically Reconstructed Digital Mammogram: Selection of Appropriate Reconstruction Technique (from RSNA 2016)
This exhibit reviews filtered back projection (FBP), the iterative reconstruction (IR) technique [maximum likelihood expectation maximization (MLEM) and simultaneous iterative reconstruction technique (SIRT)], and synthetically reconstructed digital mammograms (SDM) to evaluate and compare the characteristics of reconstructed digital breast tomosynthesis (DBT) images.
Authors: T. Gomi, K. Fujita, M. Goto, Y. Watanabe, T. Umeda, A. Okawa, T. Takeda 

May 5, 2017 — Radiation Safety in the Fluoroscopy Suite: History, Current Devices, Future Developments, and Controversies (from RSNA 2016)
Many radiation protection devices, such as newer lightweight aprons and slim fitted leaded glasses, may fit and look better, but may not offer the same degree of protection as some of their counterparts. As new data emerges regarding how much radiation exposure is too much, radiologists must be aware of risks to eyes, brain, and other critical structures so that they can take appropriate measures to maximize safety and mitigate risks.
Authors: D. Szaflarski, E. Coronel, F. Khan, A. Ahluwalia, D. Gregorius, J. Hoffmann 

Apr. 26, 2017 — From CTDIvol and DLP to SSDE and ICRP 103: CT Radiation Dose Measurement and Reporting Simplified (from RSNA 2016)
The exhibit’s authors present various methods of dose estimation and reporting in a simple way that is easy to grasp and relevant to the practicing radiologist.
Authors: J. Starkey, Y. Kurihara 

Apr. 14, 2017 — A Comprehensive CT Radiation Dose Reduction and Protocol Standardization Program in a Complex Tertiary Hospital System (from RSNA 2016) 
The Joint Commission requires the radiation dose of every CT exam to be recorded with investigation of cases where radiation dose exceeded established reference levels. The authors present their experience in instituting a radiation dose reduction program in a large complex health system using a novel web-based information distribution system and iterative process of lowest common denominator using phantom and clinical test cases prior to implementation. 
P. Rajiah, J. Guild, T. Browning, S. Toomay, V. Venkataraman, O.K. Oz, A. Whittemore, L. Ananthakrishnan, A. Chhabra, S Kalva, S. Abbara

Mar. 27, 2017 — Whole Body CT Protocol for Trauma: Review of Arm Positioning with Emphasis on Image Quality and Radiation Dose (from RSNA 2016) 
The authors review the influence of different arm positioning on image quality and radiation dose at whole-body CT for trauma and discuss optimal strategies to minimize beam hardening artifacts and reduce radiation dose when a patient’s arm cannot be moved up. 
A.A. Lemos, R. Brambilla, V. R. Tatko, M.C. Firetto, L. Gentile, C. Sorge, P. Biondetti

Dec. 12, 2016 — Dual Energy Computed Tomography in Post-(T)EVAR Patients: Advantages of the Virtual Non-contrast CT and the Iodine Overlay Measurements
This presentation illustrates how Dual Energy CT (DECT) works, how to assess the quality of the virtual non-contrast CT image (VNC) obtained with DECT scanning compared to single energy CT, how to assess and quantify the iodine overlay technique in post-(T)EVAR patients with or without endoleak, and how to assess the radiation dose in DECT scans.
L. Maaskant, J. Florie, M. L. Dijkshoorn, R. Booij, G. P. Krestin, M. Ouhlous

Nov. 7, 2016 — Management for Occupational Radiation Dose of Medical Workers
This presentation illustrates the need for radiation protection and management in occupational exposure, especially protection of the lens of the eye. It discusses the annual occupational dose among physicians, nurses, and technologists in intervention procedures (IRs) and clarifies the current occupational radiation dose to medical staff in Japan.
K. Chida, Y. Inaba, M. Nemoto, C. Hoshi, Y. Morishima, M. Kato, M. Zuguchi

Sep. 19, 2016 — Picking the Best Energy Level in CT Imaging: What the Radiologist Needs to Know
This presentation illustrates the limitations of using fixed tube voltage at 120kVp or 140kVp in CT imaging along with the advantages of using optimal photon energy (low kVp or dual energy CT (DECT) in CT imaging3), and demonstrates strategies of selecting the optimal photon energy based on patient size and clinical tasks.
J. Li 

Aug. 22, 2016 — Oops We Imaged a Pregnant Person: What Happens Next?
This presentation reviews pregnancy screening criteria and situations where pregnancy can be missed; how to estimate risk to the fetus based on exam modality and anatomic region being imaged; and provides a framework for who needs to be notified, who communicates with the patient, and what needs to be communicated to patient.
M. Welnick, M. Hartman, M. Blackwood

Aug. 8, 2016 — Technical Parameters to Optimize Body Imaging in Polytrauma Patients
Technical parameters can have a profound effect on the technical adequacy and diagnostic quality of body CT performed for polytrauma patients. These factors can influence examination speed, study dose, artefact levels, diagnostic accuracy, and interpretation confidence. This presentation highlights radiologist selectable parameters and their influence on image quality.
M. Shah, M. Abbasi, S. Jawad, C. Sayer, R. Greenhalgh, I. Vlahos

Jul. 15, 2016 — Low kV CT Imaging: Using the CT Scanner to its Fullest Potential
The widespread use of multidetector computed tomography (MDCT) scanners has led to an increased radiation exposure of the patients undergoing CT. Lowering the tube voltage (kV) has proven to be an effective means of decreasing the amount of radiation delivered to the patient while improving contrast enhancement, lesion detection, and reducing contrast dose. This exhibit reviews the basic principles and methods employed to reduce kV in routine CT examinations and provide illustrative examples of its clinical applications.
Authors: F. Sodagari, A. Arslanoglu, A. Seyal, N. Hammond, Y. Velichko, V. Yaghmai 

Jun. 30, 2016 — Ultra-low-dose Fetal Computed Tomography (ULDCT) with Model-based Iterative Reconstruction (MBIR): A Prospective Pilot Study
This exhibit reviews methods for decreasing the dose of head CTs used to follow traumatic brain injury by lowering the kV and mAs and using iterative reconstruction to diminish noise and artifacts. It demonstrates that there is no significant difference in the diagnostic quality of the lower dose head CTs with filtered back projected or iterative reconstructed images and reviews other traditional methods for reducing dose to radiosensitive organs such as the eyes and thyroid gland.
Authors: R. Imai, O. Miyazaki, K. Asano, G. Nishimura, H Horiguchi, S Nosaka 

Jun. 13, 2016 — Low Dose Techniques for Traumatic Brain Injury
This exhibit reviews methods for decreasing the dose of head CTs used to follow traumatic brain injury by lowering the kV and mAs and using iterative reconstruction to diminish noise and artifacts. It demonstrates that there is no significant difference in the diagnostic quality of the lower dose head CTs with filtered back projected or iterative reconstructed images and reviews other traditional methods for reducing dose to radiosensitive organs such as the eyes and thyroid gland.
Authors: C. Archer-Arroyo, T. Fleiter 

May 31, 2016 — Quality Improvement: Gated Thoraco-Abdominal Aortic CTA Utilizing State-of-the-Art Dual-Source Technology
This exhibit displays how quality improvements in gated studies can be achieved using a state-of-the-art dual-source CT. Technologic advancements now enable faster scanning and additional quality improvements can be achieved with increased HU for improved bolus timing. Safety can be enhanced with a substantial radiation dose reduction.
Authors: G. Chiappone, R. Layman, C. Greulich, J. Aalberg, K. Corrigan, R. White 

Apr. 21, 2016 — Third-Generation Dual-Source DECT (3rd Gen-DECT): Advances and Advantages in Clinical Practice
This exhibit will help the reader understand the latest technical advances for third-generation dual-source CT and learn how these advances can be applied in clinical practice to reduce patient dose. The exhibit includes clinical cases where third-generation dual-source CT has benefited patient care.
Authors: T. Vrtiska, R. Vasconcelos, J. Montoya, T. Macedo, T. Foley, E. Williamson, N. Weber, C. McCollough, J. Fletcher

Apr. 14, 2016 — Computed Tomography Artifacts; Mechanism, Clinical Importance, Reduction Techniques
Artifacts degrade image quality, potentially interfere with diagnosis, and may result in increased radiation exposure to the patient due to repeat examinations. This exhibit provides an overview of the artifacts encountered in CT imaging and explains the basic physics of each type. It discusses the clinical significance of the different CT artifacts and addresses methods to correct them.
Authors: B. Mansoori; M. Chalian; H. Chalian; N. Harris; L. Landeras

Mar. 31, 2016 — Change that Protocol Now! A Real-Time CT Radiation Dose Display for Reading Rooms
Did you know that real-time displays can be used to provide instantaneous feedback about scan radiation dose and quality metrics? They can also be used to monitor patient safety and effect change in CT protocols. Real-time radiation dose displays are a very useful patient and clinician relations tool in busy reading rooms where clinicians frequently visit, such as in ER/trauma radiology reading rooms.
Authors: T. O'Connell; S. Nicolaou; L. Louis; P. McLaughlin; D. Chang; J. Mayo