Scanning beyond anatomic limits of the thorax in chest CT: Findings, radiation dose, and automatic tube current modulation

Justin Campbell, Mannudeep K. Kalra, Stefania Rizzo, Michael M. Maher, Jo Anne Shepard

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. Our objective was to determine additional radiation dose associated with scanning beyond the anatomic limits of the thorax in chest CT protocol and to assess the effect of z-axis modulation on the additional radiation dose associated with the scanning protocol. MATERIALS AND METHODS. "Extra" images for routine chest CT were defined as those above lung apices (supraapical) and those caudal to the lowermost portion of lung parenchyma (infrapulmonary), including images obtained beyond the adrenal glands (infraadrenal). One hundred and forty-eight consecutive chest CT examinations (70 men, 78 women; age range, 15-90 years) performed September 13-25,2003, were reviewed to determine the number of supraapical, infrapulmonary, and infraadrenal extra images. All examinations were performed using z-axis modulation (n = 70) or fixed tube current (n = 78). The CT dose index volume and dose-length product (DLP) values for the extra images were calculated. Two radiologists reviewed these extra images for pathologic findings. Student's t test was used to perform the statistical analysis. RESULTS. One hundred forty-four (97%) examinations had supraapical extra images and 145 (98%) had infrapulmonary extra images. A total of 31 additional findings were observed in extra images. Most clinically important findings were identified in patients with a history of malignancy. With z-axis modulation, the mean DLP for supraapical and infrapulmonary extra images was 39.98 mGy-cm and 132.59 mGy-cm, respectively. With fixed tube current, the mean DLP for supraapical and infrapulmonary extra images was 30.31 mGy-cm and 95.91 mGy-cm, respectively. CONCLUSION. A substantial number of extra images are acquired during chest CT that do not add clinically important information in patients with nonmalignant indications. The use of z-axis modulation increased radiation dose for the extra images.

Original languageEnglish
Pages (from-to)1525-1530
Number of pages6
JournalAmerican Journal of Roentgenology
Volume185
Issue number6
DOIs
Publication statusPublished - 2005

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Thorax
Radiation
Lung
Adrenal Glands
Students
Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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Scanning beyond anatomic limits of the thorax in chest CT : Findings, radiation dose, and automatic tube current modulation. / Campbell, Justin; Kalra, Mannudeep K.; Rizzo, Stefania; Maher, Michael M.; Shepard, Jo Anne.

In: American Journal of Roentgenology, Vol. 185, No. 6, 2005, p. 1525-1530.

Research output: Contribution to journalArticle

Campbell, Justin ; Kalra, Mannudeep K. ; Rizzo, Stefania ; Maher, Michael M. ; Shepard, Jo Anne. / Scanning beyond anatomic limits of the thorax in chest CT : Findings, radiation dose, and automatic tube current modulation. In: American Journal of Roentgenology. 2005 ; Vol. 185, No. 6. pp. 1525-1530.
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abstract = "OBJECTIVE. Our objective was to determine additional radiation dose associated with scanning beyond the anatomic limits of the thorax in chest CT protocol and to assess the effect of z-axis modulation on the additional radiation dose associated with the scanning protocol. MATERIALS AND METHODS. {"}Extra{"} images for routine chest CT were defined as those above lung apices (supraapical) and those caudal to the lowermost portion of lung parenchyma (infrapulmonary), including images obtained beyond the adrenal glands (infraadrenal). One hundred and forty-eight consecutive chest CT examinations (70 men, 78 women; age range, 15-90 years) performed September 13-25,2003, were reviewed to determine the number of supraapical, infrapulmonary, and infraadrenal extra images. All examinations were performed using z-axis modulation (n = 70) or fixed tube current (n = 78). The CT dose index volume and dose-length product (DLP) values for the extra images were calculated. Two radiologists reviewed these extra images for pathologic findings. Student's t test was used to perform the statistical analysis. RESULTS. One hundred forty-four (97{\%}) examinations had supraapical extra images and 145 (98{\%}) had infrapulmonary extra images. A total of 31 additional findings were observed in extra images. Most clinically important findings were identified in patients with a history of malignancy. With z-axis modulation, the mean DLP for supraapical and infrapulmonary extra images was 39.98 mGy-cm and 132.59 mGy-cm, respectively. With fixed tube current, the mean DLP for supraapical and infrapulmonary extra images was 30.31 mGy-cm and 95.91 mGy-cm, respectively. CONCLUSION. A substantial number of extra images are acquired during chest CT that do not add clinically important information in patients with nonmalignant indications. The use of z-axis modulation increased radiation dose for the extra images.",
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N2 - OBJECTIVE. Our objective was to determine additional radiation dose associated with scanning beyond the anatomic limits of the thorax in chest CT protocol and to assess the effect of z-axis modulation on the additional radiation dose associated with the scanning protocol. MATERIALS AND METHODS. "Extra" images for routine chest CT were defined as those above lung apices (supraapical) and those caudal to the lowermost portion of lung parenchyma (infrapulmonary), including images obtained beyond the adrenal glands (infraadrenal). One hundred and forty-eight consecutive chest CT examinations (70 men, 78 women; age range, 15-90 years) performed September 13-25,2003, were reviewed to determine the number of supraapical, infrapulmonary, and infraadrenal extra images. All examinations were performed using z-axis modulation (n = 70) or fixed tube current (n = 78). The CT dose index volume and dose-length product (DLP) values for the extra images were calculated. Two radiologists reviewed these extra images for pathologic findings. Student's t test was used to perform the statistical analysis. RESULTS. One hundred forty-four (97%) examinations had supraapical extra images and 145 (98%) had infrapulmonary extra images. A total of 31 additional findings were observed in extra images. Most clinically important findings were identified in patients with a history of malignancy. With z-axis modulation, the mean DLP for supraapical and infrapulmonary extra images was 39.98 mGy-cm and 132.59 mGy-cm, respectively. With fixed tube current, the mean DLP for supraapical and infrapulmonary extra images was 30.31 mGy-cm and 95.91 mGy-cm, respectively. CONCLUSION. A substantial number of extra images are acquired during chest CT that do not add clinically important information in patients with nonmalignant indications. The use of z-axis modulation increased radiation dose for the extra images.

AB - OBJECTIVE. Our objective was to determine additional radiation dose associated with scanning beyond the anatomic limits of the thorax in chest CT protocol and to assess the effect of z-axis modulation on the additional radiation dose associated with the scanning protocol. MATERIALS AND METHODS. "Extra" images for routine chest CT were defined as those above lung apices (supraapical) and those caudal to the lowermost portion of lung parenchyma (infrapulmonary), including images obtained beyond the adrenal glands (infraadrenal). One hundred and forty-eight consecutive chest CT examinations (70 men, 78 women; age range, 15-90 years) performed September 13-25,2003, were reviewed to determine the number of supraapical, infrapulmonary, and infraadrenal extra images. All examinations were performed using z-axis modulation (n = 70) or fixed tube current (n = 78). The CT dose index volume and dose-length product (DLP) values for the extra images were calculated. Two radiologists reviewed these extra images for pathologic findings. Student's t test was used to perform the statistical analysis. RESULTS. One hundred forty-four (97%) examinations had supraapical extra images and 145 (98%) had infrapulmonary extra images. A total of 31 additional findings were observed in extra images. Most clinically important findings were identified in patients with a history of malignancy. With z-axis modulation, the mean DLP for supraapical and infrapulmonary extra images was 39.98 mGy-cm and 132.59 mGy-cm, respectively. With fixed tube current, the mean DLP for supraapical and infrapulmonary extra images was 30.31 mGy-cm and 95.91 mGy-cm, respectively. CONCLUSION. A substantial number of extra images are acquired during chest CT that do not add clinically important information in patients with nonmalignant indications. The use of z-axis modulation increased radiation dose for the extra images.

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