CARE Right
Committed to ALARA
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.
Case 1: CT chest angiography pediatrics
SOMATOM Drive
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 | 70 kV, 130 mAs |
| Flash scan mode | CTDIvol: 0.37 mGy |
| Scan time: 0.32 s | DLP: 8 mGy cm |
| Scan length: 144 mm | Eff. dose: 0.35 mSv |
| Rotation time: 0.28 s |
Case 2: CT chest abdomen pelvis angiography
SOMATOM Force
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 | 80 kV, 140 mAs |
| Flash scan mode | CTDIvol: 2.09 mGy |
| Scan time: 0.91 s | DLP: 154.6 mGy cm |
| Scan length: 673.6 mm | Eff. dose: 2.3 mSv |
| Rotation time: 0.25 s |
Case 3: CT abdomen pelvis
SOMATOM Perspective
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 | 110 kV, 86 mAs |
| Scan time: 13 s | CTDIvol: 6.36 mGy |
| Scan length: 518 mm | DLP: 374.27 mGy cm |
| Rotation time: 0.6 s | Eff. dose: 5.6 mSv |
Case 4: Pediatric case
SOMATOM Definition Flash with Stellar detector
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 | 80/140 Sn kV, 26/16 mAs |
| Spatial resolution: 0.30 mm | DLP: 18 mGy cm |
| Scan time: 2 s | CTDIvol: 1.28 mGy |
| Scan length: 118 mm | Eff. dose: 1.58 mSv |
| TI: 0.28 s |
Flash Spiral scan:
| Collimation: 128 x 0.6 mm | 70 kV, 14 mAs |
| Spatial resolution: 0.30 mm | DLP: 3 mGy cm |
| Scan time: 0.29 s | CTDIvol: 0.15 mGy |
| Scan length: 118 mm | Eff. dose: 0.26 mSv |
| TI: 0.28 s |
Case 5: CT abdomen
SOMATOM Definition Edge
Diagnosis: EVAR with persistent aortic endoleak
(Image: Clinique CIMOP Bizet / Paris, France)
| Collimation: 128 x 0.6 mm | 100 kV, 83 mAs |
| Spatial resolution: 0.30 mm | DLP: 190 mGy cm |
| Scan time: 3 s | CTDIvol: 3.29 mGy |
| Scan length: 543 mm | Eff. dose: 2.85 mSv |
| TI: 0.28 s |
Case 6: CT abdomen
SOMATOM Definition AS
Diagnosis: obese patient after cholecystectomy
(Image: C.I.M. Laennec / Cesson Sevigne, France)
| Collimation: 64 x 0.6 mm | 100 kV, 300 mAs |
| Spatial resolution: 0.30 mm | DLP: 529 mGy cm |
| Scan time: 10 s | CTDIvol: 13.55 mGy |
| Scan length: 373 mm | Eff. dose: 7.9 mSv |
| TI: 0.5 s |