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Automated patient centering of computed tomography images and its implementation to evaluate clinical practices in three hospitals in Indonesia. POLISH JOURNAL OF MEDICAL PHYSICS AND ENGINEERING 2022. [DOI: 10.2478/pjmpe-2022-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Purpose: This study aims to develop a software tool for investigating patient centering profiles of axial CT images and to implement it to evaluate practices in three hospitals in Indonesia.
Methods: The evaluation of patient centering accuracy was conducted by comparing the center coordinate of the patient’s image to the center coordinates of the axial CT image. This process was iterated for all slices to yield an average patient mis-centering in both the x- and y-axis. We implemented the software to evaluate the profile of centering on 268 patient images from the head, thorax, and abdomen examinations taken from three hospitals.
Results: We found that 82% of patients were mis-centered in the y-axis (i.e., placed more than 5 mm from the iso-center), with 49% of patients placed 10–35 mm from the iso-center. Most of the patients had a tendency to be placed below the iso-centers. In head examinations, patients were more precisely positioned than in the other examinations. We did not find any significant difference in mis-centering between males and females. We found that there was a slight difference between mis-centering in adult and pediatric patients.
Conclusion: Software for automated patient centering was successfully developed. Patients in three hospitals in Indonesia had a tendency to be placed under the iso-center of the gantry.
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Effective dose for kidney-ureter-bladder plain radiography, intravenous urography, and abdominal computed tomography scan: A phantom study. Appl Radiat Isot 2022; 187:110339. [DOI: 10.1016/j.apradiso.2022.110339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 05/07/2022] [Accepted: 06/17/2022] [Indexed: 11/21/2022]
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Albricker ACL, Freire CMV, Santos SND, Alcantara MLD, Saleh MH, Cantisano AL, Teodoro JAR, Porto CLL, Amaral SID, Veloso OCG, Petisco ACGP, Barros FS, Barros MVLD, Souza AJD, Sobreira ML, Miranda RBD, Moraes DD, Verrastro CGY, Mançano AD, Lima RDSL, Muglia VF, Matushita CS, Lopes RW, Coutinho AMN, Pianta DB, Santos AASMDD, Naves BDL, Vieira MLC, Rochitte CE. Diretriz Conjunta sobre Tromboembolismo Venoso – 2022. Arq Bras Cardiol 2022; 118:797-857. [PMID: 35508060 PMCID: PMC9007000 DOI: 10.36660/abc.20220213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Lu MY, Ting CY, Jao JC. Effective dose and radiation risk under 640-slice abdominal computed tomography examination without contrast medium injection. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2022; 30:657-666. [PMID: 35367977 DOI: 10.3233/xst-211101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Medical imaging plays a crucial role in modern medicine. In order to provide fast and accurate medical diagnosis, computed tomography (CT) is a commonly used tool in radiological examinations, and 640-slice CT is the most advanced CT imaging modality. OBJECTIVE To evaluate the radiation dose and the risk under 640-slice abdominal CT examination. METHODS Examinations were performed using a 640-slice CT scanner on an Alderson-Rando anthropomorphic phantom. The used scanning acquisition parameters were the same as those used on abdominal examination without contrast medium injection in clinical practice. To measure the absorbed doses, optically stimulated luminescence dosimeters (OSLDs) were put into liver, stomach, bladder, gonads, colon, small intestine, bone marrow, and skin. RESULTS According to the 1990 Recommendations of the International Commission on Radiological Protection (ICRP Publication 60), the calculated effective doses received from this examination were 0.90 mSv in males and 0.89 mSv in females. According to the 2007 Recommendations of the International Commission on Radiological Protection (ICRP Publication 103), the calculated effective dose received from this examination was 0.83 mSv in both sexes. CONCLUSIONS Radiation doses obtained from the abdominal 640-slice CT examination are lower than the yearly cumulative doses received from natural radiation, revealing there is no deterministic effect and radiation risk is relatively low; therefore, this CT examination is considered safe.
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Affiliation(s)
- Ming-Yi Lu
- Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
- Division of Radiology and Nuclear Medicine, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan, R.O.C
| | - Chien-Yi Ting
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan, R.O.C
| | - Jo-Chi Jao
- Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
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Hu X, Gou J, Lin W, Zou C, Li W. Size-specific dose estimates of adult, chest computed tomography examinations: Comparison of Chinese and updated 2017 American College of Radiology diagnostic reference levels based on the water-equivalent diameter. PLoS One 2021; 16:e0257294. [PMID: 34516579 PMCID: PMC8437305 DOI: 10.1371/journal.pone.0257294] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 08/28/2021] [Indexed: 11/29/2022] Open
Abstract
Rationale and objectives This study aimed to compare the volume computed tomography dose index (CTDIvol), dose length product (DLP), and size-specific dose estimate (SSDE), with the China and updated 2017 American College of Radiology (ACR) diagnostic reference levels (DRLs) in chest CT examinations of adults based on the water-equivalent diameter (Dw). Materials and methods All chest CT examinations conducted without contrast administration from January 2020 to July 2020 were retrospectively included in this study. The Dw and SSDE of all examinations were calculated automatically by “teamplay”. The CTDIvol and DLP were displayed on the DICOM-structured dose report in the console based on a 32cm phantom.The differences in patient CTDIvol, DLP, and SSDE values between groups were examined by the one-way ANOVA. The differences in patient CTDIvol, DLP, and SSDE values between the updated 2017 ACR and the China DRLs were examined with one sample t-tests. Results In total 14666 chest examinations were conducted in our study. Patients were divided into four groups based on Dw:270 (1.84%) in 15–20 cm group, 10287 (70.14%) in the 21–25 cm group, 4097 (27.94%) in the 26–30 cm group, and 12 (0.08%) patients had sizes larger than 30 cm. CTDIvol, DLP, and SSDE increased as a function of Dw (p<0.05). CTDIvol was smaller than SSDE among groups (p<0.05). The mean CTDIvol and DLP values were lower than the 25th, 50th, and 75th percentile of the China DRLs (p <0.05). The CTDIvol, DLP, and SSDE were lower than the 50th and 75th percentiles of the updated 2017 ACR DRLs (p <0.05) among groups. Conclusions SSDE takes into account the influence of the scanning parameters, patient size, and X-ray attenuation on the radiation dose, which can give a more realistic estimate of radiation exposure dose for patients undergoing CT examinations. Establishing hospital’s own DRL according to CTDIvol and SSDE is very important even though the radiation dose is lower than the national DRLs.
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Affiliation(s)
- Xiaoyan Hu
- Department of Radiology, Chengdu First People’s Hospital, Chengdu, Sichuan Province, China
| | - Jie Gou
- Department of Radiology, Chengdu First People’s Hospital, Chengdu, Sichuan Province, China
| | - Wei Lin
- Department of Radiology, Chengdu First People’s Hospital, Chengdu, Sichuan Province, China
| | - Chunhua Zou
- Department of Radiology, Chengdu First People’s Hospital, Chengdu, Sichuan Province, China
| | - Wenbo Li
- Department of Radiology, Chengdu First People’s Hospital, Chengdu, Sichuan Province, China
- * E-mail:
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Muhammad N, Sabarudin A, Ismail N, Karim M. A systematic review and meta-analysis of radiation dose exposure from computed tomography examination of thorax-abdomen-pelvic regions among paediatric population. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2020.109148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Aldosari S, Sun Z. A Systematic Review of Double Low-dose CT Pulmonary Angiography in Pulmonary Embolism. Curr Med Imaging 2020; 15:453-460. [PMID: 32008552 DOI: 10.2174/1573405614666180813120619] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 07/20/2018] [Accepted: 07/31/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aim of this study is to perform a systematic review of the feasibility and clinical application of double low-dose CT pulmonary angiography (CTPA) in the diagnosis of patients with suspected pulmonary embolism. DISCUSSION A total of 13 studies were found to meet selection criteria reporting both low radiation dose (70 or 80 kVp versus 100 or 120 kVp) and low contrast medium dose CTPA protocols. Lowdose CTPA resulted in radiation dose reduction from 29.6% to 87.5% in 12 studies (range: 0.4 to 23.5 mSv), while in one study, radiation dose was increased in the dual-energy CT group when compared to the standard 120 kVp group. CTPA with use of low contrast medium volume (range: 20 to 75 ml) was compared to standard CTPA (range: 50 to 101 ml) in 12 studies with reduction between 25 and 67%, while in the remaining study, low iodine concentration was used with 23% dose reduction achieved. Quantitative assessment of image quality (in terms of signal-to-noise ratio and contrast-to-noise ratio) showed that low-dose CTPA was associated with higher, lower and no change in image quality in 3, 3 and 6 studies, respectively when compared to the standard CTPA protocol. The subjective assessment indicated similar image quality in 11 studies between low-dose and standard CTPA groups, and improved image quality in 1 study with low-dose CTPA. CONCLUSION This review shows that double low-dose CTPA is feasible in the diagnosis of pulmonary embolism with significant reductions in both radiation and contrast medium doses, without compromising diagnostic image quality.
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Affiliation(s)
- Sultan Aldosari
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Australia
| | - Zhonghua Sun
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Australia
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Bajc M, Schümichen C, Grüning T, Lindqvist A, Le Roux PY, Alatri A, Bauer RW, Dilic M, Neilly B, Verberne HJ, Delgado Bolton RC, Jonson B. EANM guideline for ventilation/perfusion single-photon emission computed tomography (SPECT) for diagnosis of pulmonary embolism and beyond. Eur J Nucl Med Mol Imaging 2019; 46:2429-2451. [PMID: 31410539 PMCID: PMC6813289 DOI: 10.1007/s00259-019-04450-0] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/17/2019] [Indexed: 12/18/2022]
Abstract
These guidelines update the previous EANM 2009 guidelines on the diagnosis of pulmonary embolism (PE). Relevant new aspects are related to (a) quantification of PE and other ventilation/perfusion defects; (b) follow-up of patients with PE; (c) chronic PE; and (d) description of additional pulmonary physiological changes leading to diagnoses of left ventricular heart failure (HF), chronic obstructive pulmonary disease (COPD) and pneumonia. The diagnosis of PE should be reported when a mismatch of one segment or two subsegments is found. For ventilation, Technegas or krypton gas is preferred over diethylene triamine pentaacetic acid (DTPA) in patients with COPD. Tomographic imaging with V/PSPECT has higher sensitivity and specificity for PE compared with planar imaging. Absence of contraindications makes V/PSPECT an essential method for the diagnosis of PE. When V/PSPECT is combined with a low-dose CT, the specificity of the test can be further improved, especially in patients with other lung diseases. Pitfalls in V/PSPECT interpretation are discussed. In conclusion, V/PSPECT is strongly recommended as it accurately establishes the diagnosis of PE even in the presence of diseases like COPD, HF and pneumonia and has no contraindications.
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Affiliation(s)
- Marika Bajc
- Department of Clinical Sciences, Clinical Physiology and Nuclear Medicine, University of Lund, Lund, Sweden.
| | - Carl Schümichen
- University of Rostock, Formerly Clinic for Nuclear Medicine, Rostock, Germany
| | - Thomas Grüning
- Department of Nuclear Medicine, University Hospitals Plymouth, Plymouth, UK
| | - Ari Lindqvist
- Research Unit of Pulmonary Diseases, Clinical Research Institute, HUS Helsinki University Hospital, Helsinki, Finland
| | | | - Adriano Alatri
- Division of Angiology, Heart and Vessel Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Ralf W Bauer
- RNS Gemeinschaftspraxis, Wiesbaden, Germany
- Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt (Main), Frankfurt, Germany
| | - Mirza Dilic
- Clinic of Heart and Blood Vessel Disease, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Brian Neilly
- Department of Nuclear Medicine, Royal Infirmary, Glasgow, UK
| | - Hein J Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Roberto C Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), Logroño, La Rioja, Spain
| | - Bjorn Jonson
- Department of Clinical Sciences, Clinical Physiology and Nuclear Medicine, University of Lund, Lund, Sweden
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Karim MKA, Sabarudin A, Muhammad NA, Ng KH. A comparative study of radiation doses between phantom and patients via CT angiography of the intra-/extra-cranial, pulmonary, and abdominal/pelvic arteries. Radiol Phys Technol 2019; 12:374-381. [PMID: 31468370 DOI: 10.1007/s12194-019-00532-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 08/09/2019] [Accepted: 08/10/2019] [Indexed: 10/26/2022]
Abstract
This study aimed to evaluate effective dose and size-specific dose estimate (SSDE) of computed tomography angiography (CTA) examination using an anthropomorphic phantom. We included three CTA examination protocols to evaluate the intra- and extra-cranial arteries, pulmonary artery (CTPA), and abdominal vessels. Patient SSDEs were measured retrospectively to estimate patient dose, relative to the bodyweight of the patient and volume CT dose index (CTDIvol). Our findings revealed that the highest dose was absorbed by the left lobe of the thyroid gland during intra-/extra-cranial CTA and CTPA, that is, 14.11 ± 0.24 mGy and 16.20 ± 3.95 mGy, respectively. However, the highest absorbed dose in abdominal/pelvic CTA was the gonads (8.98 ± 0.30 mGy), while other radiosensitive organs in intra- and extra-cranial CTA, CTPA, and abdominal/pelvic CTA did not demonstrate significant differences between organs/structures with p value 0.88, 0.11, and 0.54, respectively. The estimated effective dose in intra-/extra-cranial CTA was lower in patients (0.80 ± 0.60 mSv) than in the phantom (0.83 mSv), but it was the opposite for CTPA, with the effective dose being higher in patients (7.54 ± 3.09 mSv) than in the phantom (6.68 mSv). Similar to the effective dose, only CTPA SSDEs were significantly higher in men than in women (19.74 ± 4.79 mGy versus 7.9 mGy). Effective dose and SSDE are clinically relevant parameters that can help estimate a more accurate patient dose based on a patient's size.
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Affiliation(s)
- M K A Karim
- Department of Physics, Faculty of Science, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
| | - A Sabarudin
- Programme of Diagnostic Imaging and Radiotherapy, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
| | - N A Muhammad
- Department of Physics, Faculty of Science, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - K H Ng
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
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Gharbi S, Labidi S, Mars M, Chelli M, Meftah S, Ladeb MF. Assessment of organ dose and image quality in head and chest CT examinations: a phantom study. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2018; 38:807-818. [PMID: 29869615 DOI: 10.1088/1361-6498/aac336] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The purpose of this study is to assess dose for radiosensitive organs and image quality in head and chest computed tomography (CT) examinations. Our focus was in the brain, eye lens and lung organs using two protocols; one protocol with fixed mAs and filtered back projection (FBP) and another with tube current modulation (TCM) and sinogram affirmed iterative reconstruction (SAFIRE). Measurements were performed on a 128-slice CT scanner by placing thermoluminescent dosimeters (TLDs) in an anthropomorphic adult phantom. Results were compared to a CT-Expo software. Objective image quality was assessed in terms of signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). SPSS software was used for data analyses. Results showed that, using TCM, doses were reduced by 22.84%-25.06% for brain, by 21.82%-23.48% for eye lens and by 54%-53.22% for lung with TLD and CT-Expo respectively. The increased SNR and CNR values achieved for scans performed with TCM combined with iterative reconstruction techniques were 38.68%-58.81% and 38.91%-43.60% respectively. We conclude that, using TCM, a significant mean organ dose reduction is achieved for brain, eye lens and lung organs. Then, combined with iterative reconstruction, image quality was well maintained in terms of SNR and CNR. Thus it is highly recommended in clinical practice optimization in head and chest CT examinations.
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Affiliation(s)
- S Gharbi
- Université Tunis EL Manar, Institut Supérieur des Technologies Médicales de Tunis, Laboratoire de recherche de Biophysique et de Technologies Médicales, 9, Avenue du Docteur Z. Essafi, Tunis 1006, Tunisia
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Safiullah S, Patel R, Uribe B, Spradling K, Lall C, Zhang L, Okhunov Z, Clayman RV, Landman J. Prevalence of Protective Shielding Utilization for Radiation Dose Reduction in Adult Patients Undergoing Body Scanning Using Computed Tomography. J Endourol 2017; 31:985-990. [PMID: 28719979 DOI: 10.1089/end.2017.0294] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Ionizing radiation is implicated in nearly 2% of malignancies in the United States; radiation shields prevent unnecessary radiation exposure during medical imaging. Contemporary radiation shield utilization for adult patients in the United States is poorly defined. Therefore, we evaluated the prevalence of protective shielding utilization in adult patients undergoing CT scans in United States' hospitals. MATERIALS AND METHODS An online survey was sent to established radiology departments randomly selected from the 2015 American Hospital Association Guide. Radiology departments conducting adult CT imaging were eligible; among 370 eligible departments, 215 departments accepted the study participation request. Questions focused on shielding practices during CT imaging of the eyes, thyroid, breasts, and gonads. Prevalence data were stratified per hospital location, size, and type. Main outcomes included overall protective shielding utilization, respondents' belief and knowledge regarding radiation safety, and organ-specific shielding prevalence. RESULTS Sixty-seven of 215 (31%) hospitals completed the survey; 66 (99%) reported familiarity with the ALARA (as low as reasonably achievable) principle and 56 (84%) affirmed their belief that shielding is beneficial. Only 60% of hospitals employed shielding during CT imaging; among these institutions, shielding varied based on CT study: abdominopelvic CT (13, 33%), head CT (33, 83%), or chest CT (30, 75%). CONCLUSIONS Among surveyed hospitals, 40% do not utilize CT shielding despite the majority acknowledging the ALARA principle and agreeing that shielding is a beneficial practice. Failure to address the low prevalence of protective shielding may lead to poor community health due to increased risk of radiation-related cancers.
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Affiliation(s)
- Shoaib Safiullah
- 1 Department of Urology, University of California , Irvine, Orange, California.,2 Division of Urology, University of Missouri , Columbia, Missouri
| | - Roshan Patel
- 1 Department of Urology, University of California , Irvine, Orange, California
| | - Brittany Uribe
- 1 Department of Urology, University of California , Irvine, Orange, California
| | - Kyle Spradling
- 1 Department of Urology, University of California , Irvine, Orange, California
| | - Chandana Lall
- 3 Department of Radiology, University of California , Irvine, Orange, California
| | - Lishi Zhang
- 4 Institute for Clinical and Translational Science, University of California , Irvine, Irvine, California
| | - Zhamshid Okhunov
- 1 Department of Urology, University of California , Irvine, Orange, California
| | - Ralph V Clayman
- 1 Department of Urology, University of California , Irvine, Orange, California
| | - Jaime Landman
- 1 Department of Urology, University of California , Irvine, Orange, California.,3 Department of Radiology, University of California , Irvine, Orange, California
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Evaluation of organ doses and specific k effective dose of 64-slice CT thorax examination using an adult anthropomorphic phantom. Radiat Phys Chem Oxf Engl 1993 2016. [DOI: 10.1016/j.radphyschem.2016.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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