Publication

Systematic Evaluation of Radiation Dose Reduction in CT Studies of Body Packers: Accuracy Down to Submillisievert Levels

Journal Paper/Review - Feb 11, 2016

Units
PubMed
Doi

Citation
Laberke P, Blum S, Wälti S, Fornaro J, Hausmann R, Alkadhi H, Leschka S. Systematic Evaluation of Radiation Dose Reduction in CT Studies of Body Packers: Accuracy Down to Submillisievert Levels. AJR Am J Roentgenol 2016; 206:740-6.
Type
Journal Paper/Review (English)
Journal
AJR Am J Roentgenol 2016; 206
Publication Date
Feb 11, 2016
Issn Electronic
1546-3141
Pages
740-6
Brief description/objective

OBJECTIVE
The objective of this study was to systematically evaluate the accuracy of abdominal CT performed at different radiation dose levels for the detection of body packs in human cadavers, in comparison with the accuracy of abdominal radiography.

MATERIALS AND METHODS
In this study, differing numbers of body packs (range, 0-20) were placed in the alimentary tract of human cadavers and then underwent imaging with abdominal radiography and with CT performed at different radiation dose levels (ranging from the standard abdominal CT dose to the technical minimum dose). Depiction of body packs on abdominal radiographs and on each CT scan was assessed by two independent blinded radiologists, and the accuracy of detection of body packs was calculated. The radiation dose associated with abdominal radiography was measured, and the effective radiation dose associated with CT was estimated.

RESULTS
The mean (± SD) effective radiation dose for abdominal radiography was 1.4 ± 0.3 mSv, whereas the mean effective dose of CT ranged from 0.1 to 9.6 mSv. Interobserver agreement for body pack detection was moderate (κ = 0.51) for abdominal radiography and good (κ = 0.72-0.85) for CT. In a per-body pack analysis, abdominal radiography depicted 42% of the body packs with a sensitivity of 71% and a specificity of 100%. When performed at radiation dose levels of 0.6 mSv or greater, CT correctly detected all body packs. In per-person analysis, the sensitivity and specificity of CT for the correct detection of at least one body pack per cadaver was 100% for all radiation dose levels.

CONCLUSION
CT performed at a dose of 0.6 mSv can be used for the detection of body packs. With a sensitivity and specificity of 100%, CT is superior to abdominal radiography in terms of reliability, associated radiation dose, and accuracy of detection.