Systematic Evaluation of Radiation Dose Reduction in CT Studies of Body Packers: Accuracy Down to Submillisievert Levels
abstract
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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.
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citation
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Laberke P J, 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.
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type
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journal paper/review (English)
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date of publishing
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11-02-2016
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journal title
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AJR Am J Roentgenol (206/4)
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ISSN electronic
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1546-3141
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pages
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740-6
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PubMed
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26866340
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DOI
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10.2214/AJR.15.15374
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