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Radiation exposure during computerized tomography-based neuroimaging for acute ischemic stroke: a case-control study.

Subhash C Kapur1, Jeevesh Kapur1, Vijay K Sharma2,3

  • 1Department of Diagnostic Imaging, National University Health System, 119228 Singapore, Singapore.

Journal of Integrative Neuroscience
|October 14, 2021
PubMed
Summary

This study shows that low-dose computerized tomography (CT) protocols significantly reduce radiation exposure for acute ischemic stroke patients. These lower-dose CT scans maintain diagnostic image quality while minimizing risks to sensitive organs.

Keywords:
Acute ischemic strokeComputerized tomographyNeuroimagingRadiationRadiation dose

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Area of Science:

  • Radiology
  • Medical Imaging
  • Radiation Oncology

Background:

  • Patient and clinician concerns regarding radiation exposure from computerized tomography (CT) imaging are common.
  • Standard CT protocols for acute ischemic stroke involve multiple imaging sequences, potentially increasing cumulative radiation dose.
  • Evaluating the impact of reduced radiation doses on image quality is crucial for clinical adoption.

Purpose of the Study:

  • To assess and compare radiation exposure from standard and low-dose CT protocols for acute ischemic stroke imaging.
  • To evaluate the effect of dose reduction on image quality in non-contrast CT, CT angiography, and CT perfusion scans.
  • To quantify radiation dose to radiosensitive organs during these neuroimaging procedures.

Main Methods:

  • Retrospective analysis of CT imaging data from acute ischemic stroke patients (n=391) performed in 2015.
  • Extraction of dose metrics including volume-weighted CT dose index, dose-length product, effective dose, and whole-body integral dose for brain, skin, eye, thyroid, and red bone marrow from dose-tracking software.
  • Comparison of radiation dose metrics between standard-dose and low-dose CT protocols.

Main Results:

  • The complete standard-dose stroke imaging protocol (non-contrast CT + CT angiography + CT perfusion) resulted in an effective dose of 11.48 mSv.
  • The low-dose protocol reduced the effective dose to 6.13 mSv, a 46.6% decrease (p < 0.001).
  • Reduced radiation exposure was observed for other radiosensitive organs, with no appreciable deterioration in image quality.

Conclusions:

  • Standard neuroimaging protocols for acute ischemic stroke deliver radiation doses to sensitive organs within acceptable limits.
  • Low-dose CT imaging protocols offer a significant reduction in radiation exposure for acute ischemic stroke patients.
  • Implementing low-dose CT protocols can decrease radiation burden without compromising essential diagnostic image quality.