engleski

Irradiation dose optimisation and reduction in osteoarticular disease

Learning objectives: How to optimise and reduce typical doses delivered during computed tomography (CT) in osteoarticular diseases? Background: CT is an irradiating imaging technique indicated in the evaluation of many osteoarticular diseases, therefore CT dose optimisation and reduction is very important - ALARA (As Low As Reasonably Achievable). Findings and procedure designs: Indications – validity Assessment of: complex fractures and dislocations, especially with compromised blood supply ; calcified or ossified articular bodies ; skeletal dysplasia and malformation ; bone tumor invasion ; artrography or postoperative imaging if other modality is contraindicated or unsatisfactory. Justification and substitution Substitution by non-irradiating imaging techniques such as sonography or magnetic resonance imaging (MRI) is often possible and justifiable, especially in children. Technical optimisation With dynamic or perfusion acquisition, the dose should be reduced by limiting the number of acquisition phases and using low-dose protocols. Exact centering of the anatomic zone provides optimum image quality and dose delivered. Positioning of the patient - the peripheral joints should be acquired as far as possible from the patient’s trunk in order to reduce the dose received by radiosensitive organs. Reducing kilovoltage during the examination of peripheral joints. Conclusion: Optimisation of the milliamps and kilovoltage, the limitation in the coverage of CT, substitution by non-irradiating imaging techniques as well as compliance with the indications are still the main ways to limit the doses delivered to patients.

CT; irradiation; dose reduction

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