“Right Dose Image Contest” – Clinical Imaging in Computed Tomography
SIEMENS – A total of 197 medical practices and clinical institutions from all over the world that use a Siemens Somatom computer tomograph participated in the “Right Dose Image Contest”. In addition to a public vote award, “Right Dose Excellence Awards” were given in the following categories: Trauma, Dual Energy – which allows examination of a body region using two different tube voltages – Cardiology, Vascular, Neurology, Oncology, Pediatric, routine examinations and consistency in dose management.
The winner in the category Cardiology is Ng Jia Jun from the Singapore General Hospital. A 40-year-old female patient presented with a known congenital heart defect (Eisenmenger’s syndrome) suffering from chest pain and breathing difficulties for the previous three days. With the help of a CT scan performed with a Somatom Definition Flash, it was possible to rule out a pulmonary embolism and narrowing of the coronary arteries caused by pulmonary arteries enlarged to a diameter of five centimeters. The radiation dose here was 2.35 millisievert.
In the category Trauma, the award went to Ronald Booij from the Erasmus Medical Center in Rotterdam, Netherlands. A psychiatric patient was brought to the emergency room with a knitting needle inserted into the left eye socket. The end of the needle had entered the cerebellum. Using contrast-enhanced images taken with a Somatom Definition AS scanner, it was possible to rule out an intracranial hemorrhage. The radiation dose used here was 0.63 millisievert.
The winner in the category routine examinations is Tomas Vendis from the University Hospital Pilzen, Czech Republic. The entire abdomen of a 60-year-old female was examined using low dose CT Urography with a Somatom Definition Flash following several unexplained urinary tract infections. A contrast-enhanced examination clearly showed the cause: a diverticulum – i.e. a protrusion – of the lower renal calyces. The applied radiation dose was 0.95 millisievert.
Ermidio Rezzonico from Lugano Regional Hospital, Switzerland, was chosen as the winner in the category Dual Energy, which is CT imaging with two different tube voltages. A young male was suspected of drug smuggling by Swiss customs officers. The suspect was then taken to hospital for a CT scan. With the help of the Dual Energy mode on the Somatom Definition Flash, it was possible to identify clearly 56 drug packages in the man’s stomach and in the small and large intestine. The different energy levels of Dual Energy images facilitate the detection of foreign objects inside the body. An effective dose of 6.4 millisievert was applied.
Zeng Xian-Chun is the winner of the award in the category Neurology. A 59-year-old male patient presented to the First Affiliated Hospital of Kun Ming University with unexplained headaches. Contrast-enhanced CT imaging of the blood vessels clearly showed the cause: hemorrhaging in the brain. In Dual Energy mode and using the Somatom Definition’s two X-ray tubes, an effective dose of 1.53 millisievert was applied.
Li Qingqing, award winner in the category Oncology, is also from the First Affiliated Hospital of Kun Ming University. A contrast-enhanced examination using a Somatom Definition Flash computer tomograph produced a clinical image showing a tumor in the left kidney of a 79-year-old patient. Further examinations confirmed a suspected renal cell carcinoma. An effective dose of 4.8 millisievert was applied.
The winner in the category Vascular is Liu Yong Hua from Huazhong University of Science and Technology Union Hospital in China. A patient was taken to hospital ten hours after a fall with obvious swelling in the soft tissue and restricted movement of the lower left leg. The CT scan performed with a Somatom Definition AS showed calcifications in the bilateral common iliac arteries, especially on the left side. Limitations in double cavity performance were seen in the left external iliac artery. Left lower limb soft tissue swelled obviously and drainage was performed. Since the patient was critically ill, the scan time and thus the number of motion artifacts were kept to a minimum. The radiation dose was subsequently only 0.65 millisievert.
In the category Pediatric, the award was given to Brian A. Reilly, RT at the Ann & Robert H. Lurie Children’s Hospital in Chicago, USA. Here, a five-month-old boy was scanned using a Somatom Definition Flash. He had experienced unusually noisy breathing since the age of two months. At four months, he developed stridor caused by a narrowing of the airways. A CT Angiography showed abnormal development of a double aortic arch surrounding and compressing the trachea. The applied dose was 1.21 millisievert.
In the public vote, the submission – a further pediatric case – by LÃ¡szlÃ³ PÃ©terffy from B-A-Z County and University Hospital in Miskolc, Hungary, was ultimately successful. A 12-year-old girl with asthma suffering from bronchopneumonia and with allergic reactions to all drugs was scanned using the Somatom Definition AS computer tomograph. CT imaging (without contrast medium) clearly showed chronic pneumonia and were used in this case to avoid a conventional bronchoscopy. The effective radiation dose here was 0.9 millisievert.
The St. Louis Children’s Hospital Barnes-Jewish Hospital, USA, was awarded the prize for consistency in dose management because this institution works intensively to provide the best radiation dose for every patient according to patient age, general condition, and clinical question at hand. A cardiac scan was carried out on a six-month-old girl using a Somatom Definition Flash with a radiation dose of just 0.43 millisievert. This enabled a narrowing of the pulmonary arteries to be ruled out. However, indications were found of tetralogy of Fallot, a congenital heart abnormality.