gms | German Medical Science

87. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

04.05. - 07.05.2016, Düsseldorf

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Cone-beam CT radiation exposure of patients with chronic Rhinosinusitis – application of the public domain software IVEU

Meeting Abstract

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  • corresponding author presenting/speaker Ronald Leppek - DVT-Referenzzentrum GmbH, Marburg, Germany
  • Markus Pietsch - Hannover Medical School, Clinic for Laryngology, Rhinology and Otology, Hannover, Germany
  • Fjodor Bobka - Philipps-University, Faculty of Medicine, Marburg, Germany
  • Christian Güldner - Marburg University Hospital, ENT clinic, Marburg, Germany
  • Isabell Diogo - Marburg University Hospital, ENT clinic, Marburg, Germany
  • Martin Kolodziej - Infinitt Europe GmbH, Frankfurt am Main, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 87th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Düsseldorf, 04.-07.05.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16hno08

doi: 10.3205/16hno08, urn:nbn:de:0183-16hno084

Veröffentlicht: 7. September 2016

© 2016 Leppek et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

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Text

Introduction: Comparison of dose area product (DAP), CTDIvol and dose length product (DLP) of cone-beam CT (CBCT) of paranasal sinuses (PNS) of patients with chronic rhinosinusitis (CRS). Testing the application of the PUBLIC domain software IVEU (IT-gestuetztes Verfahren zur Erfassung von Untersuchungsparametern). The IVEU software collects, analyzes and presents meta data from radiological examinations. IVEU primarily uses data from DICOM tags (DICOM header fields), but also from Dose SR (Radiation Dose Structured Reports, RDSR) and Dose Reports in DICOM images (by OCR) as well as information from other systems or files, e. g. patient dose tables, dose relevant manufacturer's information or reports of medical authorities. The software can be used by German medical radiation users without costs.

Methods: Comparison of 30 PNS-CBCT examinations of two different operators and CBCT equipment (1 ENT-clinic, 1 ENT practice) of CRS patients. First an appropriate CBCT template was designed in order to implement modality and automatic data extraction from DICOM header fields by using a catalog with rule-based lexical classification. Second predictive data analysis by means of the open source platform RapidMiner was performed. Comparison of dose area product (DAP), CTDIvol and dose length product (DLP) from DICOM entries or alternatively by means of polynomial calculated values from exposure data (tube voltage [kV] and current-time-product [mAs] as provided from manufacturer's examination-specific machine settings).

Results: CBCT machines allow a variety of examination volumes. A missed optimization of the PNS examination volume (i.e. HEAD instead of PNS) lead up to 2.5-fold dose increases:

Mean: DAP-HEAD 18.6 vs. DAP-PNS 7.4 of [dGycm2]
Median: DAP-HEAD 20.8 vs. DAP-PNS 6.7 of [dGycm2]
Mean: CTDIvol-HEAD 4.4 vs. CTDIvol-PNS 2.8 of [mGy]
Median: CTDIvol-HEAD 4.6 vs. CTDIvol-PNS 2.6 of [mGy]
Mean: DLP-HEAD 57.3 vs. DLP-PNS 24.6 of [mGycm]
Median: DLP-HEAD 60.3 vs. DLP-PNS 25.5 of [mGycm]

Conclusions: IVEU delivers fast and clearly arranged representation and evaluation of dose relevant CBCT data provided consistent DICOM data sets can be imported. Manufacturer dependent non-uniform or missing parameter entries in the DICOM header impede the RapidMiner evaluation of CTDIvol. and DLP. An efficient dose monitoring with derivation of diagnostic reference levels for PNS-CBCT examinations requires uniform DICOM entries and further software customizations.