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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Reducing radiation exposure and costs – CT scout views with an enhanced protocol versus conventional radiography after shunt surgery

Reduzierung der Strahlenbelastung und Kosten: CT-Scout-Ansichten mit verbessertem Protokoll gegenüber konventioneller Radiographie nach Shunt Operation

Meeting Abstract

  • presenting/speaker Majid Esmaeilzadeh - Neurosurgery, Hannover, Deutschland
  • Paul Bronzlik - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland
  • Hüseyin Solmaz - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland
  • Manolis Polemikos - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland
  • Peter Raab - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland
  • Heinrich Lanfermann - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland
  • Joachim K. Krauss - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV193

doi: 10.3205/22dgnc187, urn:nbn:de:0183-22dgnc1875

Published: May 25, 2022

© 2022 Esmaeilzadeh et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Implantation of a ventriculoperitoneal (VP) shunt with programmable valves and antisiphon devices has become standard treatment in many institutions. Skull and abdomen radiography combined with postoperative CT usually is performed for documentation of shunt position and valves settings after surgery which results in radiation exposure for the patient. Radiation dosage could be reduced by using CT only with enhanced scout views. Here, we investigate whether enhanced scout views may replace routine conventional radiography resulting in a reduction of radiation exposure.

Methods: After introduction of an enhanced CT imaging protocol, routine skull and abdomen radiography was no longer obtained after VP shunt surgery. The image studies of 25 patients with conventional radiography (retrospective arm of study) were then compared to 25 patients with enhanced CT imaging (prospective arm of study). Patient demographics such as age, sex and primary diagnosis were collected. The image quality of conventional radiographic images and computed tomography scout views images were independently analyzed by one neurosurgeon and one neuroradiologist.

Results: Fifty patients (30 men and 20 women) were included in the analysis. The mean age was 64.6 years in the CT only group and 60.9 years in the CT plus conventional radiography group. All patients had a VP shunt with a programmable valve and a gravitation assistant (proGAVv 2.0, Miethke Aesculap). Imaging quality was comparable in conventional radiography versus CT scouts with an enhanced protocol, and the shunt position and valve settings could be identified with ease. The estimated effective dose for radiographs was 0.68 mSv (range 0.45–1.27 mSv) and that for enhanced CT imaging 0.31 mSv (range 0.17- 0.51 mSv) (p < 0.0001).

Conclusion: CT scout obtained with an enhanced imaging protocol provided sufficient imaging quality when compared with shunt radiographies to determine shunt positioning and valve settings. In addition, the use of CT scout views only, resulted in lower radiation exposure and reduction of costs.