Browsing by Author "Dalah, Entesar"
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Publication Challenges Associated with Effective Implementation of CT Dose Check Standards and Radiation Monitoring Index in Computed Tomography: Healthcare Sector Experience(2022) Dalah, EntesarAbstract: Computed tomography (CT) radiation dose management tools should be used whenever possible, particularly with the increasing demand for acquiring CT studies. Herein, we aim to assess the advantages and challenges faced with implementing two CT dose management tools. A second aim was to highlight CT examinations exceeding dose notification values (NVs) and define the common set of causes. A total of 13,037 CT examinations collected over a six-month period, were evaluated, using two independent CT dose management tools, a CT Dose Notification prospective view tool (PVT) following CT Dose Check standards and a retrospective statistical-based view tool (RSVT). Dose NVs were set to twice the Local Diagnostic Reference Levels. There was a significant discrepancy between dose NV counts registered with prospective (4.15%) and retrospective (7.98%) tools using T-Test. A core difference is the dose configuration setup, with PVT and RSVT being dose per series and whole study, respectively. Both prospective and retrospective dose management tools were equally useful despite their technical difference. Configuring the CT prospective dose notification check tool using NVs that is based on DRLs has limitations, and one needs to establish dose NVs per series to overcome this technical hurdle. Technical challenges make the implementation of CT Dose Check standards puzzling.Publication Potentials of additional copper filtration on radiation dose and image quality for adults underwent digital chest X-ray imaging in Dubai Health Authority - UAE(2023) Dalah, EntesarObjective: To explore the potentials of adding copper (Cu) filter on image quality and patient dose of adult patients underwent chest X-ray examination Methods: Patients were divided into four groups. Group 1, patients were exposed with no added Cu filter (standard or control), group 2 a 0.1 mm Cu filter was added, group 3 acquired with 0.2 mm Cu filter and group 4 performed with 0.3 mm Cu filter. Exposure index (EI), entrance surface dose (ESD) and dose area product (DAP) were recorded from the modality and retrospectively analyzed. The visual grading analysis score (VGAS) was used to evaluate image quality. ManneWhitney T-Test and one-way ordinary ANOVA Test were used to evaluate statistical differences including gender-based findings. Results: EI, ESD and DAP data for a total of 784 patients (422 male and 362 female) that underwent indirect digital chest radiography exam were collected. Image quality was maintained when adding 0.1 mm Cu filter achieved with ~19% DAP reduction. Female showed a significant DAP reduction comparing to male registered in the same group. Conclusions: Reducing dose when using indirect digital chest radiography is possible with no trade-off on image quality. No loss of image quality was reported, images were broadly comparable. Implications for practice: This study highlights the importance of utilizing the additional copper filter in digital chest radiography.Publication Regression Analysis between the Different Breast Dose Quantities Reported in Digital Mammography and Patient Age, Breast Thickness, and Acquisition Parameters(2022-07) Dalah, EntesarAbstract: Breast cancer is the leading cause of cancer death among women worldwide. Screening mammography is considered the primary imaging modality for the early detection of breast cancer. The radiation dose from mammography increases the patients’ risk of radiation-induced cancer. The mean glandular dose (MGD), or the average glandular dose (AGD), provides an estimate of the absorbed dose of radiation by the glandular tissues of a breast. In this paper, MGD is estimated for the craniocaudal (CC) and mediolateral–oblique (MLO) views using entrance skin dose (ESD), X-ray spectrum information, patient age, breast glandularity, and breast thickness. Moreover, a regression analysis is performed to evaluate the impact of mammography acquisition parameters, age, and breast thickness on the estimated MGD and other machine-produced dose quantities, namely, ESD and organ dose (OD). Furthermore, a correlation study is conducted to evaluate the correlation between the ESD and OD, and the estimated MGD per image view. This retrospective study was applied to a dataset of 2035 mammograms corresponding to a cohort of 486 subjects with an age range of 28–86 years who underwent screening mammography examinations. Linear regression metrics were calculated to evaluate the strength of the correlations. The mean (and range) MGD for the CC view was 0.832 (0.110–3.491) mGy and for the MLO view was 0.995 (0.256–2.949) mGy. All the mammography dose quantities strongly correlated with tube exposure (mAs): ESD (R2 = 0.938 for the CC view and R2 = 0.945 for the MLO view), OD (R2 = 0.969 for the CC view and R2 = 0.983 for the MLO view), and MGD (R2 = 0.980 for the CC view and R2 = 0.972 for the MLO view). Breast thickness showed a better correlation with all the mammography dose quantities than patient age, which showed a poor correlation. Moreover, a strong correlation was found between the calculated MGD and both the ESD (R2 = 0.929 for the CC view and R2 = 0.914 for the MLO view) and OD (R2 = 0.971 for the CC view and R2 = 0.972 for the MLO view). Furthermore, it was found that the MLO scan views yield a slightly higher dose compared to CC scan views. It was also found that the glandular absorbed dose is more dependent on glandularity than size. Despite being more reflective of the dose absorbed by the glandular tissue than OD and ESD, MGD is considered labor-intensive and time-consuming to estimate.