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The American Journal of Neuroradiology’s latest Special Collection “Radiation Dose in Neuroradiology CT Protocols” gathers recent research and guidelines on this topic in one convenient resource. Collection Editors Max Wintermark and Michael H. Lev also hosted an accompanying half-hour podcast with Pina Sanelli and Pamela Schaefer. Their discussion addresses CT quality assurance, dose reduction strategies, clinical indicators for perfusion CT, acquisition parameters, and repeat studies.


Radiation Dose in Neuroradiology CT Protocols:
Collection Editors: Max Wintermark and Michael H. Lev

By now most neuroradiologists are aware of the US Food and Drug Administration notification regarding dangerous levels of radiation exposure produced in one facility while performing CT perfusion. This unfortunate event has been front page material for the media, leading to patient anxiety and, more important, to questions regarding the use of this valuable technique. It should come as no surprise that by the time of this writing, legal action against that facility and the equipment manufacturer have been initiated. Shortly thereafter, in a different facility, a technologist scanned the same region of a child’s head 151 times! Because radiation exposure from diagnostic tests has received considerable notice—even before these 2 incidents—it behooves all of us to employ our equipment judiciously.

In a timely fashion that only electronic publication allows, Drs. Max Wintermark and Mike Lev, experts on CT perfusion, have put together a wonderful editorial (to appear in the print edition of AJNR, too) and an informative Special Collection on radiation exposure-related articles. Our series of Special Collections is biannual but when we believe that our readers and society constituency need further information, we can rapidly act and deploy educational materials that will keep us all well versed and up-to-date.

At my hospital, for nearly 3 years we have used CT protocols specifically designed to deliver the smallest possible radiation dose. Although their esthetic quality is not the finest, they contain diagnostic information that is no different than those obtained with full dosages. I believe that in most patients who need a vascular CT study—perfusion and/or CT angiography—the benefits far outweigh the risks because these diseases carry significant morbidity and mortality if not diagnosed and treated promptly. As suggested by Max and Mike, the creation of a repository of ideal CT protocols is a laudable idea. AJNRBlog.org would be the ideal place for it. Further information regarding radiation exposure may be found at the Image Gently campaign.

M. Castillo
Editor-in-Chief

http://www.ajnr.org/specCol/specCollPCTToc.dtl


M. Wintermark and M.H. Lev
FDA Investigates the Safety of Brain Perfusion CT
AJNR Am J Neuroradiol 10.3174/ajnr.A1967 [PDF]

http://www.ajnr.org/cgi/reprint/ajnr.A1967v1


Podcast:

http://www.ajnr.org/misc/Podcast.dtl