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Radiation dose from Adult and Pediatric Multidetector Computed Tomography

D. Tack and PA Gevenois, Springer, 2007
Book Review
by  Jean-François Paul, France



Radiation exposure from medical sources is becoming a major concern in terms of public health. A large portion of the total radiation dose applied for medical purposes derives from the use of computed tomography (CT).
The use of CT is increasing every year, and the amount of radiation exposure per examination is also increasing with the advent of multidetector CT (MDCT).
Compared to single slice CT, MDCT allows extended coverage and multiple acquisitions with a higher tube power required for some specific acquisitions such as cardiac imaging. 

This important topic is comprehensively covered from a mostly practical viewpoint in the recent volume from Springer's Medical Radiology series.
The book is divided into two main parts :

  • The first part provides the theoretical basis of radiation issues.  The first two chapters deal with cancer risks from low level radiation, and present the two main hypotheses which are subject of intense discussion in the scientific community:  the linear no-threshold theory and the threshold hypothesis based on recent data. The third chapter presents the CT parameters that influence the radiation dose and offers practical recommendations regarding each parameter. The last chapters of this part present general strategies for radiation dose optimization, including one chapter concerning the advantages of automatic exposure control in MDCT.

  • The second part of the book presents clinical approaches for dose reduction regarding each specific body region, such as head and neck, chest, abdomen, spine. In addition, two chapters address  subjects of recent interest to the radiological community (i.e. cardiac CT and CT of children) and describe, in particular, how to  individually adapt scan parameters (e.g. kV and mAs) to the clinical situation. Dose reduction in CT fluoroscopy is also treated and nicely illustrated, with focus on both skin dose to the patient and exposure to the radiologist and staff. Finally, one chapter discusses radiation dose in screening programs, especially for lung and colon cancer.

This book provides a complete set of practical information by renowned experts, and is intended for radiologists who do not always know how to deal with radiation dose in daily practice.
Theoretical information is also provided in a clear way, with explanations of the potential risk of cancer associated with low radiation doses.
The chapters are well balanced. Tack and Gevenois have written a compact, nicely illustrated book.
This book is easy to read despite the complexity of the problem and the uncertainty of the data in this field. In brief, this book is highly recommended to any radiologist using MDCT, but also to technologists who perform the examinations and to refering physicians who order the examinations.

 
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