Newsletter - May, 2013   send this newsletter to a colleague
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Individually tailored CT protocols: maximizing safety and efficacy
V. Matarese
CT protocols offer generalized indications on how to maximize the diagnostic yield of an examination while minimizing potential harm to patients, but radiologists know that a one-size-fits-all approach to scanning is not necessarily diagnostic or safe. Protocols must be adapted, taking into account each patient's characteristics and diagnostic needs. At the MDCT satellite symposium of the 2013 European Congress of Radiology, three expert radiologists explained how CT protocols can be individually tailored to maximize safety and efficacy. Their presentations, now available as e-Lectures on MDCT.net, give a preview of a possible future scenario in which CT examinations are done according to individualized guidelines. 

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Brain, and head, and neck / Technical considerations
Radiologists working on two continents tested a high-pitch, dual-source (2x64-slice) CT angiography protocol for examining the supra-aortic vasculature. They reported that high-pitch scanning reduced motion artifacts in vessels near the aortic arch, improving image quality for the diagnosis of atherosclerotic stenosis.
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Cardiovascular / Technical considerations
High-pitch, dual-source (2x128-slice) CT angiography reached a new target for radiation dose reduction, according to German researchers reporting in European Radiology. Their small feasibility study illustrated how low tube current and voltage scanning, when supported by the SAFIRE iterative reconstruction algorithm, produced high quality images of the coronary vasculature with ultra-low radiation exposure (<0.1 mSv). The work by Schuhbaeck and coworkers is commented on in an essay by Cademartiri and colleagues in Italy.
In the International Journal of Cardiovascular Imaging, Korean researchers reported that another iterative reconstruction algorithm (AIDR) improved the quality of coronary CT angiography images obtained with a 640-slice scanner equipped with an automatic exposure control system.     

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CT colonography
The European Society of Gastrointestinal and Abdominal Radiology (ESGAR) has revised and updated its consensus statement on CT colonography. Now available in print in the journal European Radiology, these practice guidelines were first published online late last year when Andrea Laghi, a member of both the ESGAR CT Colonography Working Group and the scientific committee of this website, commented on the new edition for MDCT.net .
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Video recordings from international meetings highlighted for you

From: ECR 2013, MDCT Symposium
Vienna, March 9

Tailoring CT exams: when and how?
C. Loewe
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How to balance radiation dose and diagnostic yield
H.C. Becker
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What if the patient is at risk?
M.F. Bellin
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A selection of recent cases from our regularly updated column

Brain, head and neck
Sudden-onset hearing loss
Man, 54 years old
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Slowly progressive hearing loss
Man, 75 years old
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Woman, 77 years old
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Reduced consciousness and history of breast cancer
Woman, 42 years old
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