Dosimetric optimization of CT protocols for the preoperative planning of hip arthroplasty

Radiation dose in x-ray computed tomography (CT) has become a topic of great interest due to the increasing number of CT examinations performed worldwide. In fact, CT scans are responsible of significant doses delivered to the patients, much larger than the doses due to the most common radiographic procedures. This thesis work, carried out at the Laboratory of Medical Technology (LTM) of the Rizzoli Orthopaedic Institute (IOR, Bologna), focuses on two primary objectives: the dosimetric characterization of the tomograph present at the IOR and the optimization of the clinical protocol for hip arthroplasty. In particular, after having verified the reliability of the dose estimates provided by the system, we compared the estimates of the doses delivered to 10 patients undergoing CT examination for the pre-operative planning of hip replacement with the Diagnostic Reference Level (DRL) for an osseous pelvis examination. Out of 10 patients considered, only for 3 of them the doses were lower than the DRL. Therefore, the necessity to optimize the clinical protocol emerged. This optimization was investigated using a human femur from a cadaver. Quantitative analysis and comparison of 3D reconstructions were made, after having performed manual segmentation of the femur from different CT acquisitions. Dosimetric simulations of the CT acquisitions on the femur were also made and associated to the accuracy of the 3D reconstructions, to analyse the optimal combination of CT acquisition parameters. The study showed that protocol optimization both in terms of Hausdorff distance and in terms of effective dose (ED) to the patient may be realized simply by modifying the value of the pitch in the protocol, by choosing between 0.98 and 1.37.

Sea level trends in the Mediterranean from tide gauges and satellite altimetry

Sea level variation is one of the parameters directly related to climate change. Monitoring sea level rise is an important scientific issue since many populated areas of the world and megacities are located in low-lying regions. At present, sea level is measured by means of two techniques: the tide gauges and the satellite radar altimetry. Tide gauges measure sea-level relatively to a ground benchmark, hence, their measurements are directly affected by vertical ground motions. Satellite radar altimetry measures sea-level relative to a geocentric reference and are not affected by vertical land motions. In this study, the linear relative sea level trends of 35 tide gauge stations distributed across the Mediterranean Sea have been computed over the period 1993-2014. In order to extract the real sea-level variation, the vertical land motion has been estimated using the observations of available GPS stations and removed from the tide gauges records. These GPS-corrected trends have then been compared with satellite altimetry measurements over the same time interval (AVISO data set). A further comparison has been performed, over the period 1993-2013, using the CCI satellite altimetry data set which has been generated using an updated modeling. The absolute sea level trends obtained from satellite altimetry and GPS-corrected tide gauge data are mostly consistent, meaning that GPS data have provided reliable corrections for most of the sites. The trend values range between +2.5 and +4 mm/yr almost everywhere in the Mediterranean area, the largest trends were found in the Northern Adriatic Sea and in the Aegean. These results are in agreement with estimates of the global mean sea level rise over the last two decades. Where GPS data were not available, information on the vertical land motion deduced from the differences between absolute and relative trends are in agreement with the results of other studies.