The presence of iodinated contrast agents amplifies DNA radiation damage in computed tomography

The purpose of this study was to determine the influence of iodinated contrast agents on the formation of DNA double-strand breaks in vitro in lymphocytes and to verify these results in patients undergoing diagnostic computed tomography examinations. Blood samples were irradiated in vitro in the presence of iodinated X-ray contrast agent. Controls were irradiated without contrast agent. Fourteen patients were investigated using contrast-enhanced computed tomography (CT), and 14 other patients with unenhanced CT. Blood samples were taken prior to and 5 min and 1, 2 and 24 h after the CT examination. In these blood samples the average number of γH2Ax-foci per lymphocyte was enumerated by fluorescence microscopy. Statistical differences between foci numbers developed in the presence and absence of contrast agent were tested using an independent sample t-test. In vitro foci numbers after irradiation were significantly higher when contrast agent was present during irradiation. In vivo, γH2Ax-foci levels were 58% higher in patients undergoing contrast-enhanced CT compared with those undergoing unenhanced CT. In the presence of iodinated contrast agents DNA, damage is increased and the radiation dose is not the only factor affecting the amount of DNA damage. Individual patient characteristics and biological dosimetry applications, e.g. the analysis of γH2Ax-foci, have to be considered.

Meta-analysis: diagnostic performance of low-radiation-dose coronary computed tomography angiography

A new radiation dose-saving technique for noninvasive coronary artery imaging with computed tomography (CT) is available.

Endodontic working length measurement with preexisting cone-beam computed tomography scanning: a prospective, controlled clinical study

The determination of root canal length is a significant outcome predictor for endodontic treatments. The aim of this prospective, controlled clinical study was to analyze endodontic working length measurements in preexisting cone-beam computed tomography (CBCT) scans and to compare them with clinical root canal length determination by using an electronic apex locator (EAL).

Intraoral foreign bodies detected 40 years after a car accident using cone beam computed tomography

Foreign bodies are common findings in the maxillofacial region, most commonly the result of accidents and physical aggression. Among the objects frequently found in the orofacial tissues are fragments of metal, plastic, wood, and glass. Visualization and exact identification of the location of these objects can be challenging but is of major importance prior to surgical removal. The present case report describes the use of cone beam computed tomography to locate, visualize, and surgically remove glass particles in the oral cavity.

Cone beam computed tomography in mandibular molars referred for apical surgery

The purpose of the present study was to compare conventional intraoral periapical radiographs (PA) with limited cone beam computed tomography (CBCT) for evaluation of mandibular molars prior to apical surgery. The apical extent and homogeneity of the root canal fillings (RCF) as well as the number of root canals were examined.

Bone dimensions in the posterior mandible: a retrospective radiographic study using cone beam computed tomography. Part 1--analysis of dentate sites

This retrospective radiographic study analyzed the dimensions of the alveolar bone in the posterior dentate mandible based on cone beam computed tomography (CBCT) images. A total of 56 CBCT images met the inclusion criteria, resulting in a sample size of 122 cross sections showing posterior mandibular teeth (premolars and molars). The thickness of the buccal and lingual bone walls was measured at two locations: 4 mm apical to the cementoenamel junction (measurement point 1, MP1) and at the middle of the root (measurement point 2, MP2). Further, alveolar bone width was assessed at the level of the most coronal buccal bone detectable (alveolar bone width 1, BW1) and at the superior border of the mandibular canal (alveolar bone width 2, BW2). The vertical distance between the two as well as the presence of a lingual undercut were also analyzed. There was a steady increase in buccal bone wall thickness from the first premolar to the second molar at both MP1 and MP2. BW1 at the level of the premolars was significantly thinner than that for molars. Alveolar bone height was constant for all teeth examined. For the selection of an appropriate postextraction treatment approach, analysis of the alveolar bone dimensions at the tooth to be extracted by means of CBCT can offer valuable information concerning bone volume and morphology at the future implant site.

Characteristics and dimensions of the Schneiderian membrane and apical bone in maxillary molars referred for apical surgery: a comparative radiographic analysis using limited cone beam computed tomography

The purpose of the present study was to evaluate the thickness and the anatomic characteristics of the Schneiderian membrane and cortical bone using limited cone beam computed tomography (CBCT) scannning in patients referred for planning of apical surgery of maxillary molars.

Reasons for ordering computed tomography scans of the head in patients with minor brain injury

Minor brain injury is a frequent condition. Validated clinical decision rules can help in deciding whether a computed tomogram (CT) of the head is required. We hypothesized that institutional guidelines are not frequently used, and that psychological factors are a common reason for ordering an unnecessary CT.

A quarter century experience in liver trauma: a plea for early computed tomography and conservative management for all hemodynamically stable patients

Advances in diagnostic imaging and the introduction of damage control strategy in trauma have influenced our approach to treating liver trauma patients. The objective of the present study was to investigate the impact of change in liver trauma management on outcome.

Image quality in low-dose coronary computed tomography angiography with a new high-definition CT scanner

A new generation of high definition computed tomography (HDCT) 64-slice devices complemented by a new iterative image reconstruction algorithm-adaptive statistical iterative reconstruction, offer substantially higher resolution compared to standard definition CT (SDCT) scanners. As high resolution confers higher noise we have compared image quality and radiation dose of coronary computed tomography angiography (CCTA) from HDCT versus SDCT. Consecutive patients (n = 93) underwent HDCT, and were compared to 93 patients who had previously undergone CCTA with SDCT matched for heart rate (HR), HR variability and body mass index (BMI). Tube voltage and current were adapted to the patient's BMI, using identical protocols in both groups. The image quality of all CCTA scans was evaluated by two independent readers in all coronary segments using a 4-point scale (1, excellent image quality; 2, blurring of the vessel wall; 3, image with artefacts but evaluative; 4, non-evaluative). Effective radiation dose was calculated from DLP multiplied by a conversion factor (0.014 mSv/mGy × cm). The mean image quality score from HDCT versus SDCT was comparable (2.02 ± 0.68 vs. 2.00 ± 0.76). Mean effective radiation dose did not significantly differ between HDCT (1.7 ± 0.6 mSv, range 1.0-3.7 mSv) and SDCT (1.9 ± 0.8 mSv, range 0.8-5.5 mSv; P = n.s.). HDCT scanners allow low-dose 64-slice CCTA scanning with higher resolution than SDCT but maintained image quality and equally low radiation dose. Whether this will translate into higher accuracy of HDCT for CAD detection remains to be evaluated.

Radiation exposure in whole-body computed tomography of multiple trauma patients: bearing devices and patient positioning

Whole-body computed tomography (WBCT) plays an important role in the management of severely injured patients. We evaluated the radiation exposure of WBCT scans using different positioning boards and arm positions.

Accuracy of low-dose computed tomography (CT) for detecting and characterizing the most common CT-patterns of pulmonary disease

To assess the ability of low-dose CT to detect and characterize the most common CT patterns of pulmonary disease.

Gas embolism following intraosseous medication application proven by post-mortem multislice computed tomography and autopsy

The post-mortem use of modern imaging techniques such as multislice computed tomography (MSCT) is becoming increasingly important as an aid for conventional autopsy. This article presents a case of a 4-month-old boy who died from sudden infant death syndrome (SIDS) with intravascular gas after an intraosseus medication application documented by post-mortem MSCT. It is most likely that the gas entered the body during resuscitation. This case emphasises the advantage of post-mortem imaging as a complementary aid for the autopsy. We conclude that during emergency treatment, the medical staff should be aware of the possibility of causing a gas embolism following intraosseus medication. Resuscitation with an inserted, disconnected intraosseous needle should be avoided.

Post-mortem tissue sampling using computed tomography guidance

PURPOSE: Currently, in forensic medicine cross-sectional imaging gains recognition and a wide use as a non-invasive examination approach. Today, computed tomography (CT) or magnetic resonance imaging that are available for patients are unable to provide tissue information on the cellular level in a non-invasive manner and also diatom detection, DNA, bacteriological, chemical toxicological and other specific tissue analyses are impossible using radiology. We hypothesised that post-mortem minimally invasive tissue sampling using needle biopsies under CT guidance might significantly enhance the potential of virtual autopsy. The purpose of this study was to test the use of a clinically approved biopsy needle for minimally invasive post-mortem sampling of tissue specimens under CT guidance. MATERIAL AND METHODS: ACN III biopsy core needles 14 gauge x 160 mm with automatic pistol device were used on three bodies dedicated to research from the local anatomical institute. Tissue probes from the brain, heart, lung, liver, spleen, kidney and muscle tissue were obtained under CT fluoroscopy. RESULTS: CT fluoroscopy enabled accurate placement of the needle within the organs and tissues. The needles allowed for sampling of tissue probes with a mean width of 1.7 mm (range 1.2-2 mm) and the maximal length of 20 mm at all locations. The obtained tissue specimens were of sufficient size and adequate quality for histological analysis. CONCLUSION: Our results indicate that, similar to the clinical experience but in many more organs, the tissue specimens obtained using the clinically approved biopsy needle are of a sufficient size and adequate quality for a histological examination. We suggest that post-mortem biopsy using the ACN III needle under CT guidance may become a reliable method for targeted sampling of tissue probes of the body.