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Controlo automático de exposição (CAE) : dose no doente e qualidade de imagem

Authors: Soares, José Filipe Henriques;

Controlo automático de exposição (CAE) : dose no doente e qualidade de imagem

Abstract

O controlo automático de exposição (CAE) é o sistema que suporta a definição dos parâmetros que vão conduzir a exposição e a dose no doente. Considerando que o circuito de medida é único e efectua o cálculo (e consequente corte) através da média do sinal recebido, sem ter em conta o gradiente de assimetria das densidades coincidentes com o campo dos respectivos detectores, formulou-se como objectivo o determinar a influência de diversas configurações do CAE na dose no doente e na qualidade da imagem num sistema de Radiologia Computadorizada (CR), em três regiões de um fantôma antropomórfico: tórax, abdómen e bacia. Seguiram-se os critérios recomendados por Guidelines internacionais e as imagens obtidas foram gravadas em Dicom e identificadas para posterior análise em software OsiriX. Os valores de cada exposição foram tratados no software Statistical Package for the Social Sciences (SPSS) e determinada a média, o desvio padrão, o erro padrão, a variância e realizado o teste de Tukey (HSD). No tórax, verificou-se que, utilizando o CAE direito se obtém menor dose absorvida no que noutras configurações: – 6,1% em relação ao esquerdo, – 39,7% do que quando se utiliza o central e de – 8,6% e de – 26,8% em relação à utilização dos dois laterais e aos três em simultâneo, respectivamente. No abdómen obteve-se a menor dose absorvida utilizando o CAE esquerdo: em relação ao direito de – 6,4%, em relação ao central de – 22,2%, em relação aos dois laterais e três em simultâneo de – 2,5% e de – 8,2%. Na bacia a menor dose absorvida foi obtida com a selecção do CAE central: tanto em relação a qualquer um dos laterais como dos três em simultâneo, com valores – 55,2% e – 30,8% respectivamente. Considerando uma prótese parcial na anca esquerda as diferenças acentuam-se em relação à selecção dos dois e dos três detectores em simultâneo para – 58,1% e – 30,1% e ao coincidente com a prótese de – 83,3%. Conclui-se que a importância dada à selecção do/s detector/es do CAE tem acção directa na redução da dose no doente, sem alterar a qualidade da imagem e que que as recomendações das Guidelines nem sempre estão de acordo com o Princípio da Optimização (Directiva 97/43 da Euratom). Os resultados obtidos indicam a necessidade de reapreciação das configurações do CAE sugeridas pela Dimond III e das European Guidelines o que poderá ser comprovado com um estudo relacionando os valores obtidos no fantôma com um cadáver, que se sugere como trabalho futuro.

The automatic exposure control (AEC) is the system that supports the definition of the parameters that will lead to exposure and dose to the patient. Whereas the measuring circuit system that is unique and is calculated (and consequent cutting) by averaging the received signal, without regard to the asymmetry of the density gradient coincident with the field of the respective exposure detectors, formulated as objective to determine the influence of various configurations of the EAC in the patient dose and image quality in a system of Computed Radiography (CR) in three regions of an anthropomorphic phantom: chest, abdomen and pelvis. Followed the criteria recommended by international Guidelines and the images were saved in Dicom and identified for further analysis in software OsiriX. The values for each exposure were treated in the Statistical Package for Social Sciences (SPSS) and determined the mean, standard deviation, standard error, variance and performed the Tukey test (HSD). In the thorax, it was found that, using the obtained lower right AEC absorbed dose in other configurations: – 6,1% on the left – 39,7% than when using the central and – 8,6% and – 26,8% compared to the use of two to three sides and at the same time, respectively. The abdomen was obtained using the lowest dose absorbed AEC left: on the right – 6,4%, relative to center – 22,2% on the two sides and three simultaneous – 2,5% and – 8,2%. In the lower bowl the absorbed dose was obtained by selection of AEC central, both in relation to any of the three sides and simultaneously, with values – 55,2% and – 30.8%, respectively. Whereas a partial prosthesis on the left hip accentuate differences in relation to the selection of the two and three detectors for simultaneously – 58,1% and – 30,1% and coincident with a value of the prosthesis – 83,3%. It is concluded that the importance given to the selection detector/s AEC has direct action in reducing the dose to the patient, without changing the image quality and that the recommendations of the Guidelines are not always in accordance with the Principle of Optimization (Directive 97/43 Euratom). The results indicate the need to review the settings suggested by AEC Dimond III and European Guidelines which can be proven with a study correlating the values obtained in the phantom with a corpse, which is suggested as future work.

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Portugal
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Keywords

Automatic exposure control, AEC, Índice de exposição, Optimização da exposição, ALARA, Absorbed dose, Domínio/Área Científica::Engenharia e Tecnologia::Engenharia Médica, CAE, Dose absorvida, The index of exposure, Exposure optimization, Controlo automático de exposição

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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