Right Dose Image Contest (by Siemens)

Every year, Siemens organizes a Medical Imaging Contest. The idea is to obtain the best CT image with minimal dose. This contest doesn't focus only on image quality, but also on the dose, which is displayed in top of every image. There are always very nice images from different body parts and the competition this year is already open. Just take a look at the gallery. Of course, as it is organized by Siemens, the images have to be acquired with a scanner from the SOMATOM® Family and post-processed with syngo® software. Learn more about the challenge:

http://healthcare.siemens.com/computed-tomography/technologies-innovations/ct-image-contest

To get more information about radiation in CT, read this article:
Mannudeep K. Kalra, MD, DNB, Michael M. Maher, MD, FFR(RCSI), FRCR, Thomas L. Toth, DSc, Leena M. Hamberg, PhD, Michael A. Blake, MRCPI, FRCR, FFR(RCSI), Jo-Anne Shepard, MD and Sanjay Saini, MD (2004). Strategies for CT Radiation Dose Optimization Radiology DOI: 10.1148/radiol.2303021726

Dental Imaging - What is happening there?

The first time I was started thinking about dental imaging from a different point of view was when I heard in a talk the speaker saying: "These are statistics about medical imaging, without dental imaging.". I wondered "Why are dental imaging statistics not included?"

My first thought was "well maybe they are seldom"... then again "why would the speaker referred to them specifically?". Dental imaging is definitely increasing! but it seems these procedures are not accounted for when talking about medical imaging. The main dental imaging procedure is X-ray imaging, because X-rays are great for imaging bones and teeth. The increase comes from the fact that digital imaging is now available, which facilitates handling of images. Also, the widespread of these imaging devices make them more prone to use. When I was young, I made some dental images before I wore braces. These images had to be done in a specific clinical imaging facility and were not performed at the dentist clinic. Now, most dental clinics have these devices. Some even say that you should do an annual check up using this technology, so don't be too surprised if the dentist ask you for this next time.

Should you do it? When is it recommended?
The advantage of doing such type of exam without any complaints, it is probably that you will find a cavity before it becomes painful...or to study the evolution of a problem. The disadvantage are the cost and of course, the dose. Although the small doses present in these exams, they are still there. I refer again to this webtool, where you can calculate on your own the risks: Xrayrisk  Traditionally, dental imaging present intra-oral 2D images, but extra-oral are also possible, including 3D images (tomography) which are obtained with a CT scan. Nevertheless, complex exams such as pan-tomography or tomography should only be done in case there is a problem, not for check up...

The main problem with dental imaging is the lack of regulation (either for prescription or safety) and the training of the human resources for these exams. In imaging clinics, you have human resources with radiography studies and possibly even a physicist. In dental clinical, which human resources do they have? 

For more information about the technology and challenges, this article is a good review:
Vandenberghe B, Jacobs R, & Bosmans H (2010). Modern dental imaging: a review of the current technology and clinical applications in dental practice. European radiology, 20 (11), 2637-55 PMID: 20544352

The risk of medical imaging

In the last few years, there has been in the media several news warning to the effects of medical imaging which use ionizing radiation:

http://ps.columbia.edu/news/new-study-confirms-ps-researchers%E2%80%99-predictions-ct-induced-cancer-kids
http://www.eurekalert.org/pub_releases/2012-05/arrs-roc041912.php
http://coloncancer.about.com/b/2010/12/06/do-ct-scans-cause-cancer.htm

The editor William Hendee of Medical Physics has written an editorial about this topic:
http://online.medphys.org/resource/1/mphya6/v40/i4/p040401_s1?view=fulltext&bypassSSO=1

Most professionals are actually worried that people start refusing to undertake medical exams. Do you think this will happen?

Procrastination with IEEE

IEEE is the Institute of Electrical and Electronics Engineers (IEEE, read I-Triple-E). The good thing about procrastination with IEEE is that you don't feel that bad, because it is work related. IEEE spectrum is the magazine for the members and there is also a version online: http://spectrum.ieee.org/biomedical/imaging
I found this article very interesting in IEEE spectrum and I recommend:
http://spectrum.ieee.org/tech-talk/biomedical/imaging/medical-imaging-group-calls-for-fewer-ct-tests-and-more-research-on-health-effects

And also there are seminars available online:
http://spectrum.ieee.org/webinar/

Radiation dose in medical imaging

During this week, the French doctors in the case of radiation overdose were convicted and I was surprised to read that between 2001 and 2006, at least 400 patients underwent about 8% more radiation than the safer dose. This was mainly because radiation dose in radiological exams prior to treatment was not taken into account. I always thought that medical professionals were aware that several medical imaging exams expose the patient to radiation dose. An extra mechanism for signaling was developed in France after this case.

Aunt Minnie article:
http://www.auntminnieeurope.com/index.aspx?sec=nws&sub=rad&pag=dis&ItemID=607680&wf=1
Guardian U.K. article:
http://www.guardian.co.uk/world/2012/sep/24/french-doctors-trial-cancer-overdose

A quick internet tool gives you radiation dose of typical exams: http://www.xrayrisk.com/calculator/calculator-normal-studies.php
For imaging professionals, there is more information on radiation dose:
http://www.imagewisely.org/