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Purpose:To date there is extensive data on the radiation dose for assessing coronary artery calcium scores (CACS) with 4-64 row multidetector MDCT. However with the advent of 320 row MDCT, the entire heart can be imaged in one beat and thus potentially reduce the radiation dose. The aim of this study was to evaluate radiation dose for CACS on low-dose prospective EKG-triggered 320 row MDCT.Materials and Methods: Informed consent for this retrospective HIPAA-compliant study was waived and approved by our institution’s institutional review board IRB. One hundred and sixty eight consecutive patients (Male 133 (79%): female 35 (21%), mean body mass index BMI 29±5 and mean heart rate 58± bpm) underwent coronary calcium scoring with prospective gating. The scan parameters were 300 mA, 120 kVp, volume scan length (VSL) 160 mm, gantry rotation 0.350 msec and 320 x 0.5 mm detectors at 320 MDCT. Beta blockers were given to patients in a case heart rate HR > 65 bpm. The effective dose (ED) estimates were calculated for all patients from the dose length product and the conversion factor k (0.014 mSv/mGy/cm) as recommended by current guidelines.Results: The mean SD radiation was 1.89±0.79 mSv. Overall the range varied from 0.28-2.48 mSv. The radiation was significantly less in females as compared to males (2.02±0.73 vs. 1.41±0.87, p=60 bpm (1.87±0.79 vs. 1.77±0.84 mSv, p=0.45). On the other hand a higher radiation was noted among obese individuals as compared to those with BMIConclusion: Radiation dose obtained from 320-MDCT is similar to those obtained with 4-64 row MDCT. Further studies are needed to assess the feasibility of further lowering the tube current and tube voltage.------------------------------------------------Cite this article as:Khosa F, Khan A, Shuaib W, Clouse M, Budoff M, Blankstein R, Nasir K. Radiation exposure for coronary artery calcium score at prospective 320 row multi-detector computed tomography. Int J Cancer Ther Oncol 2013; 1(2):01023.DOI: http://dx.doi.org/10.14319/ijcto.0102.3

Purpose: Vertebral artery injuries (VAIs) can be seen in cervical injuries. This investigation was conducted to assess the impact of head and neck computed tomography (CT) angiography (CTA) on planning treatment of vertebral artery injuries, if these tests were ordered appropriately, and to estimate cost and associated exposure to radiation and contrast material. Methods: This retrospective review included all patients who underwent CT of the cervical spine and CTA of the head and neck from March 2011 to October 2012 at a single institution. Patients were divided into two groups, those with and those without cervical spine fracture appreciated on CT of the cervical spine. The frequency of vascular injury on CTA in those with a cervical fracture was assessed. The frequency of vascular injury treatment and modifications owed to a positive CTA of head and neck were also assessed. A study was considered appropriate if it was ordered in accordance with the modified Denver Screening criteria. Effective radiation dose (mSv) was calculated by multiplying dose length product (DLP) from the scanner with the standard conversion coefficient (k) (k = 0.0021 mSv/mGy x cm).Results: In the 387 CTAs of head and neck, a cervical injury was recorded in 128 patients. Twenty CTA scans were correctly ordered for non-spinal indications, and 19 were ordered off protocol. CTA was found positive in 1 patient for whom the imaging was off protocol and 1 for whom the clinical indication was non-cervical. There were 19 positive CTA cases of head and neck, none of which underwent surgical intervention. CTA was positive in 13 of 48 patients who had suffered a C2 fracture; this accounted for 13 of the 19 positive CTA studies (p < 0.01). Estimated fee for CTA was $3783, and radiation exposure was 4 mSv with a standard deviation (±1.3). Conclusion: CTA of head and neck ordered off an institutional imaging protocol has a low probability of being positive. Adherence to protocols for CTA of head and neck can reduce costs and decrease unnecessary exposure to radiation and contrast medium.---------------------------------------Cite this article as:Shuaib W, Khan AA, Mehta AS, Vijayasarathi A, Hidalgo J. Utility of CT angiography in cervical spine trauma: analysis of radiation and cost. Int J Cancer Ther Oncol 2014; 2(4):02043. DOI: 10.14319/ijcto.0204.3