Physica Medica: European Journal of Medical Physics - Volume 32 - Supplement 1 - February 2016

91 / 146

of total AGD was 5.7 mGy and third-quartile of acquisition counts was 5
images for GE Senographe DS.
We have also estimated for DS system the 75th percentile of AGD in mag-
nification acquisitions that is equal to 3.16 mGy. In few cases we found more
than 10 radiograms performed with AGD above 10 mGy.
Conclusions: The dose tracking system allows to perform fast analysis of
dosimetric data to define local LDR and to optimize the acquisition
parameters.
The 75th percentile of AGD for each radiogramwas used as local LDR. More-
over, we have inserted an alert message into Radimetrics system for exams
with doses higher than local LDR and that are performed with more than
10 acquisitions.
B.290
DOSE REDUCTION IN PEDIATRIC CT CLINICAL INVESTIGATIONS: THE
IMPACT OF THE ADAPTIVE STATISTICAL ITERATIVE RECONSTRUCTION
ALGORITHM (ASIR)
A. Ostinelli * M. Duchini P. Bonfanti S. Lomazzi M. Cacciator a A.O.
Sant’Anna, Como, Italy; b Università Insubria, Como, Italy
Introduction: The latest iterative reconstruction techniques of CT images
provide noise reduction and quality improvement at a significantly reduced
radiation doses. The extent of this reduction is a critical issue in pediatric
exposures, given the high radiosensitivity and the increased post-irradiation
life expectancy, with a consequent increase of the tumor induction prob-
ability. In this work, pediatric CT examinations were retrospectively analyzed
to evaluate the effects of the Adaptive Statistical Iterative Reconstruction
algorithm (AsiR, GE).
Materials and Methods: The retrospective study of children exposure was
based on the examinations carried out on the LightSpeed VCT-64 (GE) CT
of the Sant’Anna Hospital (Como). The scan parameters and dose indices
data collection was carried out by the DoseWatch (GE) system for clinical
dose monitoring, during the 2013 (pre-ASiR) and 2014 (post-ASiR) years.
The overall effect of the ASiR introduction was studied as a function of the
age and the anatomical region by SPSS analysis software.20 (SPSS inc.
Chicago, IL, USA).
Results: In 2013 the pediatric CT examinations were 282 (45% for brain)
and in 2014 they were 311 (41% for brain). The analysis of these clinical
investigations showed that the ASiR introduction allowed for an overall re-
duction of the CTDI values from 39.7 ± 4.8 mGy (median = 36.6 mGy)
to 28.1 ± 1.9 mGy (median = 28.1 mGy). DLP was decreased from
592 ± 87 mGycm (median = 547 mGycm) to 438 ± 39 mGycm (median
435 mGycm).
Conclusions: From the analysis of the dose indices, the introduction of ASiR
image reconstruction technique represents a valuable tool for dose reduc-
tion in pediatric CT exposures, maintaining high quality standards for clinical
images.
B.291
DEFINITION OF LOCAL REFERENCE DIAGNOSTIC LEVELS FOR CT WITH
A DOSE-TRACKING SOFTWARE
F. Palleri O. Ortenzia M. Sireu C. Ghetti a Department of Medical
Physics, University Hospital of Parma, Parma, Italy; b University of Cagliari,
Cagliari, Italy
Introduction: Dose optimization in CT examinations is a mandatory issue:
in this study local Diagnostic Reference Levels (lDRLs) for the most fre-
quent CT procedures performed in our Radiology Department have been
established by using a dose-tracking software.
Materials and Methods: The 75thpercentiles of CTDIvol and DLP of 10 CT
procedures were evaluated. Examinations were performed on adult pa-
tients from March to August 2015 in 5 Siemens CT scanners of Parma
Hospital. Dosimetric data of 13,000 exams have been extracted from an au-
tomated dose-tracking software, Radimetrics (Bayer). The CT procedures
were standard head (5947 exams), sinuses (289), dental (121), standard
chest (1976), cardiac (103), spine (327), pulmonary angiography (416), chest-
abdomen (1119), chest-abdomen-pelvis (765) and abdomen (1794).
We compared our lDRLs with Dlgs 187/00, with an Italian paper (Parolini
ER 2014) and with recent published international surveys (McGregor Ra-
diology 2015, Foley BJR 2012, Mafalanka RPD 2014).
Results: The 75thpercentiles of CTDIvol head (mGy) and DLPtot head
(mGycm) were 64 and 1005 for head, 38 and 465 for sinuses; 12 and 139
for dental.
The 75thpercentiles of CTDIvol body (mGy) and DLPtot body (mGycm) were
10 and 408 for chest, 16 and 719 for cardiac, 25 and 520 for spine, 6 and
425 for CT pulmonary angiography, 14 and 1749 for chest-abdomen, 14
and 2138 for CAP, 9 and 1390 for abdomen.
Our values result generally lower than values reported in scientific liter-
ature except for CTDIvol of Sinuses CT and DLP of CAP examinations.
Conclusions: The analysis of a large amount of data was possible with the
use of a dose-tracking software; we have established lLDRs for the most
frequent CT examinations performed in our hospital and we have focused
which are the CT scan protocols that need an optimization.
The setting of some dosimetric alerts in Radimetrics allows to control in
real time the CT scans and to perform the necessary corrective actions.
B.292
DESIGN AND IMPLEMENTATION OF AN IT MANAGEMENT SYSTEM FOR
A MEDICAL PHYSICS DEPARTMENT (MPD) ACTIVITY WORKFLOWS
M. Paolucci L. Servoli B. Checcucci R. Di Lorenzo M. Paladino
a USL Umbria 2, Servizio Di Fisica Medica, Foligno, Italy; b Istituto Nazionale
Di Fisica Nucleare, Perugia, Italy
Purpose: The activities of a MPD, either in a single Hospital or in a network
of Medical Institutions, are very complex and the data flow management
coming from different tasks is difficult and time consuming and there are
currently no commercial products that tackle in a satisfactory manner the
problem.
The aim of this work is to describe the design, implementation and oper-
ation of an Enterprise Resource Planning and a Database Management
System focused on managing the most important workflows of a MPD.
Materials and Methods: The system requirements are based on the ap-
plication of Italian national radiation protection and quality assurance (QA)
regulations, national and international guidelines and operating proce-
dures of the USL Umbria 2 MPD. The systems have been using a 3-tier
architecture, implemented via incremental releases: presentation,
middleware and data level with a presentation layer using a user friendly
Graphical User Interface.
Results: The system prototype is capable of recording information related
to all the medical instruments, MPD equipment, their relevant character-
istics, status and history, all the data coming from the quality controls and
maintenance activities, digest them and produce the relevant legal and ad-
ministrative reports.
Furthermore it has dedicated sections for Occupational Exposure to Ion-
izing Radiation (radiological surveillance of working environment and
workers) and QA program in diagnostic radiology.
The prototype system has been deployed and used from 2013.
Conclusions: The most relevant results are the increased levels of data se-
curity, the optimization of scheduled tasks, implying a more efficient use
of manpower, the homogeneity of the approach to the management of many
different activities.
Therefore there’s a high degree of innovation, which could bring signifi-
cant benefits to the work of medical physics staff and a model for future
developments.
B.293
A PROPOSAL OF MAMMOGRAPHY QC-RELATED INDICATOR FOR HTA
EVALUATION
M. Piergentili * F. Bis F. Cavagnett N. Canevaroll D. Rembado
A. Rivolta R. Rosasco E.M.L. Vaccara E. Zucchi R. Rebagliati
F. Foppiano a ASL5, La Spezia, Italy; b ASL3, Genova, Italy; c I.R.C.C.S. Azienda
Ospedaliera Universitaria San Martino, IST, Genova, Italy;d ASL2, Savona, Italy;
e ASL4, Chiavari, Italy; f ASL1, Imperia, Italy
e86 Abstracts/Physica Medica 32 (2016) e71–e96