Scanner thoracique low dose - .Scanner thoracique ultra low dose Un scanner hom©opathique ? H....

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Transcript of Scanner thoracique low dose - .Scanner thoracique ultra low dose Un scanner hom©opathique ? H....

  • Scanner thoracique ultra lowdose

    Un scanner homopathique ?

    H. ZARQANE

    imagerie ADV (Pr Kovacsik)

  • 200 mGy.cm

  • 200 mGy.cm

  • 200 mGy.cm

  • Niveau de Rfrence

    Diagnostique7 mSv

    Irradiation naturelle

    2,4 mSv

  • Niveau de Rfrence

    Diagnostique7 mSv

    Scanner optimis

    3,6 mSv

    Directive Euratom !!s Low As

    Reasonably Achievable

    Irradiation naturelle

    2,4 mSv

  • Radio thorax (F + P)

    0,2 mSv

    Scanner lowdose

    1 mSv

    Scanner optimis

    3,6 mSv

    Niveau de Rfrence

    Diagnostique7 mSv

  • Scanner Ultra Low Dose

    Radio thorax (F + P)

    0,2 mSv

    Scanner lowdose

    1 mSv

    Scanner optimis

    3,6 mSv

    Niveau de Rfrence

    Diagnostique7 mSv

  • Scanner Ultra Low Dose

    Radio thorax (F + P)

    0,2 mSv

    Scanner lowdose

    1 mSv

    Scanner optimis

    3,6 mSv

  • Scanner optimis

    Scanner Ulta Low Dose

  • Scanner Ultra Low Dose

    Radio thorax (F + P)

    0,2 mSv

    Scanner lowdose

    1 mSv

    Scanner optimis

    3,6 mSv

  • Scanner Ulta Low Dose

    Radio thorax

    Scanner optimis

  • Indications potentielles

    Non indications

    Indications

  • Indications

  • Indications

    ULD

  • Indications

    < 5%

    ULD

  • Dtection et suivi des nodules pulmonaires SOLIDES

    DLP: 158 mGy.cmDLP: 18 mGy.cm

    Image quality assessment of ultra low-dose chest CT usingsinogram-affirmed iterative reconstruction

    So Won Lee, Chest 2014

  • Dtection et suivi des nodules pulmonaires SOLIDES

    Computed tomography of the chest with model-based iterativereconstruction using a radiation exposure similar to chest X-rayexamination: preliminary observations.

    Neroladaki A, Eur Radiology, fvrier 2013

  • Dtection et suivi des nodules pulmonaires SOLIDES

    Bilan dextension thoracique de noplasie

    Suivi de nodules indtermins

  • Dtection et suivi des nodules pulmonaires SOLIDES

    Bilan dextension thoracique de noplasie

    Suivi de nodules indtermins

    Volumtrie ?

    Influence of radiation dose and iterative reconstruction algorithmsfor measurement accuracy and reproducibility of pulmonary nodule volumetry: A phantom study.

    Kim, European Radiology, Mai 2014

  • Diagnostic des pneumopathies

    DLP: 16 mGy.cm DLP: 173 mGy.cm

    Early Chest CT scan to assist diagnosis and guide treatment decision for suspected communityacquired pneumonia

    Claessens, AJR 2015

  • Exposition lamiante

    DLP: 16 mGy.cm DLP: 147 mGy.cm

    Diagnostic performance of ULD CT for detecting asbestos-related pleuropulmonary diseases

    Schaal, ECR 2015

  • Guidage des biopsies

    Safety, efficacy and feasability of ULD-CT for percutaneous needle biopsy of pulmonary lesions

    Adiga, Radiology 2014

  • Indications potentielles

  • Dpistage cancer poumon

    Reduced Lung cancer mortality with low dose computed tomographic screening

    NLST, New England 2011

    USA: Dpistage recommand chez patients haut risque (diminution mortalit 20 %)

    Dose recommande: 1-1,5 mSv

    White paper on lung cancer screeningKauczor, Eur Resp Journal

    2015

  • Dtection et suivi TUBERCULOSE pulmonaire

    DLP: 16 mGy.cm

  • Bilan de BPCO

    DLP: 16 mGy.cm DLP: 255 mGy.cm

  • Bilan de BPCO

    DLP: 16 mGy.cm

    Dtection de lemphysme ?

    ULD chest-CT: accuracy for lung densitometryand emphysema detection

    Am Journal Roentgenol, 2015

    Se: 92 % Sp: 96 %

    Image quality assessment of ultra low-dosechest CT using sinogram-affirmed iterativereconstruction

    So Won Lee, Chest 2014

    Image non diagnostique : 60 %

  • Bilan de BPCO

    DLP: 18 mGy.cmDLP: 221 mGy.cm

    Image quality assessment of ultra low-dosechest CT using sinogram-affirmed iterativereconstruction

    So Won Lee, Chest 2014

  • Bilan de BPCO

    DLP: 16 mGy.cm

    Syndrome bronchique

    Distortion architecturale

    CT of bronchiectasis: effect of radiation dose on image quality

    Yi, Am J Roentgenol2003

  • Suivi de mucoviscidose

    Image quality assessment of ultra low-dose chest CT usingsinogram-affirmed iterative reconstruction

    So Won Lee, Chest 2014

  • Non indications

  • Nodules en verre dpoli < 1 cm

    DLP: 17 mGy.cm DLP: 319 mGy.cm

    Image quality assessment of ultra low-dose chest CT usingsinogram-affirmed iterative reconstruction

    So Won Lee, Chest 2014

  • Pneumopathie interstitielle

    DLP: 17 mGy.cm DLP: 297 mGy.cm

  • SURPOIDS !!!

  • SURPOIDS !!!

  • SURPOIDS !!!

    Pourcentage scanner ULD ininterprtable

  • SURPOIDS !!!

    IMC 19

    IMC 27

  • SURPOIDS !!!

    IMC 29

  • 200 mGy.cm

  • 200 mGy.cm

    Nodules en verre dpoli < 1 cm

  • Scanner Ultra Low Dose

    Radio thorax (F + P)

    0,2 mSv

    Scanner lowdose

    1 mSv

    Scanner optimis

    3,6 mSv

  • Scanner Ultra Low Dose

    Radio thorax (F + P)

    0,2 mSv

    Scanner lowdose

    1 mSv

    Scanner optimis

    3,6 mSv

    0 mSv Pas de contrle!!!

  • CONCLUSION

    ULD

  • CONCLUSION

    ULD

  • CONCLUSIONFais tes valises

    gros !Je vais prendre

    ta place !Cest ce quon

    va voir

    Scanner optimisScanner Ultra Low

    Dose

  • CONCLUSION

  • CONCLUSION

    MERCI pour votre attention

    !!

    H. ZARQANERadiologie ADV (Pr Kovacsik)