The influence of patient positioning on radiation dose in CT imaging: A narrative review |
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| Affiliation: | 1. School of Dentistry and Medical Sciences, Faculty of Science and Health, Charles Sturt University, Wagga Wagga, NSW, 2650, Australia;2. Department of Medical Imaging, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, 13133, Jordan;3. Department of Medical Imaging, College of Medicine and Health, University of Exeter, Devon, UK;1. Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia;2. Medical Research Centre, Jazan University, Jazan, Saudi Arabia 45142;3. Department of Diagnostic Radiology, King Khalid Hospital, Najran, Saudi Arabia;4. Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia;5. Imaging Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia;1. Radiology Department, Sunshine Coast University Hospital, 6 Doherty Street, Birtinya, Sunshine Coast, Queensland 4575, Australia;2. Griffith University, Gold Coast, Queensland, Australia;1. Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA;2. Department of Radiation Oncology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA;3. Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA;1. Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran;2. Tabriz University of Medical Sciences, Faculty of Medicine, Imam Reza Hospital, Department of Radiology;3. Department of Medical Physics, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran;4. Department of Radiology, Faculty of Alliance Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran & Medical Radiation Sciences Research Group, Tabriz University of Medical Sciences, Tabriz, Iran |
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| Abstract: | ![]()
Background and purposeAlthough it is fundamental for optimal scanner operation, it is generally accepted that accurate patient centring cannot always be achieved. This review aimed to examine the reported knowledge of the negative impact of patient positioning on radiation dose and image quality during CT imaging. Furthermore, the study evaluated the current optimisation tools and techniques used to improve patient positioning relative to the gantry iso-center.MethodologyA comprehensive search through the databases PubMed, Ovid, and Google Scholar was performed. Keywords included patient off-centring, patient positioning, localiser radiograph orientation, radiation dose, and automatic patient positioning (including synonyms). The search was limited to full-text articles that were written in English. After initial title and abstract screening, a total of 52 articles were identified to address the aim of the review. No limitations were imposed on the year of publication.ResultsVertical off-centring was reported in up to 95% of patients undergoing chest and abdominal CT examinations, showing a significant influence on radiation dose. Depending on the scanner model and vendor, localiser orientation, bowtie filter used, and patient size, radiation dose varied from a decrease of 36% to an increase of 91%. A significant dose reduction was demonstrated when utilising an AP localiser, aligning with the trend for radiographers to off-center patients below the gantry iso-centre. Utilizing a 3D camera for body contour detection allowed for more accurate patient positioning and promoted further dose reduction.ConclusionPatient positioning has shown significant effects on radiation dose and image quality in CT. Developing a good understanding of the key factors influencing patient dose (off-centring direction, localiser orientation, patient size and bowtie filter selection) is critical in optimising CT scanning practices. Utilising a 3D camera for body contour detection is strongly recommended to improve patient positioning accuracy, image quality and to minimise patient dose. |
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