Marc Kohli, MD

CT
How to comply with CMS's CT radiation dose measure
Inconsistency in CT radiation doses represents a modifiable health risk, and doses can be standardized through auditing and feedback to hospitals and physicians.
June 27, 2024
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SCCT: CT-first imaging protocol could transform chest pain evaluation
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Axial contrast-enhanced CT scan in a 28-year-old premenopausal woman shows an incidentally detected solid-appearing left ovarian lesion (solid arrow) anterior to the uterus (U), associated with trace ascites in the right adnexa and cul de sac (dashed arrows). At pathologic analysis, this was shown to be ovarian dysgerminoma. Two readers misdiagnosed this lesion, one as a leiomyoma and one as an ovarian fibroma.
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Images from two representative cases. (A-C) Images in an 82-year-old man with a calcified plaque in the proximal segment of the left anterior descending artery. (A, B) Curved planar reconstruction images from CCTA with (A) hybrid iterative reconstruction (HIR) and (B) super-resolution deep learning reconstruction (SR-DLR) show that the measured PDS was 66% for the HIR image and 42% for the SR-DLR image. (C) Quantitative analysis of the invasive coronary angiography (ICA) image (reference standard) revealed a PDS of 34% (arrow). (D-F) Images in a 37-year-old woman with a noncalcified plaque in the middle segment of the left circumflex artery. (D, E) Curved planar reconstruction images from CCTA with (D) HIR and (E) SR-DLR show that the measured PDS was 47% for the HIR image and 80% for the SR-DLR image. (F) Quantitative analysis of the ICA image revealed a PDS of 72% (arrow). Blue, red, and yellow lines in A, B, D, and E represent the proximal reference point, stenosed lesion, and distal reference point, respectively, and the insets show the corresponding cross-sectional images.
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