Priscilla Butler

CT
8 strategies to optimize radiation dose in CT
How can imaging providers optimize CT dose to maximize the risk-benefit ratio and deliver better patient care? In this article, Priscilla Butler from the American College of Radiology offers eight actionable strategies for managing radiation dose while still providing diagnostic quality and accuracy.
July 13, 2017
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Example of AI-assisted pulmonary nodule detection and longitudinal volumetric assessment in a 65-year-old woman with peripheral arterial disease, a 24-pack-year smoking history, emphysema, and a family history of lung cancer. An incidental 8.5-mm right lower lobe pulmonary nodule is identified at CT angiography of the abdomen in July 2022 but does not receive follow-up. Subsequent imaging demonstrates interval growth, and CT-guided biopsy confirms stage IA lung adenocarcinoma. Contrast-enhanced axial chest CT images obtained on February 2, 2024, before robotic-assisted thoracoscopic segmentectomy, show a 12.1-mm spiculated right lower lobe pulmonary nodule. (A) Conventional contrast-enhanced axial chest CT image without AI assistance shows a 12.1-mm spiculated right lower lobe pulmonary nodule. (B) Corresponding CT image with AI-assisted pulmonary nodule detection, automated segmentation, and quantitative nodule assessment identifies a solid pulmonary nodule (nodule #1) measuring 13 × 8 (11) mm, with a volume of 739 mm3, a 45% volumetric increase compared with the previous contrast-enhanced chest CT performed on October 9, 2023 (510 mm3), and an estimated volume doubling time (VDT) of 216 days. (C) AI-generated longitudinal nodule analysis displays automated segmentation of the current (February 2, 2024) and previous (October 9, 2023) CT examinations, 3D nodule reconstruction, and quantitative volumetric assessment for longitudinal follow-up. The AI interface is displayed in the original software language (Dutch).
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