ABSTRACT
Background: Computed Tomography [CT] is main contributor of population dose from diagnostic X-ray examinations. Children are more radiosensitive than adults, thus optimization of CT examination in these patients is essential. The purpose of this study was to evaluate dose delivered to pediatric patients' undergoing CT examination of the common examinations and also establishing local Diagnostic Reference Levels [DRLs]. Materials and Methods: Questionnaires were designed for data collection at seven public hospitals and information about patient, protocol and CT system were recorded during 2013 and 2014. Dose measurement was performed in four age groups: 0-1, 1-5, 5-10 and 10-15 years old and two CT dose quantity including CTDIw and DLP were calculated. Results: Values of 40, 48, 59.5, 59.5 mGy; 16.9, 16.9, 17.14, 17.14 mGy; 17, 17, 17, 17 mGy; 17, 17, 19.2, 19.2 mGy in terms of CTDIw and 448, 538, 758, 758 mGy cm; 129, 129, 154, 167 mGy cm; 184, 225, 306, 315 mGy cm; 289, 408, 595, 670 mGy cm in terms of DLP as regional DRL for brain, sinus, chest, abdomen and pelvic examinations were obtained respectively. Conclusion: The variations in dose of some examination were considerable. As the role and usage of CT technology continues to expand, it is important that all practitioners adapt optimized protocols, especially for pediatrics scanning, following proposed reference levels
ABSTRACT
Carcinoid tumors arise from neuroendocrine cells throughout the body. Ninety percent of these tumors derived from the kulchitsky cells within the gastrointestinal tract. Metastasis to the liver from this tumor is resistant to chemotherapy. Hepatic artery embolization recommended a method for treatment of these patients. In this study we report the outcome of treatment with hepatic artery embolization in a patient with involvement >75% of liver parenchyma to metastasis. A 32 year old woman with carcinoid tumor of small intestine was admitted to our hospital. CT scan was performed and the patient had multiple liver metastases. After surgery, chemotherapy was performed for the treatment of liver metastasis but the patient showed no response to chemotherapy. Because of severe pain, the patient underwent hepatic artery embolization with polyvinyl alcohol. After two months due to recurrence of RUQ pain, 40cc of ethanol [96%] was injected into liver artery and the pain was relieved. Interventional radiology and hepatic artery embolization with poly vinyl alcohol are not certain methods for treating hypervascular metastatic liver tumor but it is considered as a suitable method for decreasing pain