Organ-based tube current modulation and bismuth eye shielding in pediatric head computed tomography.

BACKGROUND: Exposure of the eye lens to ionizing radiation results in cataract. Several dose optimization techniques to protect the lens are available for computed tomography (CT). OBJECTIVE: The radiation dose to the eye lens, volume CT dose index (CTDIvol) and image quality of various methods of dose optimization were evaluated for pediatric head CT: automated tube current modulation (ATCM), automated tube voltage selection (ATVS), organ-based tube current modulation (OBTCM) and bismuth shielding. MATERIALS AND METHODS: An anthropomorphic phantom of a 5-year-old child was scanned with nine protocols: no dose optimization technique and then adding different dose optimization techniques alone and in combination. Dose to the eye, thyroid and breast were estimated using metal oxide semiconductor field effect transistor (MOSFET) dosimetry. CTDIvol, influence of timing of shield placement, image noise and attenuation values in 13 regions of interest of the head and subjective image quality were compared. RESULTS: The eye shield significantly reduced the eye lens dose when used alone, to a similar degree as when using all software-based techniques together. When used in combination with software-based techniques, the shield reduced the eye lens dose by up to 45% compared to the no dose optimization technique. Noise was significantly increased by the shield, most pronounced in the anterior portion of the eye. CONCLUSION: The combination of ATCM, ATVS, OBTCM and a bismuth shield, with the shield placed after acquiring the localizer image, should be considered to reduce the radiation dose to the eye lens in pediatric head CT.

Normal sonographic liver and spleen dimensions in a central European pediatric population.

BACKGROUND: Organ size is influenced by a number of factors. Age, height, weight, and ethnicity are known influencing factors. Pediatric populations have changed over time, puberty beginning earlier resulting in a changing growth pattern of their organs. Hence, contemporary charts using local data are considered the most appropriate for a given population. Sonographic charts for liver size for a predominantly Caucasian population are limited, which has implications for clinical practice. The aim of this study was to define a contemporary normative range of liver and spleen sizes for a healthy, predominantly Caucasian population and for all pediatric age groups (0-18 years) and to investigate whether there is a size difference between genders and ethnicities. METHODS: Retrospective study including children with normal sonographic findings and no evidence of liver or splenic disease clinically. Craniocaudal and anteroposterior dimensions are measured for the right and left lobe of the liver, and craniocaudal dimension for the spleen. Relationship of the liver and spleen dimensions with age, body length, body surface area, weight, and gender were investigated. Charts of normal values were established. Values were compared to studies involving other ethnicities and to one study carried out in 1983 involving the same ethnicity. RESULTS: Seven hundred thirty-six children (371 boys, 365 girls) aged 1 day - 18.4 years were included. From the second year of life, the craniocaudal dimension of the right lobe of the liver is 1-2 cm larger in the Central European population compared with non-Caucasian populations at a given age. Liver size of Central European children in 2020 is greater compared to a similar population almost 40 years ago. The craniocaudal dimension of the spleen of Central European, US-American and Turkish children is similar. The difference between genders is statistically significant for both the liver and the spleen, being larger in boys. CONCLUSION: Contemporary and ethnically appropriate reference charts for liver and spleen measurements should be used, especially for liver size. The effect of ethnicity is reduced if patient height rather than age is referenced.

Convergence patterns and multiple species interactions in a designed plant mixture of five species.

It is known that convergence and divergence can occur in complex plant communities, but the relative importance of biotic and abiotic factors driving these processes is less clear. We addressed this issue in an experiment using a range of mixed stands of five species that are common in Swiss fens (Carex elata, C. flava, Lycopus europaeus, Lysimachia vulgaris and Mentha aquatica) and two levels of water and nutrients. One hundred and seventy-six experimental mixtures were maintained in large pots (75 l) for two consecutive growing seasons in an experimental garden. The stands varied systematically in the initial relative abundance of each of the five species and in overall initial stand abundance. The changes in biomass over 2 years were modelled as linear functions of treatments and the initial biomass of each species. The dynamics of the system were mainly driven by differences in the identity of species and by a negative feedback mechanism but also by different abiotic conditions. In all mixtures, C. elata became more dominant over time, which caused an overall convergence of community composition. In addition, the rate of change of each species' biomass was negatively related to its own initial abundance. Thus, a negative feedback further contributed to the convergence of communities. Species responded differently to water level and nutrient supply, causing community dynamics to differ among treatments. However, the different abiotic conditions only slightly modified the overall convergence pattern. Competitive interactions between more than two species were weaker than the negative feedback but still significantly influenced the species' final relative abundance. The negative feedback suggests that there is niche partitioning between the species, which permits their coexistence.