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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can EBCT protocol be modified in order to monitor the progression of emphysema?

Answered by
Dr.
Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6675 Questions

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Posted on Wed, 7 Sep 2016 in X-ray, Lab tests and Scans
Question: Hi, I would like to order for myself (I am a physician) a cardiac CT in order to get a calcium score which will then inform how aggressive I should be with my lipids/whether to take a statin. I would ideally like to assess for emphysematous lung changes concurrent with the EBCT (shortness of breath, impaired exercise tolerance, prior history of smoking, normal PFTs but recent data showing prior smokers with normal PFTs can/do still have chronic lung changes, want to know for peace of mind). I'm wondering if an EBCT can be protocoled to simultaneously assess for lung emphysematous changes. Also wondering how many sieverts or rads such a study would involve and how this value would compare to other studies (e.g. CXR). Thank you, XXXX
doctor
Answered by Dr. Vivek Chail 1 hour later
Brief Answer:
Protocol modification is possible after discussing with the technologist

Detailed Answer:
Hi Doctor.
Thanks for writing in to us.

EBCT is electron beam CT and is a technique where electron beams are used to generate x rays which will help in imaging. MDCT is multidetector CT and is a technique where there is use of x ray tube for imaging.

EBCT protocol can be modified to include a scan of the lungs.

In calcium scoring by MDCT, the radiation dose is 3 mSv
In a standard chest CT to study lungs the radiation dose is 7 mSv
In CT coronary angiography the radiation dose is 16 mSv

Research has shown that radiation dose in EBCT and MDCT is nearly equal.

A chest x ray has a radiation dose of 0.1 mSv.

Therefore you can see that calcium scoring can give you 30 times radiation of a chest x ray.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail 42 minutes later
Thank you very much, Dr. Chail. I am understanding you to tell me that an EBCT performed to yield a coronary calcium score can indeed be protocoled to evaluate the lung parenchyma and inspect for emphysematous changes and that the radiation dose of an EBCT is less than half the dose of a standard chest CT and 30 times the dose of a CXR. Thank you, that puts to rest a question I have had for some time.

Best regards,
XXXX
doctor
Answered by Dr. Vivek Chail 10 hours later
Brief Answer:
Please discuss protocol modification as required with the technologist

Detailed Answer:
Hi Doctor,
Thanks for writing back with an update.

The scan parameteres have to be modified to include the lungs and this can mildly increase the radiation dose of the scan. It is recommenced to talk to the technologist and then proceed with modifying the protocol as required.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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