Publications by authors named "Moulay Ali Nassiri"

5 Publications

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Assessment of patients' cumulative doses in one year and collective dose to population through CT examinations.

Eur J Radiol 2021 Sep 22;142:109871. Epub 2021 Jul 22.

Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Sherbrooke, Québec, Canada; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke (CIUSSS de l'Estrie - CHUS), Sherbrooke, Québec, Canada; Department of Nuclear Medicine and Radiobiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Canada.

Purpose: To estimate percentage of patients undergoing multiple CT exams leading to cumulative effective dose (CED) of more than 25, 50, 75 and 100 mSv in one year and assess per capita and the collective effective dose.

Methods: Data from a regional hospital network was collected retrospectively using radiation dose monitoring system at 6 facilities with 8 CT scanners. The data was analyzed to find number of patients in different dose groups, their age, gender, number of CT exams and exams needed to reach 100 mSv based on age groups.

Results: In one year 43,010 patients underwent 75,252 CT examinations. The number of exams per 1000 population was 153. Further 27% of the patients were younger than 55- years and 15.9% of them were younger than 45-year-old. A total of 0.67% of patients received a CED > 100 mSv; 3.5% had CED > 50 mSv, 11.9% with CED > 25 mSv and the maximum CED was 529 mSv. The minimum time to reach 100 mSv was a single CT exam. Seven patients received > 100 mSv in a single CT exam. 0.36% of patients had 10 or more CT exams in one year and 3.8% had 5 or more CT exams. The mean CED was 12.3 mSv, the average individual effective dose was 1.1 mSv and the collective effective dose was 521.3 person-Sv.

Conclusions: The alarming high CED received by large number of patients and with high collective dose to population requires urgent actions by all stake holders in the best interest of patient radiation safety.
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http://dx.doi.org/10.1016/j.ejrad.2021.109871DOI Listing
September 2021

Simplified size adjusted dose reference levels for adult CT examinations: A regional study.

Eur J Radiol 2021 Sep 13;142:109861. Epub 2021 Jul 13.

Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Sherbrooke, Québec, Canada; Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke (CIUSSS de l'Estrie - CHUS), Sherbrooke, Québec, Canada; Department of Nuclear Medicine and Radiobiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Canada.

Purpose: To investigate retrospective classification of adult patients into small, average, and large based on effective diameter (EDia) from localizer image of computed tomography (CT) scans and to develop regional diagnostic reference levels (DRLs) and achievable doses (AD).

Method: The patients falling within the mean ± standard deviation (SD) of EDia were classified as average; those below this range as small and above as large. The CTDIdose-length-product (DLP) and size-specific dose estimates (SSDE) of all adult patients undergoing CT examinations in 8 CT facilities for 11 months (Dec. 2019 - Oct. 2020) were evaluated. The 75th and 50th percentile values were compared with national and international values.

Results: Of the total of 69,434 CT examinations, nearly 80% fell within average size. The 75th percentile values of CTDI and DLP for small patients for abdomen-pelvic exams were nearly half of average sized patients. Similarly, the 75th percentile values for large patients were nearly double. Similar findings were not found for chest exams. Analysis of image quality and dose factors such as noise, mean axial length, slice thickness, mean number of sequences, use of iterative reconstruction and tube current modulation (TCM) resulted in identification of opportunities for improvement and optimization of different CT facilities.

Conclusions: DRLs for adult patients were found to vary widely with patient size and thus establishing DRLs only for standard sized patient is not adequate. Simplified and intuitive methods for size classification was shown to provide meaningful information for optimization for patients outside the standard size adult.
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http://dx.doi.org/10.1016/j.ejrad.2021.109861DOI Listing
September 2021

CT dose reduction: approaches, strategies and results from a province-wide program in Quebec.

J Radiol Prot 2016 06 6;36(2):346-362. Epub 2016 Jun 6.

Centre d'expertise clinique en radioprotection (CECR), Sherbrooke (Québec), Canada. Centre intégré universitaire de santé et de services sociaux de l'Estrie-Centre hospitalier universitaire de Sherbrooke (Québec), Canada.

Many studies have shown a statistically significant increase of life-time risk of radiation-induced cancer from CT examinations. In this context, in Canada, the Quebec's provincial clinical center of expertise in radiation safety (CECR) has led a province-wide tour of 180 CT installations in order to: (i) evaluate the technical and functional performance of CT scanners, (ii) evaluate and improve radiation safety practices and (iii) initiate, with local teams, a CT dose optimization process. The CT tour consisted of a two day visit of CT installations by a CECR multidisciplinary team of medical physicists, engineers and medical imaging technologists (MITs) carried out in close collaboration with local teams composed of MITs, radiologists, physicists, engineers and managers. The CECR has evaluated 112 CT scanners since 2011. Optimization of CT protocols was performed in all centers visited. The average dose reduction obtained from optimization was [Formula: see text], [Formula: see text] and [Formula: see text] for adult head, thorax and abdomen-pelvis, respectively. The main recommendations often made by the CECR experts were: (1) the implementation of low-dose protocols for the follow-up of pulmonary nodules and for renal calculi, (2) the compliance to the prescribed scan range as defined by local guidelines, (3) the correct positioning of patients and (4) the use of bismuth shielding to reduce the dose to radiosensitive organs. The CECR approach to optimize CT doses to patients is based on the active participation of local stakeholders and takes into account the performance of CT scanners. The clinical requirements as expressed by radiologists remain at the core of the optimization process.
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http://dx.doi.org/10.1088/0952-4746/36/2/346DOI Listing
June 2016

Fast GPU-based computation of spatial multigrid multiframe LMEM for PET.

Med Biol Eng Comput 2015 Sep 8;53(9):791-803. Epub 2015 Apr 8.

Département de radio-oncologie and Centre de recherche du CHU de Québec, Québec, QC, Canada.

Significant efforts were invested during the last decade to accelerate PET list-mode reconstructions, notably with GPU devices. However, the computation time per event is still relatively long, and the list-mode efficiency on the GPU is well below the histogram-mode efficiency. Since list-mode data are not arranged in any regular pattern, costly accesses to the GPU global memory can hardly be optimized and geometrical symmetries cannot be used. To overcome obstacles that limit the acceleration of reconstruction from list-mode on the GPU, a multigrid and multiframe approach of an expectation-maximization algorithm was developed. The reconstruction process is started during data acquisition, and calculations are executed concurrently on the GPU and the CPU, while the system matrix is computed on-the-fly. A new convergence criterion also was introduced, which is computationally more efficient on the GPU. The implementation was tested on a Tesla C2050 GPU device for a Gemini GXL PET system geometry. The results show that the proposed algorithm (multigrid and multiframe list-mode expectation-maximization, MGMF-LMEM) converges to the same solution as the LMEM algorithm more than three times faster. The execution time of the MGMF-LMEM algorithm was 1.1 s per million of events on the Tesla C2050 hardware used, for a reconstructed space of 188 x 188 x 57 voxels of 2 x 2 x 3.15 mm3. For 17- and 22-mm simulated hot lesions, the MGMF-LMEM algorithm led on the first iteration to contrast recovery coefficients (CRC) of more than 75 % of the maximum CRC while achieving a minimum in the relative mean square error. Therefore, the MGMF-LMEM algorithm can be used as a one-pass method to perform real-time reconstructions for low-count acquisitions, as in list-mode gated studies. The computation time for one iteration and 60 millions of events was approximately 66 s.
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http://dx.doi.org/10.1007/s11517-015-1284-9DOI Listing
September 2015

Fast GPU-based computation of the sensitivity matrix for a PET list-mode OSEM algorithm.

Phys Med Biol 2012 Oct 14;57(19):6279-93. Epub 2012 Sep 14.

Département de radio-oncologie, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.

During the last decade, studies have shown that 3D list-mode ordered-subset expectation-maximization (LM-OSEM) algorithms for positron emission tomography (PET) reconstruction could be effectively computed and considerably accelerated by graphics processing unit (GPU) devices. However, most of these studies rely on pre-calculated sensitivity matrices. In many cases, the time required to compute this matrix can be longer than the reconstruction time itself. In fact, the relatively long time required for the calculation of the patient-specific sensitivity matrix is considered as one of the main obstacle in introducing a list-mode PET reconstruction algorithm for routine clinical use. The objective of this work is to accelerate a fully 3D LM-OSEM algorithm, including the calculation of the sensitivity matrix that accounts for the patient-specific attenuation and normalization corrections. For this purpose, sensitivity matrix calculations and list-mode OSEM reconstructions were implemented on GPUs, using the geometry of a commercial PET system. The system matrices were built on-the-fly by using an approach with multiple rays per detector pair. The reconstructions were performed for a volume of 188 × 188 × 57 voxels of 2 × 2 × 3.15 mm(3) and for another volume of 144 × 144 × 57 voxels of 4 × 4 × 3.15 mm(3). The time to compute the sensitivity matrix for the 188 × 188 × 57 array was 9 s while the LM-OSEM algorithm performed at a rate of 1.1 millions of events per second. For the 144 × 144 × 57 array, the respective numbers are 8 s for the sensitivity matrix and 0.8 million of events per second for the LM-OSEM step. This work lets envision fast reconstructions for advanced PET applications such as real time dynamic studies and parametric image reconstructions.
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http://dx.doi.org/10.1088/0031-9155/57/19/6279DOI Listing
October 2012
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