Thesis (M. Tech. (Diagnostic Radiography)) Central University of Technology, Free State, 2014 / Over the past two decades, interventional radiology has been a fast developing field with great advances in technology in the diagnosing and treatment of patients. Interventional radiology procedures are minimally invasive and require little to no hospitalisation time. These procedures are fluoroscopically guided and serial runs are used for documentation, so they have the potential to deliver high doses to patients. Reports about deterministic skin reactions resulting from interventional radiology have become more and more prevalent from the early 1990s. Worldwide concern thus led to legislation for the limitation, justification and optimisation of these doses. Setting of diagnostic reference levels (DRLs) for these procedures is difficult, as they can be complex in nature and are often clinically open-ended. In the case where DRLs were used, they needed to be for a specific locality and had to be refined for the specific circumstances. Patients must be informed of the doses they will be receiving during diagnostic or interventional procedures before consent can be obtained from them. Little information on dose audits was available for South Africa at the time of the study, and it was decided to determine dose ranges at a local level. The research question of this study was: “What radiation doses do patients receive when undergoing vascular, diagnostic and interventional procedures in the interventional suites at a tertiary training hospital in the Free State?” The primary objective was to determine the doses and dose ranges to patients. A secondary objective was to identify specific high dose procedures to individual patients and to the population. A third objective was to investigate the factors influencing these doses. The data of patients who received procedures in two fluoroscopic rooms at the research site were documented over a three-year period. The dose area product (DAP) values were used to calculate skin dose. With the information gathered, dose ranges for frequently performed procedures were determined and specific high dose procedures to individuals and the population identified. Factors influencing the dose were also investigated. This included the relationship of the level of technology, a VI patient’s BMI and practitioners’ level of experience on dose as the research site was a training facility. The results indicated that both diagnostic and interventional procedures have the potential to deliver high doses, as was evident with the isolated occurrences where the response threshold for deterministic effects was exceeded. Most of the locally performed procedures delivered lower or on par radiation dose, compared to values in the literature. Increased BMI values of patients can negatively influence doses received. The level of a practitioner’s experience also plays a vital role in the dose that the patient will receive. Specific recommendations and the implementing of a dose optimisation protocol are proposed to reduce and optimise doses at the research site. This dose optimisation programme will create greater awareness about radiation dose and effects, follow-up procedures and dose reduction methods amongst role-payers. Key words: interventional radiology; limitation, justification and optimisation of radiation dose; deterministic effects; radiation dose awareness

The goal of this study was to improve dosimetry for pelvic, lung, head and neck, and other cancers sites with aspherical planning target volumes (PTV) using a new algorithm for collimator optimization for intensity modulated radiation therapy (IMRT) that minimizes the x-jaw gap (CAX) and the area of the jaws (CAA) for each treatment field. A retroactive study on the effects of collimator optimization of 20 patients was performed by comparing metric results for new collimator optimization techniques in Eclipse version 11.0. Keeping all other parameters equal, multiple plans are created using four collimator techniques: CA0, all fields have collimators set to 0°, CAE, using the Eclipse collimator optimization, CAA, minimizing the area of the jaws around the PTV, and CAX, minimizing the x-jaw gap. The minimum area and the minimum x-jaw angles are found by evaluating each field beam’s eye view of the PTV with ImageJ and finding the desired parameters with a custom script. The evaluation of the plans included the monitor units (MU), the maximum dose of the plan, the maximum dose to organs at risk (OAR), the conformity index (CI) and the number of fields that are calculated to split. Compared to the CA0 plans, the monitor units decreased on average by 6% for the CAX method with a p-value of 0.01 from an ANOVA test. The average maximum dose remained within 1.1% difference between all four methods with the lowest given by CAX. The maximum dose to the most at risk organ was best spared by the CAA method, which decreased by 0.62% compared to the CA0. Minimizing the x-jaws significantly reduced the number of split fields from 61 to 37. In every metric tested the CAX optimization produced comparable or superior results compared to the other three techniques. For aspherical PTVs, CAX on average reduced the number of split fields, lowered the maximum dose, minimized the dose to the surrounding OAR, and decreased the monitor units. This is achieved while maintaining the same control of the PTV. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2017. / FAU Electronic Theses and Dissertations Collection

Intensity modulated radiation therapy (IMRT) is a cancer treatment method in which the intensities of the radiation beams are modulated; therefore these beams have non-uniform radiation intensities. The overall result is the delivery of the prescribed dose in the target volume. The dose distribution is conformal to the shape of the target and minimizes the dose to the nearby critical organs. An inverse planning algorithm is used to obtain those non-uniform beam intensities. In inverse treatment planning, the treatment plan is achieved by using an optimization process. The optimized plan results to a high-quality dose distribution in the planning target volume (PTV), which receives the prescribed dose while the dose that is received by the organs at risk (OARs) is reduced. Accordingly, an objective function has to be defined for the PTV, while some constraints have to be considered to handle the dose limitations for the OARs. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection

The objective of this thesis is to determine and analyze the dose rate to personnel throughout the proposed IRIS nuclear power plant. To accomplish this objective, complex models of the IRIS plant have been devised, advanced transport theory methods employed, and computationally intense simulations performed. IRIS is an advanced integral, light water reactor with a 335 MWe expected power output (1000 MWth). Due to its integral design, the IRIS pressure vessel has a large downcomer region. The large downcomer and the neutron reflector provide a great deal of additional shielding. This increase in shielding ensures that the IRIS design easily accomplishes the regulatory dose limits for radiation workers. However, The IRIS project set enhanced objectives of further reducing the dose rate to significantly lower levels, comparable or below the limit allowed for general public. The IRIS nuclear power plant design is very compact and has a rather complex geometric structure. Programs that use conventional methods would take too much time or would be unable to provide an answer for such a challenging deep penetration problem. Therefore, the modeling of the power plant was done using a hybrid methodology for automated variance reduction implemented into the MAVRIC sequence of the SCALE6 program package. The methodology is based on the CADIS and FW-CADIS methods. The CADIS method was developed by J.C. Wagner and A. Haghighat. The FW-CADIS method was developed by J.C. Wagner and D. Peplow. Using these methodologies in the MAVRIC code sequence, this thesis shows the dose rate throughout most of the inhabitable regions of the IRIS nuclear power plant. This thesis will also show the regions that are below the dose rate reduction objective set by the IRIS shielding team.

Thesis (MTech (Biomedical Technology))--Cape Technikon, Cape Town, 2004 / The need for radiobiological research was bom from the discovery that high doses of radiation could cause cancer and other health effects. However, recent developments in molecular biology uncovered the effects of low doses of radiation on different biological systems and as a result new techniques have been developed to measure these effects. The aim of this study was thus to validate biomarkers of initial DNA strand breaks, micronucleus formation, and the different pt ;ases of apoptosis as biological indicators of low-dose radiation damage. Furthermore, the difference in response of blood cells to different qualities and doses of radiation was investigated by irradiating cells with low- and high-LET radiation simultaneously. Blood from one donor was irradiated with doses between 0 and 4 Gy gamma- and neutron radiation. The alkaline single-cell gel electrophoresis (comet) assay was performed on different cell preparations directly after irradiation for the detection of initial DNA strand breaks. Radiation-induced cytogenetic damage was investigated using the cytokinesis-blocked micronucleus assay while different features of apoptosis were investigated by measuring caspase activation, enzymatic DNA fragmentation, and cellular morphology. The comet assay was sensitive enough to detect DNA strand breaks above 0.25 Gy and showed that the Iymphocyte isolation process induced some endogenous damage in cells, detected by the formation of highly damaged cells and hedgehogs in isolated cell preparations only.

Orientador: Paulo Sérgio Flores Campos / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-23T21:46:21Z (GMT). No. of bitstreams: 1 Neves_FredericoSampaio_D.pdf: 1442261 bytes, checksum: c45a8c982a306e84e96e0e626c50d60c (MD5) Previous issue date: 2013 / Resumo: O objetivo no presente estudo foi avaliar a influência dos tipos de escaneamento da tomografia computadorizada de feixe cônico (TCFC) no diagnóstico de fraturas radiculares e na qualidade da imagem na presença de diferentes materiais intracanal. A amostra foi composta por trinta dentes unirradiculares divididos em três grupos (n=10): controle, fratura radicular completa e incompleta. Em cada dente foram utilizados diferentes materiais intracanal (guta-percha, pino metálico e pino de fibra de vidro), bem como a ausência de material intracanal. Cada dente foi escaneado no tomógrafo 3D Accuitomo 170 utilizando-se quatro diferentes tipos de escaneamentos (High-Resolution, High-Fidelity, Hi-Speed e Standard). Adicionalmente, os valores de produto dose área foram calculados em cada tipo de escaneamento da TCFC. As imagens foram avaliadas aleatoriamente por cinco radiologistas odontológicos. Observou-se que fraturas radiculares completas foram mais facilmente visualizadas do que as incompletas. A presença do pino metálico e da guta-percha influenciaram negativamente no diagnóstico de fratura radicular. Em relação aos tipos de escaneamento da TCFC, não houve influência no diagnóstico de fratura radicular completa. Para os casos de fratura radicular incompleta, os protocolos High-Fidelity, High-Resolution e Standard obtiveram uma maior acurácia de diagnóstico, especialmente nos grupos pino de fibra de vidro e sem preenchimento. Pôde-se concluir que os tipos de escaneamento da TCFC influenciaram pouco no diagnóstico de fraturas radiculares, sendo que a presença de materiais intracanal apresentou um maior impacto em seu diagnóstico / Abstract: The aim of this study was to evaluate the influence of cone beam computed tomography (CBCT) imaging modes in the diagnosis of root fractures as well as in subjective image quality with different intracanal materials. The sample consisted of thirty single-rooted teeth divided in three grupous (n=10): control, complete and incomplete root fracture. In each tooth different materials used were used (gutta-percha, metal post and fiber post), as well as the no filling material. Each tooth/root was scanned in a 3D Accuitomo 170 CBCT device using four different imaging modes (High-Resolution, HighFidelity, High-Speed and Standard). Additionally, the dose-area product was calculated for each CBCT imaging mode. The images were randomly evaluated by five dentomaxillofacial radiologists. Complete root fractures were visualized more easily than incomplete fractures. The presence of metal post and gutta-percha influenced negatively the diagnosis of root fracture. Regarding the CBCT imaging modes, there was no influence for complete root fracture diagnosis. In cases of incomplete root fractures, High-Fidelity, High-Resolution and Standard had a higher diagnostic accuracy, especially in the fiber post and no filling groups. In conclusion, the CBCT imaging modes had little influence in the diagnosis of complete and incomplete root fractures, while the presence of intracanal material had greater impact in the diagnosis / Doutorado / Radiologia Odontologica / Doutor em Radiologia Odontológica

La radiochirurgie par Gamma Knife constitue une modalité thérapeutique reconnue de certaines affections cérébrales. Le traitement se base sur l’administration d’un rayonnement focalisé au niveau d’une cible intracrânienne. L’efficacité de ce traitement repose sur la délivrance d’une dose d’irradiation efficace au sein d’un volume-cible associé à la délivrance d’une dose d’irradiation négligeable à l’extérieur de ce même volume-cible. En pratique, la dose d’irradiation administrée à l’intérieur du volume-cible n’est pas distribuée de manière homogène, et la dose d’irradiation reçue par les tissus situés en-dehors du volume-cible n’est pas nécessairement faible. Notre travail est basé sur l’hypothèse que l’imperfection de la distribution de la dose d’irradiation au sein du volume-cible et en-dehors de celui-ci peut être responsable des échecs et des complications rencontrées en radiochirurgie. Dans deux modèles cliniques de traitement radiochirurgical, le schwannome vestibulaire et la névralgie du trijumeau, nous avons montré qu’il existait une relation entre les paramètres de distribution de dose d’irradiation et certains résultats du traitement radiochirurgical par Gamma Knife de ces pathologies. Nous avons développé deux modèles expérimentaux d’irradiation radiochirurgicale de rats, l’un ciblé sur le striatum et l’autre sur le nerf trijumeau, permettant d’analyser les conséquences histologiques des variations de la distribution de dose à l’intérieur du volume-cible ainsi qu’à distance de celui-ci. Nous avons démontré que la réponse radiobiologique des tissus irradiés était fortement dépendante de ce paramètre dosimétrique, et que ce dernier constituait une donnée de la planification chirurgicale aussi importante que la dose de prescription. Nous avons corrélé ces résultats avec certaines observations réalisées dans d’autres indications de traitement radiochirurgical ainsi que dans l’analyse histologique de tumeurs traitées par Gamma Knife. Ces études mettent en évidence le rôle important joué par l’optimalisation de la distribution de la dose d’irradiation dans l’amélioration des résultats cliniques du traitement radiochirurgical. Les valeurs optimales de la distribution de dose dans les différentes indications de traitement radiochirurgical doivent être recherchées, et les différentes méthodes mises à notre disposition lors de la planification dosimétrique pour améliorer la distribution de dose doivent être utilisées avec discernement pour obtenir la dosimétrie radiochirurgicale la plus parfaite possible. / Doctorat en sciences médicales / info:eu-repo/semantics/nonPublished

<p>Kompjuterizovana tomografija (CT) je jedan od najznačajnijh dijagnostičkih modaliteta, čija upotreba raste iz decenije u deceniju. U ukupnom broju radiolo&scaron;kih pregleda CT je zastupljena sa 5-10%, ali je njen doprinos ukupnoj dozi za populaciju veći od 50%. Osnovni pokazatelji kvaliteta slike i doza, kao i prateći radijacioni rizik zavise od primenjene radiografske tehnike odnosno CT pregleda. U smislu&nbsp; dobre radiolo&scaron;ke prakse i u skladu sa osnovnim principima za&scaron;tite od zračenja, poželjna je primena najniže moguće doze za pacijenta uz održavanje kvaliteta slike i dijagnostičke informacije. Cilj istraživanja jeste definisanje optimalnog protokola pregleda vi&scaron;eslojnom CT za dijagnozu pojedinih regija tela, kao i da se utvrde doze i radijacioni rizik za pacijente pre i nakon optimizacije protokola. Analizom je obuhvaćeno ukupno 437 pacijenata, koji su podeljeni u grupe prema regijama tela koje su snimane: I&ndash;nekontrastni CT glave, II-CT glave sa i.v. kontrastom, III-CT grudnog ko&scaron;a, IV-CT abdomena i karlice i V-CT angio (CT angiografija aortoilijačnog segmenta i donjih ekstremiteta). Studija je izvedena u 2 faze: u I fazi je kori&scaron;ćen standardni protokol za regiju tela koja se snimala, a u II fazi CT pregledi su izvedeni po modifikovanom protokolu (promenom parametra vrednosti mAs), uz minimalne zahteve u pogledu kvaliteta slike.Na osnovu dozimetrijskih&nbsp; pokazatelja procenjena je efektivna doza i radijacioni rizik za pacijente u obe faze. U studiji su kori&scaron;ćene smernice iz Vodiča EUR 16262&nbsp; EN, u kojima su definisani parametri za procenu kvaliteta slike da bi se analizirali različiti anatomski preseci određenih regija tela koji su se snimali. Kvalitet slike za svakog pacijenta je ocenjen pomoću trostepene skale vizualizacije za svaki parametar anatomske regije: 0-detalji su vidljivi, 1-detalji se prikazuju, 2-detalji se jasno prikazuju. Kori&scaron;ćena je subjektivna metoda gde su dva iskusna radiologa vr&scaron;ili interpretaciju slike. Konačna ocena kvaliteta slike svakog pregleda odgovara zbiru svih parametara procenjenih po trostepenoj skali&nbsp; vizualizacije. Zatim je za potrebe izračunavanja veličine FOM (figure of merit) izračunata vrednost indeksa ocene kvaliteta slike (zbir svih&nbsp; ocena parametra/brojem parametara). Vrednost FOM je izračunata kao količnik indeksa ocene kvaliteta slike i efektivne doza po pacijentu. Prosečna vrednost FOM za svaku grupu ispitanika nam je poslužila kao relativni pokazatelj za upoređivanje između neoptimizovane i optimizovane grupe ispitanika za isti tip pregleda. Poređenjem vrednosti efektivne doze u prvoj i drugoj fazi istraživanja kvantifikovano je smanjenje radijacionog opterećenja za pacijente nakon optimizacije protokola. Rezultati su pokazali da je optimalnim izborom protokola u&nbsp;&nbsp; smislu parametara ekspozicije (smanjenjem vrednosti mAs) moguće značajno smanjiti dozu zračenja kod pregleda glave za 7,5%, kod pregleda glave sa angiografijom za 7%, kod pregleda grudnog ko&scaron;a za 40%, kod pregleda abdomena i karlice za 25%. Grupa CT angio&nbsp; nije mogla da bude optimizovana, jer aparat nije prihvatao promenu kvaliteta slike kod zadatih parametara optimizacije. Primenom standardnih protokola postiže se kvalitet slike bolji nego &scaron;to je neophodno, a samim tim i veća doza zračenja nego &scaron;to je potrebno. Optimalnim izborom protokola u smislu parametara ekspozicije moguće je značajno smanjiti dozu zračenja, uz održavanje kvaliteta slike koji je dovoljan za adekvatnu radiolo&scaron;ku interpretaciju slike.</p> / <p>Computed&nbsp; tomography (CT) is one of the most significant diagnostic methods whose application has been increasing from decade to decade.&nbsp; Among the total number of radiological examinations CT accounts for 5-10%, however, its contribution in the whole dosage for the population is greater than 50%. Main indicator of the quality of images and dosages as well as the accompanying irradiation risk depend on applied radiographic technique that is CT examination. In the sense of good radiological practice and in accordance with basic principles of protection from irradiation, the application of the lowest possible dosage for a patient together with preserving the quality of image and diagnostic information are mostly welcomed. The goal of the research is to define the optimum examination protocol by multislice CT in diagnostics of certain body regions as well as to determine dosages and irradiation risk for patients both before and after protocol optimization. The analysis has included 437 patients divided into groups according to body regions which have been scanned: I-unenhanced head CT, II contrast enhanced head CT, III&ndash;chest CT, IV&ndash;abdomen and pelvis CT and&nbsp; V&ndash;angio CT (CT angiography of aortoiliac segment and lower extremities). The study has been conducted in 2 phases: in the first phase standard protocol for the scanned body region has been applied, and in the second phase CT examinations have been carried out according to the modified&nbsp; protocol&nbsp; (by change of parameters of values mAs)&nbsp; with minimum&nbsp; requirements&nbsp; regarding&nbsp; the&nbsp; image&nbsp; quality. On&nbsp; the&nbsp; basis&nbsp; of&nbsp; dosimetric&nbsp; indicators&nbsp; the&nbsp; efficient&nbsp; dosage&nbsp; and&nbsp; irradiation&nbsp; risk&nbsp; for&nbsp; the patients in both phases have been assessed. In the study the guidelines form the Guide EUR&nbsp; 16262&nbsp; EN&nbsp; have&nbsp; been&nbsp; observed&nbsp; where&nbsp; parameters for&nbsp; the&nbsp; assessment&nbsp; of&nbsp; image quality&nbsp; have&nbsp; been&nbsp; defined&nbsp; in&nbsp; order&nbsp; to&nbsp; analyze&nbsp; different&nbsp; anatomic&nbsp; cross sections of certain body&nbsp; regions.&nbsp; Image quality&nbsp; for&nbsp; each&nbsp; patient&nbsp; was&nbsp; assessed&nbsp; by&nbsp; three-level visualization&nbsp; scale&nbsp; for&nbsp; each&nbsp; parameter&nbsp; of&nbsp; anatomic&nbsp; region:&nbsp; 0&ndash;details&nbsp; are&nbsp; visible, 1&ndash;details are&nbsp; presented,&nbsp; 2&ndash;details are clearly&nbsp; presented.&nbsp; A&nbsp; subjective&nbsp; method&nbsp; was applied&nbsp; where&nbsp; two&nbsp; experienced&nbsp; radiologists performed&nbsp; the&nbsp; image interpretation. Final assessment&nbsp; of&nbsp; image quality&nbsp; of&nbsp; every&nbsp; examination corresponds&nbsp; to&nbsp; the&nbsp; sum&nbsp; of&nbsp; all parameters&nbsp; according&nbsp; to&nbsp; three-level&nbsp; visualization&nbsp; scale. Further,&nbsp; for&nbsp; the&nbsp; need&nbsp; of calculation of the size of FOM (figure of merit) the value of the index of assessment of the&nbsp; image&nbsp; quality&nbsp; (sum of all assessments of parameters/number of&nbsp; parameters) has been&nbsp; calculated.&nbsp; The&nbsp; value of&nbsp; FOM&nbsp; has&nbsp; been&nbsp; calculated as a quotient&nbsp; of&nbsp; the&nbsp; image quality assessment index and effective dosage per patient.&nbsp; The average value of FOM for&nbsp; every&nbsp; group&nbsp; of&nbsp; patients&nbsp; has&nbsp; offered us a&nbsp; relative&nbsp; indicator for&nbsp; comparison of&nbsp; non-optimum&nbsp; and optimum group of&nbsp; patients&nbsp; for&nbsp; the&nbsp; same&nbsp; type&nbsp; of&nbsp; examinations.&nbsp; By comparison of values of effective dosage in the first and second phase of the research a decrease in irradiation load for patients after protocol optimization was quantified. The results have&nbsp; shown&nbsp; that&nbsp; by&nbsp; optimum&nbsp; protocol&nbsp; selection&nbsp; in&nbsp; the&nbsp; sense&nbsp; of&nbsp; exposition parameters (by&nbsp; reduction of&nbsp; values of&nbsp; mAs) it is&nbsp; possible to reduce significantly&nbsp; the irradiation dosage at&nbsp; unenhanced head CT examination for 7,5%, at contrast enhanced head CT examination for 7%, at chest CT examination for 40%, at abdomen&nbsp; and pelvis CT examination for 25%. The group CT angio could not be optimized since the device&nbsp; did&nbsp; not&nbsp; accept&nbsp; the&nbsp; change in image quality at set&nbsp; optimization parameters. By application&nbsp; of&nbsp; standard&nbsp; protocols the image quality&nbsp; better&nbsp; than required&nbsp; was&nbsp; achieved and along with this, a higher irradiation dosage occurred than required. By selection of protocol in the sense&nbsp; of&nbsp; exposition parameters it is possible to reduce irradiation dosage significantly along with preserving image quality which is&nbsp; sufficient for adequate radiological image interpretation.</p>

Computed tomography urography (CTU) is today the imaging method used to investigate patients with suspected urinary tract malignancy, replacing the old imaging method intravenous pyelography (IVP) about a decade ago. The downside of this shift was that the effective radiation dose to the examined patient was eight times higher for CTU compared to IVP. Based on four different studies, the present thesis focused on efforts to reduce the CTU radiation dose.   In study I, the number of cysts and solid lesions in the separate scan phases was evaluated in 57 patients undergoing four-phase CTU 1997-98. The number of scans was reduced from four to three when the nephrographic scan was abolished following study I. Study II registered the diameter of renal cell carcinoma (RCC) and the presenting symptoms in the total number of patients (n=232) diagnosed with RCC between 1997 and 2003. The results from study II showed that the critical size for RCCs to cause macroscopic hematuria was ≥ 4 cm. Study III was a dose-escalation study aimed to decide the minimal possible tube load in the unenhanced and excretory phase scans if the low dose images are reviewed together with normal dose corticomedullary phase images. Study III showed that it is possible to reduce the mean effective dose in three phase CTU from 16.2 mSv to 9.4 mSv with a combined low and normal dose CTU protocol. Study IV investigated the changes in the CTU protocol between 1997 and 2008, and the development of the effective radiation dose. Study IV clarified how the CTU protocol has changed between 1997 and 2008 and as a result the mean effective radiation dose to patients undergoing CTU in 2008 is only 39% of the effective dose in 1997.   In conclusion, the findings from the studies included in this thesis have contributed to a reduced radiation dose to patients undergoing CTU. The mean effective dose from CTU is at present only three times higher compared to that from the IVP.

Introdução: O uso da tomografia de múltiplos detectores para avaliar a doença arterial coronariana tem aumentado, fornecendo informações valiosas para rotina clínica. O risco potencial da exposição à radiação, por outro lado, exige manter a dose de radiação tão baixo quanto razoavelmente possível. Objetivo: testar e avaliar o ajuste de parâmetros de aquisição no bolus tracking (BT) para reduzir a dose de radiação nos exames de angiotomografias das artérias coronárias (ATCC), sem comprometer a qualidade da imagem. Métodos: Este é um estudo prospectivo de 289 pacientes que realizaram ATCC. Os pacientes foram distribuídos consecutivamente em 4 grupos: A (n = 70), B (n = 79), C (n = 68) e D (n = 72). O grupo A foi o protocolo de referência - recomendado pelo fabricante do tomógrafo. As imagens dos outros grupos foram adquiridas por parâmetros de configuração diferentes do BT, em tempo, para alcançar a redução da dose de radiação. As imagens da fase da angiografia, para todos os grupos, foram realizadas com configurações semelhantes. Foram avaliados parâmetros de qualidade de imagem qualitativa e quantitativamente e a exposição da radiação. Resultados: A dose de radiação do BT foi significativamente diferente entre os grupos, principalmente quando comparados os grupos D e A (p < 0,001), grupos C e A (p < 0,001) e grupos B e A (p < 0,001), com a maior redução no grupo D (redução de 50% em relação ao grupo A). Não houve nenhuma diferença significativa entre os grupos em relação à dose de radiação efetiva e à qualidade de imagem da fase angiográfica. No entanto, a dose de radiação efetiva total (BT + fase angiográfica) foi estatisticamente diferente entre os grupos A e D (p = 0,025). Conclusão: O ajuste do tempo para a aquisição do BT reduz significativamente a dose de radiação efetiva em até 50%, sem reduzir a qualidade da imagem, oferecendo uma nova perspectiva para a redução da radiação total durante a ATCC / Introduction: Modern multidetector computed tomography scanners for assessing coronary artery disease have been growing in use, providing valuable information in clinical routine. The potential risk of radiation exposure, on the other hand, requires keeping radiation dose as low as reasonably achievable. Objectives: Test and evaluate the bolus tracking (BT) acquisition parameters adjustment to reduce radiation dose in coronary computed tomography angiography (CCTA), without compromising image quality. Methods: This is a prospective study of 289 patients referred to CCTA. Patients were consecutively distributed into 4 groups: A (n=70), B (n=79), C (n=68) and D (n=72). Group A was the reference protocol - recommended by the scanner manufacturer. The images of other groups were acquired by setting different time BT parameters in order to achieve radiation dose reduction. The images of angiography phase for all groups were performed with similar settings. Qualitative and quantitative image quality parameters and radiation exposures were evaluated. BT radiation dose was significantly different among groups, mainly when comparing groups D and A (p < 0.001), groups C and A (p < 0.001) and groups B and A (p < 0.001), with the highest reduction in group D (50% reduction in relation to group A). There was no significant difference between groups regarding effective radiation dose for the angiographic phase or image quality. However, total effective radiation dose (BT + angiographic phase) was statistically different between groups A and D (p= 0.025). Conclusion: Time adjustment of BT acquisition significantly reduces effective radiation dose in up to 50%, without reducing image quality, offering a new perspective for total radiation reduction during CCTA