A 55-year-old woman presented with a mucopurulent sinusal discharge from the right supragluteal region, with symptoms over the previous five months. This abscess began as a slowly swelling growth, which eventually turned into a discharging sinus, and she was diagnosed with a gluteal abscess. The patient underwent incisional drainage, and intra-operatively, the sinus tract could be seen extending to the retroperitoneum. A subsequent CT scan and an MRI of the abdomen revealed a large heterogeneous retroperitoneal cystic mass on the right side of midline, extending inferiorly into the anterior thigh along the iliopsoas. Superiorly, a tubular projection extended from the lesion, indenting the ileocaecal junction, while a fluid filled cutaneous fistulous tract was seen, extending to the right flank. A diagnosis of pseudomyxoma retroperitonei, likely of retrocaecal appendicular origin, was proposed. An explorative laparotomy with an appendectomy, and the evacuation of the retroperitoneal collection were completed. The subsequent histopathology confirmed the diagnosis of appendicular mucinous cystadenoma, with pseudomyxoma retroperitonei.

Introduction: Radiation exposure during the CT examination has always been a concern due to its associated cancer risk. The guidelines suggest the optimization of radiation dose reduction. Therefore, this study aims to determine the feasibility of dose reduction strategies on radiation dose reduction using a phantom. Methods: Head and body phantoms of 16 cm and 32 cm, respectively, were used to calculate the radiation dose and measure the quantitative image quality. The phantoms were positioned and scanned with the standard protocol and low dose protocol. For dose reduction strategies, scan length was reduced in head phantom, and tube voltage and tube current were manipulated individually and by combining both and tested in both head and body phantoms. Also, the influence of rotation time was investigated in body phantom. Quantitative image quality was determined by drawing a region of interest on the obtained image. Results: Reducing scan length showed 41% reduction of radiation dose and reducing tube current, and tube voltage showed up to 75% reduction of radiation dose in head phantom and 70% reduction of radiation dose in body phantom compared to the standard protocol. The reduction of the rotation time, however, reduced the scan time and the radiation dose but the maximum mAs or tube current allowed was limited. Quantitative image quality was reduced when using a lower dose protocol. Conclusion: The dose reduction strategies showed a reduced dose, but the quantitative image quality score was reduced when scanned with low dose protocol. Further manipulation can be performed to maintain image quality.

Introduction: Reducing radiation dose for CT examinations has been accompanied by an increase in image noise. Studies have highlighted the application of a higher matrix size for improving image quality when assessing the lungs. This study aims to evaluate the influence of a low kVp and higher matrix size on radiation dose and image quality for abdominopelvic CT. Methods: This experiment was done on a 32 cm body phantom and scanned using a 128 slice CT scanner. The study utilised various combinations of kVp settings (140, 120, 100, 80 & 70) and matrix sizes (1024, 768 & 512). The image obtained was analysed objectively and subjectively. For objective analysis, we calculated SNR, and CNR. For subjective analysis, two radiologists evaluated the image in a 3-point scoring scale. Results: The study reported an increase in SNR (0.8%) and CNR (46%) at 120 kVp when increasing the matrix size from 512 x 512 to 768 x 768. Similarly, there was an increase of 14.5 % and 56.4 % in CNR and SNR using 1024 matrix size. The DLP was reduced by 4.5%, 50% and 70.6 % using 100, 80 and 70 kVp respectively. However, there was no change in DLP with higher matrix sizes. Conclusion: The study reported a combination of 100 kVp and 768 matrix size resulted in an almost similar (↓0.9 %) SNR and improved CNR (↑46.4 %) compared to 120 kVp and 512 matrix size. Qualitative analysis also showed a similar image quality with decreased radiation dose for abdominopelvic CT.