Dose comparison between CTDI and the AAPM Report No. 111 methodology in adult, adolescent, and child head phantom

Abstract

The standard computed tomography dose index (CTDI) metric tends to underestimate scatter radiation in cone beam computed tomography (CBCT) acquisition; therefore, the American Association of Physicists in Medicine (AAPM) Task Group 111 proposed a new dosimetry methodology to measure equilibrium dose at the center of a phantom (z = 0) using a 2-cm thimble ionization chamber. In this study, we implement the CTDI and the AAPM method with a thimble chamber on adult, adolescent, and child head phantoms using the Toshiba Aquilion One CBCT and compare the results to the CTDI measured with a 10-cm pencil chamber. Following the AAPM protocol, the normalized (100 mAs) equilibrium doses (D eq ) computed using dose measurements taken in the central hole of the phantom (D eq,c ), the peripheral hole of the phantom, (D eq,p ), and by the CTDI w equation (D eq,w ) are 20.13 ± 0.19, 21.53 ± 0.48, and 20.93 ± 0.40 mGy for adult; 21.55 ± 0.40, 21.14 ± 0.43, and 21.08 ± 0.45 mGy for adolescent; and 24.58 ± 0.40, 24.92 ± 0.85, and 24.77 ± 0.72 mGy for child, respectively. The CTDI w , which measured 17.70, 19.86, and 22.43 mGy for adult, adolescent and child respectively, is about 10% lower than their corresponding D eq ’s. The extended AAPM method proposed by Deman et al., which estimates the dose profile along the rotational axis (z axis), has demonstrated consistency between theoretical and experimental results for all phantoms. With the introduction of the child and the adolescent head phantoms, we not only have emphasized the practical aspects including relative convenience of the CTDI method and accuracy of the AAPM method, but also proposed a method to approximate D eq for different sized patients.