Computed Tomography Dose Index Values Research Articles

Evaluating polyester resin as a viable substitute for PMMA in computed tomography dosimetry phantoms

The current study aimed to evaluate the suitability of polyester resin as an alternative material to polymethyl methacrylate (PMMA) for computed tomography (CT) dosimetry phantoms using the GEANT4/GATE Monte Carlo simulation platform. Cylindrical phantoms (32 cm diameter) constructed of polyester resin and PMMA were simulated and compared in terms of atomic composition, effective atomic number, electron density, mass density, and photon interaction mechanisms. Weighted CT dose index (CTDIw) values were calculated for each phantom at 80, 110, and 130 kVp tube voltages based on measurements of CTDI100,c and CTDI100,p. Results demonstrated that the physical properties of polyester closely matched those of PMMA, and the polyester phantom displayed equivalent dosimetric behavior to the PMMA phantom at all tube voltages tested. CTDIw values from the polyester phantom were within 1.4 % of the PMMA phantom across all tube voltages. Conversion coefficients were derived to equate polyester CTDIw values to PMMA dose equivalents. This study found that a polyester resin phantom exhibited radiation dosimetry commensurate with the standard PMMA phantom for CT dose assessment. Consequently, polyester resin represents a viable substitute material when PMMA is unavailable for construction of CT dosimetry phantoms.

Establishment of local diagnostic reference levels for computed tomography with cloud-based automated dose-tracking software in Türkiye

The purpose of this study is to establish local diagnostic reference levels (LDRLs) for computed tomography (CT) procedures using cloud-based automated dose-tracking software. The study includes the dose data obtained from a total of 104,272 examinations performed on adult patients (>18 years) using 8 CT scanners over 12 months. The protocols included in our study were as follows: head CT without contrast, cervical spine CT without contrast, neck CT with contrast, chest CT without contrast, abdomen-pelvis CT without contrast, lumbar spine CT without contrast, high-resolution computed tomography (HRCT) of the chest, and coronary CT angiography (CTA). Dose data were collected using cloud-based automatic dose-tracking software. The 75th percentiles of the distributions of the median volume CT dose index (CTDIvol) and dose length product (DLP) values were used to determine the LDRLs for each protocol. The LDRLs were compared with national DRLs (NDRLs) and DRLs set in other countries. Inter-CT scanner variability, which is a measure of how well clinical practices are standardized, was determined for each protocol. Median values for each protocol were compared with the LDRLs for dose optimization in each CT scanner. The LDRLs (for DLP and CTDIvol, respectively) were 839 mGy.cm and 41.2 mGy for head CT without contrast, 530.6 mGy.cm and 19.8 mGy for cervical spine CT without contrast, 431.9 mGy.cm and 15.5 mGy for neck CT with contrast, 364.8 mGy.cm and 9.3 mGy for chest CT without contrast, 588.9 mGy. cm and 11.2 mGy for abdomen-pelvis CT without contrast, 713 mGy.cm and 24.3 mGy for lumbar spine CT without contrast, 326 mGy.cm and 9.5 mGy for HRCT, and 642.3 mGy.cm and 33.4 mGy for coronary CTA. The LDRLs were comparable to or lower than NDRLs and DRLs set in other countries for most protocols. The comparisons revealed the need for immediate initiation of an optimization process for CT protocols with higher dose distributions. Furthermore, protocols with high inter-CT scanner variability revealed the need for standardization. There is a need to update the NDRLs for CT protocols in Turkey. Until new NDRLs are established, local institutions in Turkey can initiate the optimization process by comparing their dose distributions to the LDRLs established in our study. Automated dose-tracking software can play an important role in establishing DRLs by facilitating the collection and analysis of large datasets.

Reconstruction of organ doses for patients undergoing computed tomography examinations in Canada 1992-2019.

We derived the first comprehensive organ dose library for Canadian pediatric and adult patients who underwent computed tomography (CT) scans between 1992 and 2019 to support epidemiological analysis of radiation risk. We calculated organ absorbed doses for Canadian CT patients in two steps. First, we modeled Computed Tomography Dose Index (CTDI) values by patient age, scan body part, and scan year for the scan period between 1992 and 2019 using national survey data conducted in Canada and partially the United Kingdom survey data as surrogates. Second, we converted CTDI values to organ absorbed doses using a library of organ dose conversion coefficients built in an organ dose calculation program, the National Cancer Institute dosimetry system for CT. In result, we created a library of doses delivered to 33 organs and tissues by different patient ages and genders, scan body parts and scan years. In the scan period before 2000, the organs receiving the greatest dose in the head, chest and abdomen-pelvis scans were the active marrow (3.7-15.2mGy), lungs (54.7-62.8mGy) and colon (54.9-68.5mGy), respectively. We observed organ doses reduced by 24% (pediatric head and torso scans, and adult head scans) and 55% (adult torso scans) after 2000. The organ dose library will be used to analyse the risk of radiation exposure from CT scans in the Canadian CT patient cohort.

An evaluation of CT radiation doses within the Yorkshire Lung Screening Trial.

To evaluate radiation doses for all low-dose CT scans performed during the first year of a lung screening trial. For all lung screening scans that were performed using a CT protocol that delivered image quality meeting the RSNA QIBA criteria, radiation dose metrics, participant height, weight, gender, and age were recorded. Values of volume CT dose index (CTDIvol) and dose length product (DLP) were evaluated as a function of weight in order to assess the performance of the scan protocol across the participant cohort. Calculated effective doses were used to establish the additional lifetime attributable cancer risks arising from trial scans. Median values of CTDIvol, DLP, and effective dose (IQR) from the 3521 scans were 1.1mGy (0.70), 42.4mGycm (24.9), and 1.15mSv (0.67), whilst for 60-80kg participants the values were 1.0mGy (0.30), 35.8mGycm (11.4), and 0.97mSv (0.31). A statistically significant correlation between CTDIvol and weight was identified for males (r = 0.9123, P < .001) and females (r = 0.9052, P < .001), however, the effect of gender on CTDIvol was not statistically significant (P = .2328) despite notable differences existing at the extremes of the weight range. The additional lifetime attributable cancer risks from a single scan were in the range 0.001%-0.006%. Low radiation doses can be achieved across a typical lung screening cohort using scan protocols that have been shown to deliver high levels of image quality. The observed dose levels may be considered as typical values for lung screening scans on similar types of scanners for an equivalent participant cohort. Presentation of typical radiation dose levels for CT lung screening examinations in a large UK trial. Effective radiation doses can be of the order of 1mSv for standard sized participants. Lifetime attributable cancer risks resulting from a single low-dose CT scan did not exceed 0.006%.

Study of CT Acquisition Protocols Using Two Head Phantoms

Computed Tomography (CT) scans promote a higher dose deposition than conventional radiology exams. These exams have significantly increased patient and collective doses and have become a global public health concern. There is a great need to improve protocols to seek for lower doses while maintaining the diagnostic image quality. The development of phantoms allows the testing of different acquisition protocols. In this study were tested two cylindrical head phantoms of polymethylmethacrylate (PMMA). One CT head phantom is the head standard test with 16 cm in diameter and the other head phantom developed is smaller at 12 cm in diameter. Both phantoms are 15 cm long. Different acquisition protocols were performed on a Philips CT scanner, Access model with 16 channels. The central slice of the phantoms was irradiated successively and measurements were performed using a pencil ionization chamber to obtain the CT air Kerma indexes in PMMA (Ck,PMMA,100) and CT dose indexes (CTDI). From these results, the CT Dose Index values weighted and volumetric (CTDIw, CTDIvol) were obtained to 10 cm scans of the central region of the head phantoms, in helical mode. The scans were performed using different voltage values (80, 100 and 120 kV) and charge (mA.s). Dose values varied from 5.59 to 21.51 mGy. The highest recorded dose value was 21.51 mGy for the smaller head phantom and 19.25 mGy for the standard head phantom with 120 kV. Considering the generation of images with the same diagnostic objective, the results obtained showed that the volumetric dose index (CTDIvol) presented a higher dose value in the 12 cm diameter phantom. This phantom has smaller volume than the standard head phantom.

Application of OSL strips in CT dosimetry according to the AAPM methodology

Computed tomography (CT) images contribute to high-quality medical diagnosis, but radiation dose can be quite high, requiring accurate assessment. CT dose index (CTDI) was developed for dosimetric purposes, but for scanners operated exclusively in axial mode. Nowadays, CTDI underestimate patient dose in helical CT exams. AAPM report TG111 (2010) suggested a new metric in which the patient's radiation dose is obtained from dose profiles constructed from several measurements made with a small ionization chamber. It is also possible to obtain dose profiles using properly calibrated OSL (optically stimulated luminescence) strips. The main objective of the present work is to contribute to optimizing CT dosimetry, comparing dose profiles obtained with OSL strips with measurements obtained by other authors. In this work, a “pencil” ionization chamber and 20 cm x 0.3 cm OSL strips were X-ray-irradiated, in air and in the holes of two cylindrical CT phantoms, using 100, 120, 140 kV peak voltages, both in lab and in a clinical CT scanner. Irradiated strips were read using an OSL reader built in the GDRFM. OSL profiles were calibrated against ionization chamber. From them, CTDIw and CTDIvol values were determined, differing approximately 3.9% from those of the CT scanner. From the profiles, also the planar equilibrium dose Deq,p (TG111) was evaluated in some CT protocols; Deq,p exceeded the CTDI values from the CT scanner in every case. E.g.: The percentage difference between Deq,p and CTDIvol for the head phantom ranged between 33-25%. Thus, in some cases, it could be advantageous to use calibrated OSL dosimeters instead of ionization chambers to obtain the profiles, saving time, because it is possible to obtain five OSL profiles from a single phantom irradiation.

Postoperative computed tomography imaging of pediatric patients with craniosynostosis: radiation dose and image quality comparison between multi-slice computed tomography and O-arm cone-beam computed tomography

BackgroundWhen postoperative multi-slice computed tomography (MSCT) imaging of patients with craniosynostosis is used, it is usually performed a few days after surgery in a radiology department. This requires additional anesthesia for the patient. Recently, intraoperative mobile cone-beam CT (CBCT) devices have gained popularity for orthopedic and neurosurgical procedures, which allows postoperative CT imaging in the operating room.ObjectiveThis single-center retrospective study compared radiation dose and image quality of postoperative imaging performed using conventional MSCT scanners and O-arm CBCT.Materials and methodsA total of 104 pediatric syndromic and non-syndromic patients who were operated on because of single- or multiple-suture craniosynostosis were included in this study. The mean volumetric CT dose index (CTDIvol) and dose-length product (DLP) values of optimized craniosynostosis CT examinations (58 MSCT and 46 CBCT) were compared. Two surgeons evaluated the subjective image quality.ResultsCBCT resulted in significantly lower CTDIvol (up to 14%) and DLP (up to 33%) compared to MSCT. Multi-slice CT image quality was considered superior to CBCT scans. However, all scans were considered to be of sufficient quality for diagnosis.ConclusionThe O-arm device allowed for an immediate postoperative CBCT examination in the operating theater using the same anesthesia induction. Radiation exposure was lower in CBCT compared to MSCT scans, thus further encouraging the use of O-arms. Cone-beam CT imaging with an O-arm is a feasible method for postoperative craniosynostosis imaging, yielding less anesthesia to patients, lower health costs and the possibility to immediately evaluate results of the surgical operation.

Evaluation of the relationship between phantom position and computed tomography dose index in cone beam computed tomography when assuming breast irradiation.

This study aims to investigate the influence of the phantom position on weighted computed tomography dose index (CTDIw) in cone beam computed tomography (CBCT) when assuming breast irradiation. Computed tomography dose index (CTDI) was measured by the x‐ray volume imaging of CBCT using parameters for image‐guided radiation therapy (IGRT) in right breast irradiation. The measurement points of CTDI ranged from 0 (center) to 16 cm in the right–left (RL) direction, and from 0 (center) to 7.5 cm in the anterior–posterior (AP) direction, which assumed right breast irradiation. A nonuniform change exists in the relative value of CTDIw when the phantom deviated from the isocenter of CBCT. The CTDIw was ~30% lower compared with the value at the isocenter of CBCT when the phantom deviated 7.5 and 16 cm at the AP and RL directions, respectively. This study confirmed the influence of the phantom position on the CTDI values of CBCT. The CTDI measured at the isocenter of CBCT overestimates that measured at the irradiation center of the breast.

Radiation doses from head, neck, chest and abdominal CT examinations: an institutional dose report.

We aimed to obtain typical values for head, neck, chest, and abdominal computed tomography (CT) examinations from routine patients in 2018, and to review our data with national and international diagnostic reference levels (DRLs). Single-phase head, neck, chest, and abdominal CT scans of adults performed in 64-slice CT in 2018 were included in this study. Radiation dose parameters of CT scans were obtained from the picture archiving and communication system of our hospital. Volumetric CT dose index (CTDIvol) and dose length product (DLP) values were recorded. Effective dose (ED) and scan length was calculated. A 16 cm diameter phantom is referenced for head CT, and 32 cm diameter phantom is referenced for neck, chest, and abdominal CT. Descriptive statistics of the variables were given according to the normality testing. Median CTDIvol value was 53 mGy for the head, 13.1 mGy for the neck, 8.3 mGy for the chest, and 8.6 mGy for the abdomen. Median DLP value was 988 mGy.cm for the head, 299 mGy.cm for the neck, 314 mGy.cm for the chest, and 457 mGy.cm for the abdomen. Median ED value was 2.07 mSv for the head, 1.76 mSv for the neck, 4.4 mSv for the chest, and 6.8 mSv for the abdomen. Considering national DRLs, median CTDIvol values of head, chest, and abdomen were lower, whereas median DLP and ED values of head and chest were higher. For the abdomen, the median DLP and ED values were lower. Overall radiation dose parameters obtained in this study points out the need for optimization of head CT examinations in our institution.

STUDY ON A SPECIFIC TEST METHOD FOR DOSIMETRIC CHARACTERIZATION OF ULTRA-WIDE DETECTOR COMPUTED TOMOGRAPHY

The purpose of this study was to establish a specific test method for dosimetric characterization of wide-beam computed tomography (CT). For a wide beam, the dose distribution curve and the area of the curve were obtained by using pencil-like ionization chamber, a long CT dose profiler probe, a head phantom and a body phantom. The absolute dose conversion coefficient was multiplied to obtain the total integration integral of the absolute dose distribution, and then the computed tomography dose index (CTDI) value under any wide beam condition was obtained by dividing the collimation width. It was calculated that the absolute dose conversion coefficient was 1.135 under the narrow beam of 8mm. To a 160mm-wide beam, the value of CTDI was 7.57mGy/100mAs after normalized in the head 80kV CT scanning, and it was 9.80mGy/100mAs after normalized in the body 120kV CT scanning. The specific test method solves the problem that the previous measurement method underestimates the CTDI value.

National Diagnostic Reference Level (DRL) for nuclear medicine computed tomography-positron emission tomography hybrid imaging studies for kuwait population: second phase dose audit-2019.

Objective:Diagnostic reference levels (DRLs) for CT part of positron emission tomography-CT (PET-CT) examinations are limited. The study was aiming to execute the second phase of the national DRL in support of optimisation and dose reduction in State of KW.Methods:In this multicentre collaborative PET-CT study, oncology patient data were exclusively collected due to the National MOH Ethical Committee recommendation and limitation of the other studies. Median, Mean, SD, 75th, 25th percentiles as well as whole body (WB) effective dose (ED) were calculated. The study was UK-IPEM-based methodology and it was the second phase of the study in Kuwait.Results:Half body (HB) and WB scans were 65 and 35% of the total enterers (309). The third quartile dose–length product (DLP) (mGy x cm) and volumetric CT dose index (mGy) values for the HB (537, 5) were higher than the UK NDRL (400, 4.3) but were lower than the Swiss NDRL (620, 6) and the France NDRL (762, 7.7). Comparatively, the proposed NDRLs for the WB (684, 4.1) were lower than Swiss National Data (720, 5.0) though, the Swiss had about 5000 (HB) & 706 (WB), the UK had 370 (HB) and France had 1000 (HB) entries. Calculated ED varied from 4.1 to 10.2 mSv, (mean values = 6.9 mSv) for HB and from 2.6 to 7 mSv (mean value = 4.6 mSv).Conclusions:There was 9.1% improvement in NDRL for 2019, compared to 2018, but there is a continuous need for improving NDRL.Advances in knowledge:Data provided a trend of NDRL that is served as a national data bank for continuous optimisation.

Monte Carlo Simulation of the Computed Tomography Dose Index (CTDI) Using GATE

This work relates to the study and characterization of the CTDI (Computed Tomography Dose Index) for the 16 slices CT scanner. The CTDI has been simulated with the Monte Carlo code GATE for PMMA (polymethylmethacrylate) digital phantoms of various diameters (1–50 cm) at various kVp (80, 110, 130) and mAs (100, 200, 300, 400 mAs) levels. After using a High-Performance Computing (HPC) station, a good agreement was observed (less than 1.18% for head phantom and 1.85% for body phantom for all applied voltages) between simulations and experimental measurements with standard PMMA phantoms. Results of simulations demonstrated the following. Firstly, GATE is an adapted tool to estimate CTDI values and can be used to optimize CT parameters in clinical applications. Secondly, Monte Carlo simulation may be able to estimate the absorbed dose when the CTDI method has limitations (use of homogeneous standards cylindrical phantom, the dose measurement in air not in tissue).

CT Dosimetry: What Has Been Achieved and What Remains to Be Done.

Radiation dose in computed tomography (CT) has become a hot topic due to an upward trend in the number of CT procedures worldwide and the relatively high doses associated with these procedures. The main aim of this review article is to provide an overview of the most frequently used metrics for CT radiation dose characterization, discuss their strengths and limitations, and present patient dose assessment methods. Computed tomography dosimetry is still based on a CT dose index (CTDI) measured using 100-mm-long pencil ionization chambers and standard dosimetry phantoms (CTDI100). This dose index is easily measured but has important limitations. Computed tomography dose index underestimates the dose generated by modern CT scanners with wide beam collimation. Manufacturers should report corrected CTDI values in the consoles of CT systems. The size-specific dose estimate has been proposed to provide an estimate of the average dose at the center of the scan volume along the z-axis of a CT scan. Size-specific dose estimate is based on CTDI and conversion factors and, therefore, its calculation incorporates uncertainties associated with the measurement of CTDI. Moreover, the calculation of size-specific dose estimate is straightforward only when the tube current modulation is not activated and when the patient body diameter does not change considerably along the z-axis of the scan. Effective dose can be used to provide typical patient dose values from CT examinations, compare dose between modalities, and communicate radiogenic risks. In practice, effective dose has been used incorrectly, for example, to characterize a CT procedure as a low-dose examination. Organ or tissue doses, not effective doses, are required for assessing the probability of cancer induction in exposed individuals. Monte Carlo simulation is a powerful technique to estimate organ and tissue dose from CT. However, vendors should make available to the research community the required information to model the imaging process of their CT scanners. Personalized dosimetry based on Monte Carlo simulation and patient models allows accurate organ dose estimation. However, it is not user friendly and fast enough to be applied routinely. Future research efforts should involve the development of advanced artificial intelligence algorithms to overcome drawbacks associated with the current equipment-specific and patient-specific dosimetry.

Radiation Dose to the Fetus From Computed Tomography of Pregnant Patients-Development and Validation of a Web-Based Tool.

Estimations of radiation dose absorbed by the fetus from computed tomography (CT) in pregnant patients is mandatory, but currently available methods are not feasible in clinical routine. The aims of this study were to develop and validate a tool for assessment of fetal dose from CT of pregnant patients and to develop a user-friendly web interface for fast fetal dose calculations. In the first study part, 750 Monte Carlo (MC) simulations were performed on phantoms representing pregnant patients at various gestational stages. The MC code simulating vendor-independent dose distributions was validated against CT dose index (CTDI) measurements performed on CT scanners of 2 vendors. The volume CTDI-normalized fetal dose values from MC simulations were used for developing the computational algorithm enabling fetal dose assessments from CT of various body regions at different exposure settings. In the institutional review board-approved second part, the algorithm was validated against patient-specific MC simulations performed on CT data of 29 pregnant patients (gestational ages 8-35 weeks) who underwent CT. Furthermore, the tool was compared with a commercially available software. A user-friendly web-based interface for fetal dose calculations was created. Weighted CTDI values obtained from MC simulations were in excellent agreement with measurements performed on the 2 CT systems (average error, 4%). The median fetal dose from abdominal CT in pregnant patients was 2.7 mGy, showing moderate correlation with maternal perimeter (r = 0.69). The algorithm provided accurate estimates of fetal doses (average error, 11%), being more accurate than the commercially available tool. The web-based interface (www.fetaldose.org) enabling vendor-independent calculations of fetal doses from CT requires the input of gestational age, volume CTDI, tube voltage, and scan region. A tool for fetal dose assessments from CT of pregnant patients was developed and validated being freely available on a user-friendly web interface.

Development of a head CT dose index (CTDI) phantom based on polyester resin and methyl ethyl ketone peroxide (MEKP): a preliminary study

This paper aims to develop phantoms for measurement of computed tomography dose index (CTDI) based on a polyester resin mixed with methyl ethyl ketone peroxide (MEKP) as catalyst. CT number and CTDI values of the polyester resin phantoms were compared with a standard polymethyl methacrylate (PMMA) phantom as reference. The percentage of MEKP was varied from 0.3 to 0.6 wt%. The polyester resin phantoms had diameter of 160 mm, length of 150 mm and five cylindrical holes with diameter of 13.5 mm. One hole was positioned at the centre of the phantom and the other four near its periphery, 10 mm from the edge. The results show that the CT number of the polyester resin phantom was about 1%–9% higher than that of the standard PMMA phantom. Among the polyester resin phantoms, the one with 0.3 wt% MEKP is closest to the standard PMMA phantom in terms of CT number. In addition, the difference in weighted CTDI value between the 0.3 wt% polyester resin phantom and the PMMA is less than 5%. Thus, the 0.3 wt% polyester resin is potentially used as an alternative to the standard PMMA, with the advantage of a lower cost.

Dose reduction for CT coronary calcium scoring with a calcium-aware image reconstruction technique: a phantom study

ObjectiveTo assess the dose reduction potential of a calcium-aware reconstruction technique, which aims at tube voltage-independent computed tomography (CT) numbers for calcium.Methods and materialsA cardiothoracic phantom, mimicking three different patient sizes, was scanned with two calcium inserts (named D100 and CCI), containing calcifications varying in size and density. Tube voltage was varied both manually (range 70–150 and Sn100 kVp) and automatically. Tube current was automatically adapted to maintain reference image quality defined at 120 kVp. Data was reconstructed with the standard reconstruction technique (kernel Qr36) and the calcium-aware reconstruction technique (kernel Sa36). We assessed the radiation dose reduction potential (volumetric CT dose index values (CTDIvol)), noise (standard deviation (SD)), mean CT number (HU) of each calcification, and Agatston scores for varying kVp. Results were compared with the reference acquired at 120 kVp and reconstructed with Qr36.ResultsAutomatic selection of the optimal tube voltage resulted in a CTDIvol reduction of 22%, 15%, and 12% compared with the reference for the small, medium, and large phantom, respectively. CT numbers differed up to 64% for the standard reconstruction and 11% for the calcium-aware reconstruction. Similarly, Agatston scores deviated up to 40% and 8% for the standard and calcium-aware reconstruction technique, respectively.ConclusionCT numbers remained consistent with comparable calcium scores when the calcium-aware image reconstruction technique was applied with varying tube voltage. Less consistency was observed in small calcifications with low density. Automatic reduction of tube voltage resulted in a dose reduction of up to 22%.Key Points• The calcium-aware image reconstruction technique allows for consistent CT numbers when varying the tube voltage.• Automatic reduction of tube voltage results in a reduced radiation exposure of up to 22%.• This study stresses the known limitations of the current Agatston score technique.

Monte Carlo dose index estimation in computed tomography

We numerically study the computed tomography dose index (CTDI) quantity based on the Monte Carlo method using GATE software. In this work, it was demonstrated that the CTDI values decreased following an exponential form as a function of phantom diameter. As expected, the absorbed dose is shown to have a good relationship which increases linearly with X-ray tube current (mAs) values. The simulation presented in particularly that the (CTDI) dose increases not-linearly dependence with photon deposited energy (kVp). It seems that the average percent of the absorbed dose in the abdominal phantom was lower than the heat phantom object's absorbed dose, which was equal to 80%. In conclusion, the use of Monte Carlo simulation represents a dosimetry tool for radiation protection in the field of radiology imaging.

Diagnostic reference levels for paediatric CT in Jordan

This study aimed to investigate the current status of Diagnostic Reference Levels (DRLs) in paediatric CT across Jordan. The dose data for four main CT examinations (brain, chest, abdominopelvic, and chest, abdomen and pelvis (CAP)) in hospitals and imaging centres (n = 4) were measured. The volume CT dose index (CTDIvol) and Dose Length Product (DLP) values were compared within the different hospitals and age groups (<1 year, 1–4 years, 5–10 years and 11–18 years). DRLs in Jordan were compared to international DRLs. The paediatric population consisted of 1818 children; 61.4% of them were male. There were significant variations between the DRLs for each CT scanner with an up to four-fold difference in dose between hospitals. There were apparent significant differences between Jordan and other countries with the DLPs in Jordan being relatively high. However, for CTDIvol, the values in Jordan were close to those of other countries. This study confirmed variations in the CTDIvol and DLP values of paediatric CT scans in Jordan. These variations were attributed to the different protocols and equipment used. There is a need to optimise paediatric CT examinations doses in Jordan.

Monte Carlo simulations of different CT X-ray energy spectra within CTDI phantom and the influence of its changes on radiochromic film measurements

PurposeIn this work we use Monte Carlo simulations to investigate change in Computed tomography (CT) X-ray energy spectra between exposures in air and within CT dose index (CTDI) phantom. While the results of these simulations will be relevant when measuring CTDI with any dosimeter, we apply the appropriate beam quality change correction for CTDI measurements using XR-QA2 model GafChromic™ film. MethodsDose profiles were measured with film strips, sandwiched between acrylic rods cut in half, placed within CTDI phantoms and scanned before and after irradiation with document scanner in reflective mode. Reference dosimetry system was calibrated in terms of air kerma in air, which was converted into absorbed dose using ratio of mass-energy absorption coefficients water-to-air for a given beam quality, following the AAPM TG-61 protocol. ResultsBeam qualities for all film positions within CTDI phantom show beam softening for HVLs above 6 mm Al and beam hardening for HVLs bellow 6 mm Al. Calculated CTDI values using HVL in air for all CTDI positions, and those calculated using the appropriate calibration curves based on beam quality correction show for Head CTDI phantom differences ranging from 0.3% to 2.1% and for Body CTDI phantom from 2.5% to 5.7%. ConclusionsWe describe method for CTDI measurements using radiochromic film dosimetry protocol corrected by the beam quality change within the phantom. Our results show differences in CTDI measurements of up to 5.7% when compared to using film calibration curves for beam quality in air.

Comparison of Planer Dose Equilibrium and Computed Tomography Dose Index and Implications for Reported Patient Dose Information

Technical developments are ongoing in CT, and there has been a continually increasing trend in patient prescription, resulting in increased exposure. Currently, doses delivered during CT are generally evaluated using computed tomography dose index (CTDI), which is measured with a 10 cm pencil ionization chamber placed in a 14 cm PMMA phantom. However, shortfalls in CTDI have been identified by the American Association of Physicists in Medicine (AAPM) who have proposed a new method, dose equilibrium (DEq). In this paper, the dose equilibrium was used to estimate the dose in two protocols (thoracic and abdominopelvic) and compared to CTDI values. In addition, a retrospective correction was applied to 20 patient CTDI’s by characterizing the specific DEq profile of the system scans. The results indicated the dose equilibrium estimations of two protocols, thoracic and abdominopelvic, were 29% and 30% respectively, higher than those informed by the CT scanner. In addition, a retrospective dose correction estimation of a random sample of twenty patients demonstrated an annual underestimation in absorbed dose by between 26% and 28%. Continued use of the CTDI method in quality assurance of modern CT could result in greater patient risk. AAPM Task Group 111 presents a more accurate, safer method to estimate dose and its adoption is paramount.