Size-specific Dose Estimates Values Research Articles

Redefining Radiation Metrics: Evaluating Actual Doses in Computed Tomography Scans.

Computed tomography (CT) contributes significantly to the collective dose from medical sources, raising concerns about potential health risks. However, existing radiation dose estimation tools, such as volume computed tomography dose index (CTDIvol), dose-length product (DLP), effective dose (ED), and size-specific dose estimate (SSDE), have limitations in accurately reflecting patient exposure. This study introduces a new parameter, size-specific dose-length product (DLPss), aiming to enhance the precision of radiation dose estimation in real-life scenarios. A retrospective analysis of 134 chest CT studies was conducted. Relationships between CTDIvol and anthropometric parameters were examined, and SSDE was calculated based on effective diameter. Additionally, the novel parameter, DLPss, was introduced, considering scan length and cross-sectional dimensions. Analysis reveals variations in scan length, effective diameter, and CTDIvol between genders. Strong correlations were observed between CTDIvol and effective diameter, particularly in men. The average CTDIvol for the entire group was 7.83 ± 2.92 mGy, with statistically significant differences between women (7.38 ± 3.23 mGy) and men (8.30 ± 2.49 mGy). SSDE values showed significant gender differences, with men exhibiting higher values. The average SSDE values for women and men were 9.15 ± 2.5 mGy and 9.6 ± 2.09 mGy, respectively, with a statistically significant difference (p = 0.03). The newly introduced DLPss values ranged around 343.90 ± 81.66 mGy·cm for the entire group, with statistically significant differences between women (323.53 ± 78.69 mGy·cm) and men (364.89 ± 79.87 mGy·cm) (p < 0.05), providing a comprehensive assessment of total radiation dose. The study highlights the need for accurate radiation dose estimation, emphasizing the impact of CT examination parameters on dose variability. The proposed DLPss parameter offers a promising approach to enhancing precision in assessing radiation risk during CT scans. Further research is warranted to explore additional parameters for a comprehensive understanding of radiation exposure and to optimize imaging protocols for patient safety.

Institutional clinical indication-based typical dose values of multiphasic abdominopelvic computed tomography examinations.

Our study aimed to obtain clinical indication-based typical dose values and size-specific dose estimates (SSDEs) for multiphasic abdominopelvic computed tomography (CT) examinations and to review our data with published diagnostic reference levels (DRLs). In this retrospective study, multiphasic liver, kidney, pancreas, and mesenteric ischemia protocol CT scans performed at our center between January 2018 and December 2021 were analyzed. The clinical indications were hepatocellular carcinoma, renal cell carcinoma, pancreas adenocarcinoma, and mesenteric ischemia. The computed tomography dose index volume (CTDIvol) and dose-length product (DLP) values were recorded, and the SSDE and effective dose (ED) values were calculated. The water-equivalent diameter (Dw) value required for the SSDE calculation was measured using the automated calculation of the Dw program. The total number of patients was 514, with 86 patients excluded from this study. The dose values were calculated for 426 patients (183 female and 243 male; 111 liver, 120 kidney, 85 pancreas, and 110 mesenteric). The median values for the CTDIvol, DLP, SSDE, and ED were 6.86 mGy, 683.02 mGy. cm, 8.75 mGy, and 10.45 mSv for the liver CT; 8.37 mGy, 908.37 mGy.cm, 10.37 mGy, and 13.89 mSv for the kidney CT; 7.82 mGy, 517.98 mGy.cm, 10.01 mGy, and 7.92 mSv for the pancreas CT; and 9.48 mGy, 983.68 mGy.cm, 12.78 mGy, and 13.86 mSv for the mesenteric CT, respectively. All dose values were lower than the published DRLs. The literature reveals large differences in the multiphasic abdominopelvic CT protocols, especially in the number of phases and scan length. This situation makes comparing dose values difficult. Dose studies revealing the protocol parameters in detail are needed so that institutions can compare and optimize their own protocols. Additionally, users should periodically check the dose values in their own institutions.

Determination of water-equivalent diameter (Dw) and size-specific dose estimates (SSDE) for adult patients in abdominal CT examinations

This work aims to calculate size-specific dose estimates (SSDE) and establish the relationship between water equivalent diameter (Dw) values and SSDE in images of abdominal CT examinations undergone by 30 adult patients. These patients had a mean age of 51 years, a mean height of 164 cm, and a mean weight of 62.71 kg. The water equivalent diameters (Dw) measured 25.30 cm on average, with mean volumetric computed tomography dose index (CTDIvol) doses of 7.95 mGy and a mean SSDE of 11.31 mGy. Images were retrospectively collected using a Hitachi Supria 16-slice CT scanner, and Dw and SSDE values were calculated based on lateral and anteroposterior (LAT + AP) measurements of cross-sectional images from each CT examination. Dw was calculated from ED, and their close correspondence allowed for interchangeable use, following AAPM guidelines. The calculated doses (SSDE) were significantly higher than the doses displayed by the scanner (CTDI). Furthermore, a strong correlation (R2 = 0.63) was observed between SSDE and Dw. Consequently, assessing patient dose based on size becomes essential to optimize radiation exposure in CT imaging.

Patient Dose Estimation in Computed Tomography-Guided Biopsy Procedures.

This study establishes typical Diagnostic Reference Levels (DRL) values and assesses patient doses in computed tomography (CT)-guided biopsy procedures. The Effective Dose (ED), Entrance Skin Dose (ESD), and Size-Specific Dose Estimate (SSDE) were calculated using the relevant literature-derived conversion factors. A retrospective analysis of 226 CT-guided biopsies across five categories (Iliac bone, liver, lung, mediastinum, and para-aortic lymph nodes) was conducted. Typical DRL values were computed as median distributions, following guidelines from the International Commission on Radiological Protection (ICRP) Publication 135. DRLs for helical mode CT acquisitions were set at 9.7 mGy for Iliac bone, 8.9 mGy for liver, 8.8 mGy for lung, 7.9 mGy for mediastinal mass, and 9 mGy for para-aortic lymph nodes biopsies. In contrast, DRLs for biopsy acquisitions were 7.3 mGy, 7.7 mGy, 5.6 mGy, 5.6 mGy, and 7.4 mGy, respectively. Median SSDE values varied from 7.6 mGy to 10 mGy for biopsy acquisitions and from 11.3 mGy to 12.6 mGy for helical scans. Median ED values ranged from 1.6 mSv to 5.7 mSv for biopsy scans and from 3.9 mSv to 9.3 mSv for helical scans. The study highlights the significance of using DRLs for optimizing CT-guided biopsy procedures, revealing notable variations in radiation exposure between helical scans covering entire anatomical regions and localized biopsy acquisitions.

SIZE-SPECIFIC DOSE ESTIMATES IN PEDIATRIC BRAIN CT IN RELATION TO AGE AND WEIGHT.

The size-specific dose estimate (SSDE) is used for radiation dose management in computed tomography (CT) and represents patient's absorbed dose more accurately than volume CT dose index. The relationship between SSDE and age or weight was investigated using 980 pediatric brain CT scans. Monolinear, power, and bilinear functions were fitted to the plots of SSDE against age or weight, and SSDE was estimated using the obtained functions. SSDE showed a biphasic increase with increasing age and weight: a rapid initial increase and subsequent a slow increase. Bilinear and power functions were successfully fitted to the plots, and mean estimation errors were close to 0, irrespective of the age or weight group. The standard SSDE values estimated from the obtained functions agreed well with the median values for each age or weight group. The curve-fitting method is expected to aid radiation dose management for pediatric brain CT using SSDE.

An in-house step-wedge phantom for the calibration of pixel values in CT localizer radiographs for water-equivalent diameter measurement

Abstract Introduction: To develop an in-house acrylic-based step-wedge phantom with several thickness configurations for calibrating computed tomography (CT) localizer radiographs in order to measure the water-equivalent diameter (Dw) and the size-specific dose estimate (SSDE). Method: We developed an in-house step-wedge phantom using 3 mm thick acrylic, filled with water. The phantom had five steps with thicknesses of 6, 12, 18, 24, and 30 cm. The phantom was scanned using a 64-slice Siemens Definition AS CT scanner with tube currents of 50, 100, 150, 200, and 250 mA. The relationship between pixel value (PV) and water-equivalent thickness (tw) was obtained for the different step thicknesses. This was used to calibrate the CT localizer radiographs in order to measure Dw and SSDE. The results of Dw and SSDE from the radiographs were compared with those calculated from axial CT images. Results: The relationship between PV and tw from CT localizer radiographs of the phantom step-wedge produced a linear relationship with R2 &gt; 0.990. The linear relationships of the Dw and SSDE values obtained from CT localizer radiographs and axial CT images had R2 values &gt; 0.94 with a statistical test of p-value &gt; 0.05. The Dw difference between those from CT localizer radiographs and axial CT images was 3.7% and the SSDE difference between both was 4.3%. Conclusion: We have successfully developed a step-wedge phantom to calibrate the relationship between PV and tw. Our phantom can be easily used to calibrate CT localizer radiographs in order to measure Dw and SSDE.

Relative Error between Organ Doses and Size-specific Dose Estimates for a Specific Location When the Mean CTDIvol Value Is Used for Calculation

Size-specific dose estimates (SSDEs) are dose indices that account for differences in body shape in computed tomography (CT) scans, allowing the evaluation of approximate absorbed doses in any cross section that could not be obtained with the volume CT dose index (CTDIvol). When using automatic exposure control (AEC), CTDIvol is modulated in the body axis direction, but the value displayed after the examination is the mean CTDIvol for the entire scan, and it is expected that the SSDE value will change depending on which value is used in the calculation. In this study, using a human body phantom, we examined the influence of whether the mean CTDIvol or the modulation value for each slice is used to calculate the SSDE on local organ dose evaluation. A program to calculate water equivalent diameter according to the procedure in the American Association of Physicists in Medicine Report No. 220 was developed and compared. As a result, SSDE calculated using the mean CTDIvol (local-SSDEmean) overestimated organ doses in the lung region by 18%-56% compared with those calculated by a web system for evaluating CT exposure doses (WAZA-ARIv2, Japan). In contrast, local-SSDEmodulated, which was calculated using the modulated value of the CTDIvol, was able to estimate the organ dose with a relative error of 10%-13%. The average local-SSDE over the entire body axis direction was not significantly different between the two methods, regardless of which method was used for CTDIvol. If the mean CTDIvol is stored in the Digital Imaging and Communications in Medicine (DICOM) header tag (0018, 9345) of the CT image and the modulated CTDIvol value is not available for each slice, the calculated local SSDE will contain many errors and will not correctly reflect the organ doses at the scan region. In such cases, it is available to use the method of evaluating local organ doses by multiplying the SSDE, which is the average of the SSDE for the entire scan, by a factor for each organ.

A new approach to dose reference levels in pediatric CT: Age and size-specific dose estimation

BackgroundAlthough paediatrics' are more radio-sensitivity than adults, the number of requested paediatric CT examinations is increasing globally. Significant efforts have been focused on achieving the lowest possible radiation dose for paediatric patients, particularly adjusting for size differences. This study aims to establish Diagnostic Reference Levels (DRLs) for paediatric patients based on size-specific dose estimates (SSDE). MethodIn this retrospective national study, CT scans for brain, chest, abdominopelvic, and chest, abdomen, and pelvis (CAP) were collected from four hospitals in Jordan undergoing paediatric CT scans. A total of 1818 cases were randomly selected in four age categories (<1 year, 1–4 years, 5–10 years, 11–18 years). The SSDE values were determined by multiplying the volume CT dose index (CTDIvol) with the conversion factor extracted from the American Association of Physicists in Medicine Report 204. ResultsVariations exist between the DRLs between the different hospitals, age groups, and variations in protocols with different types of CT scanners. The DRL values (CTDIvol, dose-length product (DLP) and SSDE) for the four age categories were as follows; <1 year: brain (47.88 mGy, 741.67 mGy cm and 58.40 mGy), chest (5.65 mGy, 124 mGy cm and 13.91 mGy), abdominopelvic (12.65 mGy, 321.5 mGy cm and 28.72 mGy) and CAP (16.12 mGy, 507.72 mGy cm and 38.04 mGy). 1–4 years, brain (54.79 mGy, 979.12 mGy cm and 55.88 mGy), chest (7.37 mGy, 220.85 mGy cm and 14.68 mGy), abdominopelvic (16.16 mGy, 424.72 mGy cm and 32.68 mGy) and CAP (16.13 mGy, 742.1 mGy cm and 33.54 mGy). 5–10 years: brain (65.03 mGy, 1129.94 mGy cm and 55.92 mGy), chest (12.57 mGy, 383.9 mGy cm and 22.45 mGy), abdominopelvic (12.34 mGy, 450.75 mGy cm and 22.23 mGy) and CAP (13.46 mGy, 748.85 mGy cm and 25.69 mGy). 11–18 years, brain (60.7 mGy, 1207.9 mGy cm and 41.81 mGy), chest examination (12.94 mGy, 496.2 mGy cm and 20.49 mGy), abdominopelvic (16.13 mGy, 803.07 mGy cm and 23.06 mGy) and CAP (16.13 mGy, 1101.5 mGy cm and 23.85 mGy). ConclusionThere were increases in CTDIvol, DLP, and SSDE with ascending age groups. SSDE and age are closely matched to delivered radiation in paediatric CT; however, radiation dose levels remain high in Jordan. This work highlights the need for caution when administering radiation in the paediatric population.

Comparison of Water-Equivalent Diameter Measured from CT Localizer Radiograph Based on Two phantoms of the Step-Wedge and Computed Tomography Dose Index

The purpose of this study is to compare the water-equivalent diameter (Dw) and size-specific dose estimate (SSDE) obtained from CT localizer radiograph based on the step-wedge and computed tomography dose index (CTDI) phantoms. The two phantoms were scanned using a 64-slice SIEMENS Somatom CT Scanner with tube currents of 100 mA and 120 kV. The CT localizer radiographs of two phantoms were obtained. Subsequently, relationships between pixel values (PV) and water-equivalent thickness (tw) were developed. Based on those relationships, the Dw and SSDE of twenty patients were calculated from the CT localizer radiographs. The results of the Dw and SSDE measured using CT localizer radiographs based on the two phantoms were compared. The relationships between PV and tw obtained from both CT localizer radiographs of the phantoms of step-wedge and CTDI are established. The Dw and SSDE values from the CT localizer radiograph calibrated with the CTDI phantom and step-wedge phantom also have linear relationship with R2 &gt; 0.99. The statistical test value with p-value &gt; 0.05 indicating that the two measurements of Dw and SSDE based on two phantoms are not statistically different. The results from the step-wedge phantom are comparable with those from the CTDI phantom. The relationship PV and tw with CT localizer radiograph from the step-wedge phantom can produce accurate calibration results. The results of the calibration of the step-wedge phantom can then determine the value of Dw and SSDE.

Size-specific dose estimates for pediatric head CT protocols based on the AAPM report TG-293

PurposeTo establish the Size Specific Dose Estimate (SSDE) typical values for pediatric head CT examinations based on the AAPM report TG-293; to provide a new stratification based on the water-equivalent diameter (Dw), given that SSDE is related to the head size. Methods296 Head CT scans of pediatric patients collected using a dose monitoring software were retrospectively analysed. Typical values were derived stratifying data by age in three methods: the first proposed by the European Guidelines on Diagnostic Reference Levels for Pediatric Imaging (RP185), the second by the National Istisan Report 20/22 and a local one related to the clinical protocols (LStrata). For each scan, a self-developed Matlab routine calculated the water-equivalent diameter (Dw) and related SSDE values with the conversion factors fH16and fB16provided by the AAPM reports TG-293 and TG-204, respectively. Eventually, a Dwstratification was introduced starting from a measure of the lateral dimension of the head. ResultsSSDE based on TG-204 overestimatesthe dose up to 12%. Four Dwgroups were identified thanks to the good correlation between the head lateral dimension andDw: Dw < 14 cm, 14 ≤ Dw < 16 cm, 16 ≤ Dw< 17 cm, Dw≥ 17 cm. The Dw-stratified dosimetric indices presentgreater variability than those grouped by age because of the large variability of the size of the infant's head. ConclusionsThe variability of the SSDE metric underlines that age-optimized protocols are not when size is considered.

Size-Specific Dose Estimates for Thoracic and Abdominal Computed Tomography Examinations at Two Moroccan Hospitals.

Size-specific dose estimates (SSDE) are the latest topic of interest in patient radiation-dose studies in computed tomography (CT). The aim of this study is to calculate and evaluate the doses (SSDE) by measuring the effective diameter (ED) of cross-sectional images collected during CT examinations of the chest and abdomen in Moroccan hospitals. Doses (SSDE) were calculated based on cross-sectional images by measuring the effective diameters of 75 patients in both examinations (45 for the thorax and 30 for the abdomen). Specific conversion factors for (ED) were used to convert the registered CTDIvol to SSDE, according to the instruction in the American Association of Physicists (AAPM) Report 204. In thoracic CT, the CTDIvol and SSDE values ranged from 5.8 to 10.7mGy (mean: 8.08) and 9.55 to 15.37mGy (mean: 12.13), respectively. For abdominal CT, CTDIvol and SSDE values ranged from 4.8 to 12.2mGy (mean: 7.95) and 8.01 to 14.15mGy (mean: 11.31), respectively. The results show that the SSDE is a useful tool and could potentially educate CT operators on its effective use as a way to optimize radiation dose instead of CTDIvol, in particular to establish diagnostic reference levels.

Dose quantities for measurement and comparison of doses to individual patients in computed tomography (CT)

The dose quantities displayed routinely on CT scanners, the volume averaged CT dose index (CTDIvol) and dose length product, provide measures of doses calculated for standard phantoms. The American Association of Medical Physics has published conversion factors for the adjustment of CTDIvol to take account of variations in patient size, the results being termed size-specific dose estimate (SSDE). However, CTDIvol and SSDE, while useful in comparing and optimising doses from a set procedure, do not provide risk-related information that takes account of the organs and tissues irradiated and associated cancer risks. A derivative of effective dose that takes account of differences in body and organ sizes and masses, referred to here as size-specific effective dose (SED), can provide such information. Data on organ doses from NCICT software that is based on Monte Carlo simulations of CT scans for 193 adult phantoms have been used to compute values of SED for CT examinations of the trunk and results compared with corresponding values of SSDE. Relationships within ±8% were observed between SED and SSDE for scans extending over similar regions for phantoms with a wide range of sizes. Coefficients have been derived from fits of the data to estimate SED values from SSDEs for different regions of the body for scans of standard lengths based on patient height. A method developed to take account of differences in scan length gave SED results within ±5% of values calculated using the NCI phantom library. This approach could potentially be used to estimate SED from SSDE values, allowing their display at the time a CT scan is performed.

Evaluation of Size-Specific Dose Estimates for Optimizing Pediatric Chest CT Protocol

Introduction: The importance of estimating patient-sized adjusted radiation dose for pediatric computed tomography (CT) has long been accepted. High doses of ionizing radiation to children are often common in chest CT examination, as the volume CT dose index (CTDIvol) is measured by a 32 cm phantom. Our study was aimed to evaluate the effectiveness of size-specific dose estimate (SSDE) to compensate the underestimated pediatric absorbed dose. Materials and methods: CTDIvol and dose-length product (DLP) of 320 pediatric chest CT (<1, 1-5, 5-10, 10-15 years) were obtained from Picture-Archieving and Communication System (PACS) in a hospital affiliated to the Shiraz University of Medical Sciences. CTDIvol was converted to SSDE based on the patient's effective diameter. The Statistical Package for Social Science (SPSS) was used for data analysis. Results: The variations between standard phantom (32cm) and the patients' mean effective diameter were approximately 65%, 57%, 47%, and 38%, across <1, 1-5, 5-10, 10-15 year age groups, respectively. Mean of SSDE for each age group was significantly higher than the corresponding CTDIvol values. Also, mean CTDIvol and SSDE values differed between age groups significantly (p<0.001). Results showed a strong correlation between age and the two dose indicators, CTDIvol (0.361) and SSDE (0.184) with p<0.05. Conclusion: Pediatrics receive radiation doses comparable to the dose for adult-sized patients in chest CT protocol if dosimetry procedure is not individualized. Thus, the application of size-based conversion coefficient is paramount in estimating the absorbed dose in pediatric chest CT.

Size-specific dose estimates of adult, chest computed tomography examinations: Comparison of Chinese and updated 2017 American College of Radiology diagnostic reference levels based on the water-equivalent diameter.

Rationale and objectivesThis study aimed to compare the volume computed tomography dose index (CTDIvol), dose length product (DLP), and size-specific dose estimate (SSDE), with the China and updated 2017 American College of Radiology (ACR) diagnostic reference levels (DRLs) in chest CT examinations of adults based on the water-equivalent diameter (Dw).Materials and methodsAll chest CT examinations conducted without contrast administration from January 2020 to July 2020 were retrospectively included in this study. The Dw and SSDE of all examinations were calculated automatically by “teamplay”. The CTDIvol and DLP were displayed on the DICOM-structured dose report in the console based on a 32cm phantom.The differences in patient CTDIvol, DLP, and SSDE values between groups were examined by the one-way ANOVA. The differences in patient CTDIvol, DLP, and SSDE values between the updated 2017 ACR and the China DRLs were examined with one sample t-tests.ResultsIn total 14666 chest examinations were conducted in our study. Patients were divided into four groups based on Dw:270 (1.84%) in 15–20 cm group, 10287 (70.14%) in the 21–25 cm group, 4097 (27.94%) in the 26–30 cm group, and 12 (0.08%) patients had sizes larger than 30 cm. CTDIvol, DLP, and SSDE increased as a function of Dw (p<0.05). CTDIvol was smaller than SSDE among groups (p<0.05). The mean CTDIvol and DLP values were lower than the 25th, 50th, and 75th percentile of the China DRLs (p <0.05). The CTDIvol, DLP, and SSDE were lower than the 50th and 75th percentiles of the updated 2017 ACR DRLs (p <0.05) among groups.ConclusionsSSDE takes into account the influence of the scanning parameters, patient size, and X-ray attenuation on the radiation dose, which can give a more realistic estimate of radiation exposure dose for patients undergoing CT examinations. Establishing hospital’s own DRL according to CTDIvol and SSDE is very important even though the radiation dose is lower than the national DRLs.

SIZE-SPECIFIC DOSE ESTIMATES FOR PEDIATRIC NON-CONTRAST HEAD CT SCANS: A RETROSPECTIVE PATIENT STUDY IN TUNJA, COLOMBIA.

This investigation is aimed to study the feasibility of size-specific dose estimate (SSDE) to patient dosimetry in pediatric head CT scans and to establish typical values in a hospital in Tunja, Colombia. The volumetric computed tomography index (CTDIvol) and the dose-length product of 468 pediatric patients from newborn to 15-year-olds, who underwent non-contrast head CT scans, were collected retrospectively. For 186 cases only, SSDE was estimated using patient attenuated-based size metrics and CTDIvol,16-to-SSDE conversion factors reported in AAPM report 293. Results showed that SSDE is an accurate metric that can be used to establish typical dose values from pediatric head CT scans. Median SSDE values of 33.5, 31.6, 36.2 and 57.9mGy were established as typical dose values for the 0-<3months, 3months-<1 y, 1-<6 y and≥6 y, respectively, to further assist the optimization process at the hospital. Further studies with more robust data of patients and hospitals should be conducted to establish local and national dose reference levels from pediatric CT scans in Colombia.

The comparison of Size-Specific Dose Estimate (SSDE) in chest CT examination calculated based on volumetric CT Dose Index (CTDIvol) reference phantom and Dose Length Product (DLP)

The radiation dose of X-ray radiation exposure that comes from a CT scan is not easy to determine, because a CT scan uses several beams of X-ray radiation for one scan. In addition, the X-ray exposure dose on the CT scan is not the sum of the X-ray radiation exposure doses from each beam. Therefore, the Size-SpecificDoseEstimate (SSDE) parameter is used, which means as the estimated radiation exposure dose received by the patient. The SSDE value is a function of the CTDIvol which is determined from the reference phantom or from the derived Dose Length Product (DLP) values. The CTDIvol value determined from the reference phantom has the same value for the weight interval of the patient, so that the patient gets the same dose of X-ray exposure even though the body size is different. The CTDIvol value determined by Dose Length Product (DLP) depends on the lateral length of the patient’s body. Because the lateral body length of each patient is different, the CTDIvol value will be different, so the SSDE value will vary more. The results showed different SSDE values for each patient according to body mass index.

Effect of Phantom Size and Tube Voltage on the Size-Conversion Factor for Patient Dose Estimation in Computed Tomography Examinations

Introduction: This study aimed to establish the conversion factors to normalize the output dose of volumetric computed tomography dose index (CTDIvol) to the patient dose (i.e. size-specific dose estimate (SSDE)) for various phantom diameters and tube voltages. Material and Methods: In-house cylindrical acrylic phantoms with physical diameters ranging from 8 to 40 cm were developed in this study. Each phantom had a hole in the center and four holes in the peripheral areas. The phantoms were scanned by a Siemens Somatom Definition AS CT Scanner using different tube voltages (i.e. 80, 100, 120, and 140 kVps) and with 200 mAs and 10 mm slice thickness. In addition, the doses in every hole and phantom were measured using a Raysafe X2 CT Sensor. The weighted SSDE (SSDEw) values were calculated using the five holes in every measurement. The size-conversion factors for the body and the head CTDI phantoms were established by dividing the SSDEw for various sizes with the SSDEw at the water-equivalent diameter of 33.90 cm and 16.95 cm, respectively. Results: The results revealed that the size-conversion factor exponentially decreased with an increase in the phantom size. It was also found that the size-conversion factor was affected by the tube voltages. Furthermore, the different size-conversion factor between 80 and 140 kVp was more than 15% in very thin and obese patients. Conclusion: Higher accuracy of the size-specific dose estimation can be achieved considering the impact of the tube voltages beside the size of the patient.

ESTIMASI NILAI DOSIS RADIASI EFEKTIF PASIEN DARI CITRA MEDIS CT SCAN ASTEION MULTI 32 SLICE BAGIAN ABDOMEN

Receipt of radiation doses in patients by CT scan media really contributed to the radio diagnostic field. So far, volume Computed Tomography Dose Index (CTDIvol) and Dose Length Product (DLP) are the dose parameters used as a prescription of the dose to the patients from the examination process on the CT scan. However, these parameters have the disadvantage that they only describe the dose output from the device without regard to patient size. Size Specific Dose Estimate (SSDE) is a dose correction based on patient size and an effective dose is the dose value that arises due to differences in biological sensitivity values. Calculation of SSDE values and total effective doses were carried out in this study from data of patients who had undergone an abdominal CT scan examination. Patient radiation dose data were obtained from documents collected from the Radiology Department at the Prima Pekanbaru hospital. The data was obtained from examination results of Toshiba Asterion Multi (CTB 400 tube) CT scan of the abdomen of 20 patients. The data analysis shows that the average value of SSDE for male and female patients are 19.64 mGy and 17.4 mGy and the average total effective dose for male and female patients are 12.63 mSv and 9.16 mSv. These data indicate that the level of radiation dose received by patients is below the threshold that has been evaluated based on BAPETEN provisions.

Estimation of size-specific dose estimates (SSDE) for paediatric and adults patients based on a single slice

Volume averaged CT dose index (CTDIvol) is an important dose index utilized for CT dosimetry. Measurements of CTDIvol are performed in reference cylindrical phantoms of specified diameters. A size-specific dose estimate (SSDE) has been recommended for assessment of doses delivered to individual patients. Evaluation of the SSDE requires the size of the scanned region of the patient to be estimated in terms of water-equivalent diameter (Dw) to allow calculation of a dose value appropriate for the patient. Estimation of Dw, however, may be challenging and time consuming as it requires assessment of Dw for each slice within the scanned region. A study has been carried out to investigate the suitability of using Dw,mid for a single slice at the middle of the scanned region to estimate a value of Dw,mean to apply to all slices. 351 phantoms (158 paediatric and 193 adult) developed from reconstructed CT images of patients were employed. Six scan regions were studied: chest, abdomen, pelvis, chest and abdomen, abdomen and pelvis, and the whole trunk. Results show that the use of Dw,mid can lead to over or underestimation of Dw,mean by up to 13% for paediatric and adult patients. SSDE values based on Dw,mid and Dw,mean were assessed for each phantom, and a linear regression analysis was performed. Use of the analysis could provide a simple and practical approach to assessing SSDE for a given scan based on Dw,mid with the root-mean-square errors estimated to be in the range of 1.2%–4.0% for paediatric and 1.2%–5.9% for adults.

Size-specific dose estimates for various weighting factors of CTDI equation.

Size-specific dose estimate (SSDE) was proposed by the American Association of Physicists in Medicine (AAPM) Task Group 204 to consider the effect of patient size in the x-ray CT dose estimation. Size correction factors to calculate SSDE were derived based on the conventional weighted CT dose index (CTDIw) equation. This study aims to investigate the influence of Bakalyar's and the authors' own CTDIw equations on the size correction factors described by the AAPM Task Group 204, using Monte Carlo simulations. The simulations were performed by modeling four types of x-ray CT scanner designs, to compute the dose values in water for cylindrical phantoms with 8-40cm diameters. CTDI100 method and the AAPM Task Group 111's proposed method were employed as the CT dosimetry models. Size correction factors were obtained for the computed dose values of various phantom diameters for the conventional, Bakalyar's, and the authors' weighting factors. Maximum difference between the size correction factors for the Bakalyar's weighting factor and those of the AAPM Task Group 204 was 27% for a phantom diameter of 11.2cm. On the other hand, the size correction factors calculated for the authors' weighting factor were in good agreement with those from the AAPM Task Group 204 report with a maximum difference of 17%. The results indicate that the SSDE values obtained with the authors' weighting factor can be evaluated by using the size correction factors reported by the AAPM Task Group 204, which is currently accepted as a standard.