Influence of difference in cross-sectional dose profile in a CTDI phantom on X-ray CT dose estimation: a Monte Carlo study

Identification of the computed tomography dose index for tube voltage variations in a polyester-resin phantom

The aim of this study is to measure the volumetric computed tomography dose index (CTDI_vol) for different tube voltages for a polyester-resin (PESR) phantom, and to compare it to values for a standard polymethyl methacrylate (PMMA) phantom. Both phantoms are head phantoms with a diameter of 16 cm. The phantoms were scanned by a CT scanner (GE Revolution EVO 64/128 slice) with tube voltages of 80, 100, 120, and 140 kV. The other scan parameters were constant (i.e. tube current of 100 mA, rotation time of 1 s, and collimation width of 10 mm). The CTDI_100,c and CTDI_100,p were obtained by measuring the dose with an ionization chamber inserted into five holes within the phantoms. The CTDI_vol was calculated based on the CTDI_100,c and CTDI_100,p values. The measurements were repeated three times for each hole. It was found that the CTDI_vol values for the PESR phantom were dependent on tube voltage value, and were similar to the dependency in a PMMA phantom. The maximum CTDI_vol difference between the PESR and PMMA phantoms was 7.5%. We conclude that the dose measured in the PESR phantom is similar to that in the PMMA phantom and that the PESR phantom can be used as an alternative if the PMMA phantom is not available.

Investigation of Eye Lens Dose Estimate based on AAPM Report 293 in Head Computed Tomography

Background:

Estimation of eye lens dose is important in head computed tomography (CT) examination since the eye lens is a sensitive organ to ionizing radiation.

Objective:

The purpose of this study is to compare estimations of eye lens dose in head CT examinations using local size-specific dose estimate (SSDE) based on size-conversion factors of the American Association of Physicists in Medicine (AAPM) Report No. 293 with those based on size-conversion factors of the AAPM Report No. 220.

Material and Methods:

This experimental study is conducted on a group of patients who had undergone nasopharyngeal CT examination. Due to the longitudinal (z-axis) dose fluctuation, the average global SSDE and average local SSDE (i.e. particular slices where the eyes are located) were investigated. All estimates were compared to the measurement results using thermo-luminescent dosimeters (TLDs). The estimated and measured doses were implemented for 14 patients undergoing nasopharyngeal CT examination.

Results:

It was found that the percentage differences of the volume CT dose index (CTDI_vol), average global SSDE based on AAPM No. 220 (SSDE_o,g), average local SSDE based on AAPM No. 220 (SSDE_o,l), average global SSDE based on AAPM No. 293 (SSDE_n,g) and average local SSDE based on AAPM No. 293 (SSDE_n,l) against the measured TLD doses were 22.5, 21.7, 15.0, 9.3, and 2.1%, respectively. All comparisons between dose estimates and TLD measurements gave p-values less than 0.001, except for SSDE_n,l (p-value = 0.566).

Conclusion:

SSDE based on AAPM Report No. 293 can be used to accurately estimate eye lens radiation doses by performing the calculations on a number of specific slices containing the eyes.

THE CONCEPT OF X-RAY CT DOSE EVALUATION METHOD USING RADIOCHROMIC FILM AND FILM-FOLDING PHANTOM

In this paper, we propose a novel radiochromic film (RCF)-based computed tomography (CT) dosimetry method, which is different from the method based on CT dose index. RCF dosimetry using Gafchromic QA2 films was performed using two lengths of film-folding phantoms. The phantom was exposed to X-ray CT through a single scan, while the RCF was sandwiched between the phantoms. We analysed the dose profile curve in two directions to investigate the dose distribution. We observed a difference in the dose distribution as the phantom size changed. Our results contradict with the results of previous studies such as Monte Carlo simulation or direct measurement. The ability to visually evaluate 2D dose distributions is an advantage of RCF dosimetry over other methods. This research investigated the ability of 2D X-ray CT dose evaluation using RCF and film-folding phantom.

Accuracy of weighted CTDI in estimating average dose delivered to CTDI phantoms: An experimental study

PURPOSE

The concept of the weighted computed tomography dose index ( CTDI w ) was proposed in 1995 to represent the average CTDI across an axial section of a cylindrical phantom. The purpose of this work was to experimentally re-examine the validity of the underlying assumptions behind CTDI w for modern MDCT systems.

METHODS

To enable experimental mapping of CTDI 100 in the axial plane, in-house 16 and 32 cm cylindrical phantoms were fabricated to allow the pencil chamber to reach any arbitrary axial location within the phantoms. The phantoms were scanned on a clinical MDCT with five beam collimation widths, three bowtie filters, and four kV levels. To evaluate the linearity and rotational invariance assumptions implicitly made when the weighting factors of 1/3 and 2/3 in the CTDI w formula were originally derived, CTDI 100 was measured at different radial and angular locations within the phantom for different collimation, bowtie, and kV combinations. The average CTDI ( CTDI avg ) across the axial plane was calculated from the experimental two-dimensional (2D) dose distribution and was compared with the traditional CTDI w .

RESULTS

For both phantoms under all scan conditions, the axial dose distributions were found to have significant angular dependence, potentially due to the x-ray attenuation by the patient couch or the head holder. The radial dose profiles were also found to significantly deviate from linearity in many cases due to the presence of the bowtie filter. When only the 12 o'clock peripheral CTDI 100 and the traditional weighting factors were used to calculate CTDI w , the average dose was overestimated in the 16 cm phantom by up to 8.4% at isocenter and up to 35.3% when the phantom was off-centered by 6 cm; in the 32 cm phantom at isocenter, the average dose was overestimated by up to 12.8%. Using an average of the four peripheral CTDI 100 measurements at the 12, 3, 6, and 9 o'clock locations reduced the error of CTDI w to within 1.2% in the 16 cm phantom. For the 32 cm phantom, even by using the average of the peripheral measurements, the traditional CTDI w underestimated the average dose by up to 4.3% due to aggressive drop-off of the CTDI 100 at the phantom periphery.

CONCLUSIONS

The linearity and rotational-invariance assumptions behind the traditional CTDI w formalism may not be valid for modern CT systems and thus CTDI w may not accurately represent the average dose or radiation output within a CTDI phantom. Utilizing data from all four peripheral locations always improves accuracy of CTDI w in representing the true average dose. For the large (32 cm) phantom, nonlinear models and more measurement points are needed if a more precise estimation of the average axial dose is required.

[Influence of Absorbed Dose by Difference of Scanning Starting Angle in Multiphasic CT Imaging]

Presently, the scanning start angle of the X-ray tube of X-ray computed tomography (CT) scanners cannot be controlled. As a result, there is room for reducing patient dose because the peaks of the dose distributions may overlap during multiphasic CT imaging. This study investigated methods of dose reduction by performing a Monte Carlo simulation of the X-ray tube scanning start angle and locally absorbed dose in multiphasic CT imaging. In the Monte Carlo simulation, the largest decrease in the absorbed dose was seen, when the scanning start angle between the phases was±180°. Even though with present X-ray CT scanners, the scanning start angle cannot be controlled, it is possible to decrease the absorbed dose by taking the orbital synchronized scanning and scanning range into consideration. In future we hope that, we will be able to easily reduce the dose by controlling the scanning start angle.

Comparison of central, peripheral, and weighted size-specific dose in CT

The objective of this study is to determine X-ray dose distribution and the correlation between central, peripheral and weighted-centre peripheral doses for various phantom sizes and tube voltages in computed tomography (CT). We used phantoms developed in-house, with various water-equivalent diameters (Dw) from 8.5 up to 42.1 cm. The phantoms have one hole in the centre and four holes at the periphery. By using these five holes, it is possible to measure the size-specific central dose (Ds,c), peripheral dose (Ds,p), and weighted dose (Ds,w).The phantoms are scanned using a CT scanner (Siemens Somatom Definition AS), with the tube voltage varied from 80 up to 140 kVps. The doses are measured using a pencil ionization chamber (Ray safe X2 CT Sensor) in every hole for all phantoms. The relationships between Ds,c, Ds,p, and Ds,w, and the water-equivalent diameter are established. The size-conversion factors are calculated. Comparisons between Ds,c, Ds,p, and Ds,ware also established. We observe that the dose is relatively homogeneous over the phantom for water-equivalent diameters of 12-14 cm. For water-equivalent diameters less than 12 cm, the dose in the centre is higher than at the periphery, whereas for water-equivalent diameters greater than 14 cm, the dose at the centre is lower than that at the periphery. We also find that the distribution of the doses is influenced by the tube voltage. These dose distributions may be useful for calculating organ doses for specific patients using their CT images in future clinical practice.

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 8-40 cm 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 11.2 cm. 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.

[Influence of Bowtie Filter and Patient Positioning on In-plane Dose Distribution and Image Quality in ECG-gated CT]

In electrocardiographic (ECG)-gated computed tomography (CT) for diagnosis of cardiac diseases, radiation dose and image quality are optimized by limiting field of view (FOV) and centering on the heart. However, it is necessary to set wide FOV with large bowtie filter depending on patient positioning or various diagnoses such as aortic diseases. The purpose of this study is to clarify influence of bowtie filter and patient positioning on in-plane dose distribution, organ-absorbed dose, image quality in ECG-gated CT. In-plane dose distribution and organ-absorbed dose were evaluated with radio photoluminescence glass dosimeters, and signal-to-noise ratio (SNR) were measured for evaluation of image quality. The bowtie filter was used small (S) and large (L). With automatic exposure control, volume computed tomography dose index was 55.3 mGy at S and 71.8 mGy at L. The phantom was positioned on the heart of phantom (Heart) and the center of phantom (Body). In Heart-L compared with Heart-S, organ-absorbed dose was 1.29 times at breasts. In Heart-S compared with Body-S, in-plane dose distribution was increased 25% at left anterior and decreased 20% at right posterior. In SNR, S and L were decreased from 50 mm off-center. To set appropriate bowtie filter and positioning was reduced radiation dose and improved image quality in ECG-gated CT.

New weighting factor of weighted CTDI equation for PMMA phantom diameter from 8 to 40 cm: A Monte Carlo study

PURPOSE

The weighted computed tomography dose index (CTDI_w ) uses measured CTDI values at the center and periphery of a cylindrical phantom. The CTDI_w value is calculated using conventional, Bakalyar's, and Choi's weighting factors. However, these weighting factors were produced from only 16- and 32-cm-diameter cylindrical phantoms. This study aims to devise new weighting factors to provide more accurate average dose in the central cross-sectional plane of cylindrical phantoms over a wide range of object diameters, by using Monte Carlo simulations.

METHODS

Simulations were performed by modeling a Toshiba Aquilion ONE CT scanner, in order to compute the cross-sectional dose profiles of polymethyl methacrylate (PMMA) cylindrical phantoms of each diameter (8-40 cm at 4-cm steps), for various tube voltages and longitudinal beam widths. Two phantom models were simulated, corresponding to the CTDI₁₀₀ method and the method recommended by American Association of Physicists in Medicine (AAPM) task group 111. The dose-computation PMMA cylinders of 1 mm diameter were located between the phantom surfaces and the centers at intervals of 1 mm, from which cross-sectional dose profiles were calculated. By using linear least-squares fits to the obtained cross-sectional dose profiles data, we determined new weighting factors to estimate more accurate average doses in the PMMA cylindrical phantoms by using the CTDI_w equation: CTDI_w = W_center ・ CTDI_center + W_periphery ・ CTDI_periphery . In order to demonstrate the validity of the devised new weighting factors, the percentage difference between average dose and CTDI_w value was evaluated for the weighting factors (conventional, Bakalyar's, Choi's, and devised new weighting factors) in each calculated cross-sectional dose profile.

RESULTS

With the use of linear least-squares techniques, new weighting factors (W_center = 3/8 and W_periphery = 5/8 where W_center and W_periphery are weighting factors for CTDI_center and CTDI_periphery ) were determined. The maximum percentage differences between average dose and CTDI_w value were 16, -12, -8, and -6% for the conventional, Bakalyar's, Choi's, and devised new weighting factors, respectively.

CONCLUSIONS

We devised new weighting factors (W_center = 3/8 and W_periphery = 5/8) to provide more accurate average dose estimation in PMMA cylindrical phantoms over a wide range of diameter. The CTDI_w equation with devised new weighting factors could estimate average dose in PMMA cylindrical phantoms with a maximum difference of -6%. The results of this study can estimate the average dose in PMMA cylindrical phantoms more accurately than the conventional weighting factors (W_center = 1/3 and W_periphery = 2/3).

Evaluation of Size Correction Factor for Size-specific Dose Estimates (SSDE) Calculation

American Association of Physicists in Medicine (AAPM) Report No.204 recommends the size-specific dose estimates (SSDE), wherein SSDE=computed tomography dose index-volume (CTDIvol )×size correction factor (SCF), as an index of the CT dose to consider patient thickness. However, the study on SSDE has not been made yet for area detector CT (ADCT) device such as a 320-row CT scanner. The purpose of this study was to evaluate the SCF values for ADCT by means of a simulation technique to look into the differences in SCF values due to beam width. In the simulation, to construct the geometry of the Aquilion ONE X-ray CT system (120 kV), the dose ratio and the effective energies were measured in the cone angle and fan angle directions, and these were incorporated into the simulation code, Electron Gamma Shower Ver.5 (EGS5). By changing the thickness of a PMMA phantom from 8 cm to 40 cm, CTDIvol and SCF were determined. The SCF values for the beam widths in conventional and volume scans were calculated. The differences among the SCF values of conventional, volume scans, and AAPM were up to 23.0%. However, when SCF values were normalized in a phantom of 16 cm diameter, the error tended to decrease for the cases of thin body thickness, such as those of children. It was concluded that even if beam width and device are different, the SCF values recommended by AAPM are useful in clinical situations.