Patient organ and effective dose estimation in CT: comparison of four software applications
Tóm tắt
Radiation dose in computed tomography (CT) has become a topic of high interest due to the increasing numbers of CT examinations performed worldwide. Hence, dose tracking and organ dose calculation software are increasingly used. We evaluated the organ dose variability associated with the use of different software applications or calculation methods. We tested four commercial software applications on CT protocols actually in use in our hospital: CT-Expo, NCICT, NCICTX, and Virtual Dose. We compared dose coefficients, estimated organ doses and effective doses obtained by the four software applications by varying exposure parameters. Our results were also compared with estimates reported by the software authors. All four software applications showed dependence on tube voltage and volume CT dose index, while only CT-Expo was also dependent on other exposure parameters, in particular scanner model and pitch caused a variability till 50%. We found a disagreement between our results and those reported by the software authors (up to 600%), mainly due to a different extent of examined body regions. The relative range of the comparison of the four software applications was within 35% for most organs inside the scan region, but increased over the 100% for organs partially irradiated and outside the scan region. For effective doses, this variability was less evident (ranging from 9 to 36%). The two main sources of organ dose variability were the software application used and the scan region set. Dose estimate must be related to the process used for its calculation.
Tài liệu tham khảo
Goske MJ, Applegate KE, Boylan J et al (2008) The Image Gently campaign: working together to change practice. AJR Am J Roentgenol 190:273–274. https://doi.org/10.2214/AJR.07.3526
Palorini F, Origgi D, Granata C, Matranga D, Salerno S (2014) Adult exposures from MDCT including multiphase studies: first Italian nation widesurvey. Eur Radiol 24:469–483. https://doi.org/10.1007/s00330-013-3031-7
Zenone F, Aimonetto S, Catuzzo P et al (2012) Effective dose delivered by conventional radiology to Aosta Valley population between 2002 and 2009. Br J Radiol 85:e330–e338. https://doi.org/10.1259/bjr/19099861
Pearce MS, Salotti JA, Little MP et al (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 380:499–505. https://doi.org/10.1016/S0140-6736(12)60815-0
Mathews JD, Forsythe AV, Brady Z et al (2013) Cancer risk in 680000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ 346:f2360–f2378. https://doi.org/10.1136/bmj.f2360
Brenner DJ, Elliston C, Hall E, Berdon W (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol 176:289–296. https://doi.org/10.2214/ajr.176.2.1760289
Brenner DJ, Hall EJ (2007) Computed tomography- an increasing source of radiation exposure. N Engl J Med 357:2277–2284. https://doi.org/10.1056/NEJMra072149
Schegerer AA, Nagel HD, Stamm G, Adam G, Brix G (2017) Current CT practice in Germany: results and implications of a nationwide survey. Eur J Radiol 90:114–128. https://doi.org/10.1016/j.ejrad.2017.02.021
Pola A, Corbella D, Righini A et al (2018) Computed tomography use in a large italian region: trend analysis 2004-2014 of emergency and outpatient CT examinations in children and adults. Eur Radiol 28:2308–2318. https://doi.org/10.1007/s00330-017-5225-x
Hall EJ, Brenner DJ (2008) Cancer risks from diagnostic radiology. Br J Radiol 81:362–378. https://doi.org/10.1259/bjr/01948454
Hendee WR, O’Connor MK (2012) Radiation risks of medical imaging: separating fact from fantasy. Radiology 264:312–321. https://doi.org/10.1148/radiol.12112678
Zanca F, Demeter M, Oyen R, Bosmans H (2012) Excess radiation and organ dose in chest and abdominal CT due to CT acquisition beyond expected anatomical boundaries. Eur Radiol 22:779–788. https://doi.org/10.1007/s00330-011-2332-y
Samei E, Tian X, Segars WP (2014) Determining organ dose: the holy grail. Pediatr Radiol 44:460–467. https://doi.org/10.1007/s00247-014-3117-7
Shrimpton PC, Hillier MC, Lewis MA, Dunn M (2006) National survey of doses from CT in the UK: 2003. Br J Radiol 79:968–980. https://doi.org/10.1259/bjr/93277434
Zankl M, Veit R, Williams G et al (1988) The construction of computer tomographic phantoms and their application in radiology and radiation protection. Radiat Environ Biohys 27:153–164. https://doi.org/10.1007/BF01214605
Kalender WA, Schmidt B, Zankl M, Schmidt M (1999) A PC program for estimating organ dose and effective dose values in computed tomography. Eur Radiol 9:555–562. https://doi.org/10.1007/s003300050709
Sahbaee P, Segars WP, Samei E (2014) Patient-based estimation of organ dose for a population of 58 adult patients across 13 protocol categories. Med Phys 41:072104. https://doi.org/10.1118/1.4883778
Xu XG (2014) An exponential growth of computational phantom research in radiation protection, imaging, and radiotherapy: a review of the fifty-year history. Phys Med Biol 59:R233–R302. https://doi.org/10.1088/0031-9155/59/18/R233
Khursheed A, Hillier MC, Shrimpton PC, Wall BF (2002) Influence of patient age on normalized effective doses calculated for CT examinations. Br J Radiol 75:819–830. https://doi.org/10.1259/bjr.75.898.750819
Lechel U, Becker C, Langenfeld-Jäger G, Brix G (2009) Dose reduction by automatic exposure control in multidetector computed tomography: comparison between measurement and calculation. Eur Radiol 19:1027–1034. https://doi.org/10.1007/s00330-008-1204-6
Stamm G, Nagel HD (2002) CT-Expo—a novel program for dose evaluation in CT. Rofo 174:1570–1576. https://doi.org/10.1055/s-2002-35937
Long DJ, Lee C, Tien C et al (2013) Monte Carlo simulations of adult and pediatric computed tomography exams: validation studies of organ doses with physical phantoms. Med Phys 40:013901. https://doi.org/10.1118/1.4771934
Lee C, Kim KP, Long D et al (2011) Organ doses for reference adult male and female undergoing computed tomography estimated by Monte Carlo simulations. Med Phys 38:1196–1206. https://doi.org/10.1118/1.3544658
Lee C, Kim KP, Long DJ, Bolch WE (2012) Organ doses for reference pediatric and adolescent patients undergoing computed tomography estimated by Monte Carlo simulation. Med Phys 39:2129–2146. https://doi.org/10.1118/1.3693052
Bolch W, Lee C, Wayson M, Johnson P (2010) Hybrid computational phantoms for medical dose reconstruction. Radiat Environ Biohys 49:155–168. https://doi.org/10.1007/s00411-009-0260-x
Hurtado JL, Lee C, Lodwick D, Goede T, Williams JL, Bolch WE (2012) Hybrid computational phantoms representing the reference adult male and adult female: construction and applications for retrospective dosimetry. Health Phys 102:292–304. https://doi.org/10.1097/HP.0b013e318235163f
(1994) Plan and operation of the Third National Health and Nutrition Examination Survey, 1988-94. Series 1: programs and collection procedures. Vital Health Stat 32:1–407
Geyer AM, O’Reilly S, Lee C, Long DJ, Bolch WE (2014) The UF/NCI family of hybrid computational phantoms representing the current US population of male and female children, adolescents and adults-application to CT dosimetry. Phys Med Biol 59:5225–5242. https://doi.org/10.1088/0031-9155/59/18/5225
Ding A, Gao Y, Liu H et al (2015) Virtual Dose: a software for reporting organ doses from CT for adult and pediatric patients. Phys Med Biol 60:5601–5625. https://doi.org/10.1088/0031-9155/60/14/5601
Gu J, Bednarz B, Caracappa PF, Xu XG (2009) The development, validation and application of a multi-detector CT (MDCT) scanner model for assessing organ doses to the pregnant patient and the fetus using Monte Carlo simulations. Phys Med Biol 54:2699–2717. https://doi.org/10.1088/0031-9155/54/9/007
Zhang J, Na YH, Caracappa PF, Xu XG (2009) RPI-AM and RPI-AF, a pair of mesh-based, size-adjustable adult male and female computational phantoms using ICRP-89 parameters and their calculations for organ doses from monoenergetic photon beams. Phys Med Biol 54:5885–5908. https://doi.org/10.1088/0031-9155/54/19/015
Na YH, Zhang B, Zhang J, Caracappa PF, Xu XG (2010) Deformable adult human phantoms for radiation protection dosimetry: anthropometric data representing size distributions of adult worker populations and software algorithms. Phys Med Biol 55:3789–3811. https://doi.org/10.1088/0031-9155/55/13/015
Xu XG, Taranenko V, Zhang J, Schi C (2007) A boundary-representation method for designing whole-body radiation dosimetry models: pregnant females at the ends of three gestational periods—RPI-P3, -P6 and -P9. Phys Med Biol 52:7023–7044. https://doi.org/10.1088/0031-9155/52/23/017
Ding A, Mille MM, Liu T, Caracappa PF, Xu XG (2012) Extension of RPI-adult male and female computational phantoms to obese patients and a Monte Carlo study of the effect on CT imaging dose. Phys Med Biol 57:2441–2459. https://doi.org/10.1088/0031-9155/57/9/2441
Menzel HG, Clement C, DeLuca P (2009) ICRP Publication 110. Realistic reference phantoms: an ICRP/ICRU joint effort. A report of adult reference computational phantoms. Ann ICRP 39:1-164. https://doi.org/10.1016/j.icrp.2009.09.001
Gao Y, Quinn B, Mahmood U et al (2017) A comparison of pediatric and adult CT organ dose estimation methods. BMC Med Imaging 17:28. https://doi.org/10.1186/s12880-017-0199-3
Lee C, Kim KP, Bolch WE, Moroz BE, Folio L (2015) NCICT: a computational solution to estimate organ doses for pediatric and adult patients undergoing CT scans. J Radiol Prot 35:891–909. https://doi.org/10.1088/0952-4746/35/4/891
Turner AC, Zhang D, Khatonabadi M et al (2011) The feasibility of patient size-corrected, scanner-independent organ dose estimates for abdominal CT exams. Med Phys 38:820–829. https://doi.org/10.1118/1.3533897
Turner AC, Zankl M, De Marco JJ et al (2010) The feasibility of a scanner-independent technique to estimate organ dose from MDCT scans: using CTDIvol to account for differences between scanners. Med Phys 37:1816–1825. https://doi.org/10.1118/1.3368596
(2007). The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP 37):1-332. https://doi.org/10.1016/j.icrp.2007.10.003.
Huda W, Ogden KM, Khorasani MR (2008) Converting dose-length product to effective dose at CT. Radiology 248:995–1003. https://doi.org/10.1148/radiol.2483071964
American Association of Physicists in Medicine (2010) Report of AAPM Task Group 111 Comprehensive methodology for the evaluation of radiation dose in x-ray computed tomography, College Park, MD: AAPM.
Deak PD, Smal Y, Kalender WA (2010) Multisection CT protocols: sex- and age-specific conversion factors used to determine effective dose from dose-length product. Radiology 257:158–166. https://doi.org/10.1148/radiol.10100047
Zhang Y, Li X, Segars WP, Samei E (2012) Organ doses, effective doses, and risk indices in adult CT: comparison of four types of reference phantoms across different examination protocols. Med Phys 39:3404–3423. https://doi.org/10.1118/1.4718710
Li X, Samei E, Segars WP et al (2011) Patient-specific radiation dose and cancer risk estimation in CT: part II. Application to patients. Med Phys 38:408–419. https://doi.org/10.1118/1.3515864