Effective dose from computed tomography (CT) examinations is usually estimated using the scanner-provided dose-length product and using conversion factors, also known as k-factors, which correspond to scan regions and differ by age according to five categories: 0, 1, 5, 10 y and adult. However, patients often deviate from the standard body size on which the conversion factor is based. In this study, a method for deriving body size-specific k-factors is presented, which can be determined from a simple regression curve based on patient diameter at the centre of the scan range. Using the International Commission on Radiological Protection reference paediatric and adult computational phantoms paired with Monte Carlo simulation of CT X-ray beams, the authors derived a regression-based k-factor model for the following CT scan types: head-neck, head, neck, chest, abdomen, pelvis, abdomen-pelvis (AP) and chest-abdomen-pelvis (CAP). The resulting regression functions were applied to a total of 105 paediatric and 279 adult CT scans randomly sampled from patients who underwent chest, AP and CAP scans at the National Institutes of Health Clinical Center. The authors have calculated and compared the effective doses derived from the conventional age-specific k-factors with the values computed using their body size-specific k-factor. They found that by using the age-specific k-factor, paediatric patients tend to have underestimates (up to 3-fold) of effective dose, while underweight and overweight adult patients tend to have underestimates (up to 2.6-fold) and overestimates (up to 4.6-fold) of effective dose, respectively, compared with the effective dose determined from their body size-dependent factors. The authors present these size-specific k-factors as an alternative to the existing age-specific factors. The body size-specific k-factor will assess effective dose more precisely and on a more individual level than the conventional age-specific k-factors and, hence, improve awareness of the true exposure, which is important for the clinical community to understand.
The Trinity test device contained about 6 kg of plutonium as its fission source, resulting in a fission yield of 21 kT. However, only about 15% of the 239Pu actually underwent fission. The remaining unfissioned plutonium eventually was vaporized in the fireball and after cooling, was deposited downwind from the test site along with the various fission and activation products produced in the explosion. Using data from radiochemical analyses of soil samples collected postshot (most many years later), supplemented by model estimates of plutonium deposition density estimated from reported exposure rates at 12 h postshot, we have estimated the total activity and geographical distribution of the deposition density of this unfissioned plutonium in New Mexico. A majority (about 80%) of the unfissioned plutonium was deposited within the state of New Mexico, most in a relatively small area about 30–100 km downwind (the Chupadera Mesa area). For most of the state, the deposition density was a small fraction of the subsequent deposition density of 239+240Pu from Nevada Test Site tests (1951–1958) and later from global fallout from the large US and Russian thermonuclear tests (1952–1962). The fraction of the total unfissioned 239Pu that was deposited in New Mexico from Trinity was greater than the fraction of fission products deposited. Due to plutonium being highly refractory, a greater fraction of the 239Pu was incorporated into large particles that fell out closer to the test site as opposed to more volatile fission products (such as 137Cs and 131I) that tend to deposit on the surface of smaller particles that travel farther before depositing. The plutonium deposited as a result of the Trinity test was unlikely to have resulted in significant health risks to the downwind population.
Many organ dose calculation tools for computed tomography (CT) scans rely on the assumptions: (1) organ doses estimated for one CT scanner can be converted into organ doses for another CT scanner using the ratio of the Computed Tomography Dose Index (CTDI) between two CT scanners; and (2) helical scans can be approximated as the summation of axial slices covering the same scan range. The current study aims to validate experimentally these two assumptions. We performed organ dose measurements in a 5 year-old physical anthropomorphic phantom for five different CT scanners from four manufacturers. Absorbed doses to 22 organs were measured using thermoluminescent dosimeters for head-to-torso scans. We then compared the measured organ doses with the values calculated from the National Cancer Institute dosimetry system for CT (NCICT) computer program, developed at the National Cancer Institute. Whereas the measured organ doses showed significant variability (coefficient of variation (CoV) up to 53% at 80 kV) across different scanner models, the CoV of organ doses normalised to CTDIvol substantially decreased (12% CoV on average at 80 kV). For most organs, the difference between measured and simulated organ doses was within ±20% except for the bone marrow, breasts and ovaries. The discrepancies were further explained by additional Monte Carlo calculations of organ doses using a voxel phantom developed from CT images of the physical phantom. The results demonstrate that organ doses calculated for one CT scanner can be used to assess organ doses from other CT scanners with 20% uncertainty (k = 1), for the scan settings considered in the study.
An innovative gynecological HDR brachytherapy applicator system for treatment An innovative gynecological HDR brachytherapy applicator system for treatment delivery and real-time verification delivery and real-time verification
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