Fifty-four consecutive CT scans have been used to construct a tomographic computational model of a 14-year-old female torso suitable for the determination of organ doses from CT. The model, known as ADELAIDE, is in the form of an input file compatible with user codes based on XYZDOS.MOR from the readily available EGS4 Monte Carlo radiation transport code. ADELAIDE's dimensions are close to the Australian averages for her age so the model is representative of a 14-year-old girl. The realistic anatomy in the model differs considerably from that in Cristy's 15-year-old mathematical computational model by having realistically shaped organs that are appropriately located within a real external contour. Average absorbed dose to organs from simulated CT examinations of the chest and abdomen have been calculated for ADELAIDE using EGS4 within a geometry specific to the General Electric Hi-Speed Advantage CT scanner and using an x-ray spectrum calculated using data from the scanner's x-ray tube. The simulations include the scanner's beam shaping filter and patient table. It is suggested that the resulting values have fewer possible sources of uncertainty than organ doses derived from dose coefficients calculated for a MIRD style model with mathematical anatomy and a spectrum that may not match that of the scanner. The organ doses were normalized using the scanner's CTDI measured free-in-air and an EGS4 simulation of the CTDI measurement. Effective dose to the torso from 26-slice chest and 24-slice abdomen examinations (at 120 kV, 200 mAs, 7 mm slices) is 4.6 +/- 0.1 mSv and 4.3 +/- 0.1 mSv respectively.

A number of computer codes, developed using semi-empirical models, are available to compute x-ray spectra from a tungsten target for different tube parameters. In this study x-ray spectra measured with a high-purity germanium detector are compared with those computed using the empirical models and previously published measured data. The computer codes used to generate the spectra are based on models proposed by Birch et al. and Tucker et al. The measured x-ray spectra agreed well with the computed x-ray spectra using the model of Tucker et al. whereas the model of Birch et al. produced a "harder" x-ray spectrum compared to the measured spectra. Our measured x-ray spectra compared well with the previously published measured spectral data of Fewell et al.

The off-axis x-ray spectra from a constant potential x-ray generator were measured with a high purity germanium spectrometer cooled to liquid nitrogen temperature. The measured spectra were compared with off-axis x-ray spectra calculated using a code based on the semiempirical model developed by Tucker et al. and Monte Carlo simulated x-ray spectra using the EGS4 code system. In this study, both the Tucker model, and the EGS4 code system, were found to produce off-axis bremsstrahlung x-ray spectra which agreed well with the spectra measured at three emerging angles. In the measured and the EGS4 generated spectra the total K-characteristic peaks were in increasing order, as observed in the anode to cathode direction, whereas the Tucker model produced maximum total K-characteristic peaks at the 6 degrees anode side, and lesser amounts at the central axis and the 6 degrees cathode side. Large differences in the total K-characteristic lines is seen among the three different methods. The EGS4 code system was able to produce x-ray spectra for a combination of target materials.

CT is a high-dose examination and possibly the dominant contributor to dose from diagnostic radiology. Estimates of organ doses are obtained from Monte Carlo calculations and used to quantify radiation risk. To ensure the validity of using Monte Carlo calculations to estimate actual dose, measurements must be compared with calculations. We have measured doses to CT head and chest dosimetry phantoms and compared them with Monte Carlo (EGS4) calculated doses in voxel-based computational models of the phantoms. The simulation used an x-ray spectrum calculated from the specified values of the scanner's x-ray tube parameters. The scanner's beam-shaping filter was included in the modelling. Measured and calculated doses to both the head and chest phantoms agreed to within 7%. The inclusion of Rayleigh scattering in the calculations has a significant effect if only one slice is scanned but not if multiple slices are scanned.

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The critical nature of health care demands high performance levels from medical equipment. To ensure these performance levels are maintained, medical physicists and biomedical engineers conduct a range of measurements on equipment during acceptance testing and on-going quality assurance programs. Wherever there are measurements, there are measurement uncertainties with potential conflicts between the measurements made by installers, owners and occasionally regulators. Prior to 1993, various methods were used to calculate and report measurement uncertainties. In 1993, the International Organization for Standardization published the Guide to the Expression of Uncertainty in Measurement (GUM). The document was jointly published with six international organizations principally involved in measurements and standards. The GUM is regarded as an international benchmark on how measurement uncertainty should be calculated and reported. Despite the critical nature of these measurements, there has not been widespread use of the GUM by medical physicists and biomedical engineers. This may be due to the complexity of the GUM. Some organisations have published guidance on the GUM tailored to specific measurement disciplines. This paper presents the philosophy behind the GUM, and demonstrates, with a medical physics measurement example, how the GUM recommends uncertainties be calculated and reported.

Introduction: Diagnostic Reference Levels (DRL) of procedures involving ionizing radiation are important tools to optimizing radiation doses delivered to patients and in identifying cases where the levels of doses are unusually high. This is particularly important for paediatric patients undergoing computed tomography (CT) examinations as these examinations are associated with relatively high-dose. Methods: Paediatric CT studies, performed at our institution from January 2010 to March 2014, have been retrospectively analysed to determine the 75th and 95th percentiles of both the volume computed tomography dose index (CTDI vol ) and dose-length product (DLP) for the most commonly performed studies to: 1 establish local diagnostic reference levels for paediatric computed tomography examinations performed at our institution, 2 benchmark our DRL with national and international published paediatric values, and 3 determine the compliance of CT radiographer with established protocols. Results: The derived local 75th percentile DRL have been found to be acceptable when compared with those published by the Australian National Radiation Dose Register and two national children's hospitals, and at the international level with the National Reference Doses for the UK. The 95th percentiles of CTDIvol for the various CT examinations have been found to be acceptable values for the CT scanner Dose-Check Notification. Benchmarking CT radiographers shows that they follow the set protocols for the various examinations without significant variations in the machine setting factors. Conclusion: The derivation of DRL has given us the tool to evaluate and improve the performance of our CT service by improved compliance and a reduction in radiation dose to our paediatric patients. We have also been able to benchmark our performance with similar national and international institutions.

Introduction Ultrasound is the examination of choice for the diagnosis of hypertrophic pyloric stenosis (HPS). A correct diagnosis is dependent on the technique and measurement accuracy. However, in the world literature there is a wide range of values suggested for the diagnosis of this condition. The current minimum measurements used to diagnose HPS seem excessively large, and therefore, we set out to redefine these values. Methods A retrospective study was performed on 607 patients (615 scans) being investigated for HPS. The length and transverse diameter of the pyloric canal, and thickness of the pyloric muscle were measured. All results were correlated with clinical and surgical findings. Results In this study, the muscle thickness in the normal group was <2.0 mm than in HPS infants having a muscle thickness of 2.0–5.0 mm. All the pyloric canal lengths in the normal group were <5.0 mm than in those with HPS having a length of 10.0–24.0 mm. The transverse diameters ranged from 6.0 to 11.0 mm in the normal group compared with those with HPS having a diameter between 8.0 and 16.0 mm. Conclusions The current criteria for sonographic diagnosis of HPS should be redefined. The canal length is the single most important discriminator, with a clear separation between normal and abnormal. The commonly used 16.0‐mm measurement is too long and should be reduced to 10.0 mm (without the risk of false positives). In many cases, the muscle thickness in those with HPS is as low as 2.0 mm, considerably less than the 3.0 mm that is currently used. The transverse diameter is not a useful discriminator for HPS. The use of current values will delay the diagnosis and timely treatment of this condition.