Effective dose in paediatric computed tomography

Chapple, Claire-Louise; Willis, S; Frame, J.W.

doi:10.1088/0031-9155/47/1/308

Cited by 77 publications

(31 citation statements)

References 17 publications

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“…In order to calculate the effective dose for this study, the E eff /DLP factors had to be used. These factors emerged from a study in North England by Chapple et al (2002). The purpose of this study was to correlate the risk-related quantity E eff to the more simply derived quantity DLP.…”

Section: Effective Dosementioning

confidence: 99%

Effective Dose Variation in Pediatric Computed Tomography: Dose Reference Levels in Greece

Yakoumakis

Karlatira²,

Gialousis³

et al. 2009

Health Physics

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Computed tomography provides high-resolution imaging of the human body. However, it contributes mainly to the doses on the population. Additionally, the fact that children are two to three times more sensitive to the x rays compared to the adults results in the increased need of taking action for the reduction of the dose regarding the computed tomography examinations. The first part of this paper presents the results of an investigation on the variation of doses to children while the second part compares those results with the European standards. This project took place in twelve hospitals distributed throughout the country. The weighted computed dose-index and the dose length product were calculated for four different age-categories (namely 0, 1, 5 and 10-year-old) and for the three most often examinations (brain, thorax and abdomen). Effective dose values were estimated using coefficients and patients' data. The measurements showed that only a few hospitals are taking into account the protocols regarding the age of the children. As a result, many patients receive high doses without this being necessary. Thus, reducing dose methods should be adapted in order to improve the optimization of this high dose modality.

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Section: Effective Dosementioning

confidence: 99%

Effective Dose Variation in Pediatric Computed Tomography: Dose Reference Levels in Greece

Yakoumakis

Karlatira²,

Gialousis³

et al. 2009

Health Physics

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“…But DLP and CTDI w have the important advantage of being measurable and thus offered by the scanner at the end of a study or even earlier for prospective planning. Since the literature gives factors to translate DLP values into effective dose (Table 5, [8,38]), DLP as the only practical risk parameter must be checked regularly by both the radiologist and the technician. Historically, with sequential CT, contiguous slices were usually measured, giving a more or less homogeneous dose distribution that we define as 100%.…”

Section: Optimise Scan Parameters For Volume Coveragementioning

confidence: 99%

CT dose reduction in children

Vock

2005

Eur Radiol

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“…While a myriad of physical 3,4 and computerized [5][6][7][8][9][10] anthropomorphic phantoms exist for dosimetric applications, they only represent standard or limited patient sizes at discrete reference ages ͑e.g., 0, 1, 5, 10, and 15 years of age͒ and do not reflect the size and hence dose variation from patient to patient. Furthermore, the current protocol designs rely on dose as a surrogate for the risk of cancer incidence, neglecting the fact that the same dose delivered to two patients may entail substantially different risks due to age and gender differences.…”

Section: Introductionmentioning

confidence: 99%

Patient‐specific radiation dose and cancer risk estimation in CT: Part II. Application to patients

et al. 2010

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Purpose: Current methods for estimating and reporting radiation dose from CT examinations are largely patient-generic; the body size and hence dose variation from patient to patient is not reflected. Furthermore, the current protocol designs rely on dose as a surrogate for the risk of cancer incidence, neglecting the strong dependence of risk on age and gender. The purpose of this study was to develop a method for estimating patient-specific radiation dose and cancer risk from CT examinations. Methods: The study included two patients ͑a 5-week-old female patient and a 12-year-old male patient͒, who underwent 64-slice CT examinations ͑LightSpeed VCT, GE Healthcare͒ of the chest, abdomen, and pelvis at our institution in 2006. For each patient, a nonuniform rational B-spine ͑NURBS͒ based full-body computer model was created based on the patient's clinical CT data. Large organs and structures inside the image volume were individually segmented and modeled. Other organs were created by transforming an existing adult male or female full-body computer model ͑developed from visible human data͒ to match the framework defined by the segmented organs, referencing the organ volume and anthropometry data in ICRP Publication 89. A Monte Carlo program previously developed and validated for dose simulation on the LightSpeed VCT scanner was used to estimate patient-specific organ dose, from which effective dose and risks of cancer incidence were derived. Patient-specific organ dose and effective dose were compared with patient-generic CT dose quantities in current clinical use: the volume-weighted CT dose index ͑CTDI vol ͒ and the effective dose derived from the dose-length product ͑DLP͒. Results: The effective dose for the CT examination of the newborn patient ͑5.7 mSv͒ was higher but comparable to that for the CT examination of the teenager patient ͑4.9 mSv͒ due to the size-based clinical CT protocols at our institution, which employ lower scan techniques for smaller patients. However, the overall risk of cancer incidence attributable to the CT examination was much higher for the newborn ͑2.4 in 1000͒ than for the teenager ͑0.7 in 1000͒. For the two pediatric-aged patients in our study, CTDI vol underestimated dose to large organs in the scan coverage by 30%-48%. The effective dose derived from DLP using published conversion coefficients differed from that calculated using patient-specific organ dose values by Ϫ57% to 13%, when the tissue weighting factors of ICRP 60 were used, and by Ϫ63% to 28%, when the tissue weighting factors of ICRP 103 were used. Conclusions: It is possible to estimate patient-specific radiation dose and cancer risk from CT examinations by combining a validated Monte Carlo program with patient-specific anatomical models that are derived from the patients' clinical CT data and supplemented by transformed models of reference adults. With the construction of a large library of patient-specific computer models encompassing patients of all ages and weight percentiles, dose and risk can be estimated for any ...

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Effective dose in paediatric computed tomography

Cited by 77 publications

References 17 publications

Effective Dose Variation in Pediatric Computed Tomography: Dose Reference Levels in Greece

Effective Dose Variation in Pediatric Computed Tomography: Dose Reference Levels in Greece

CT dose reduction in children

Patient‐specific radiation dose and cancer risk estimation in CT: Part II. Application to patients

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