Organ-based tube current modulation in a clinical context: Dose reduction may be largely overestimated in breast tissue

Euler, André; Szücs-Farkas, Zsolt; Falkowski, Anna L.; Kawel-Böhm, Nadine; D’Errico, Luigia; Kopp, Sebastién; Bremerich, Jens; Niemann, Tilo

doi:10.1007/s00330-015-4085-5

Cited by 17 publications

(12 citation statements)

References 20 publications

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“…Herein, we gave an overview of the dose-reducing potential of OBTCM reported in the literature. All studies were performed with anthropomorphic phantoms in which the breasts were centered anteriorly and fully located in the reduced current zone (7,(9)(10)(11)(12). The real position of the breasts in women lying supine is more lateral, which explains the lower potential for breast dose reduction observed in our study.…”

Section: Discussionmentioning

confidence: 91%

Estimating the Patient-specific Dose to the Thyroid and Breasts and Overall Risk in Chest CT When Using Organ-based Tube Current Modulation

et al. 2018

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Purpose To assess the potential dose reduction to the thyroid and breasts in chest computed tomography (CT) with organ-based tube current modulation (OBTCM). Materials and Methods In this retrospective study (from January 2015 to December 2016), the location of the breasts with respect to the reduced tube current zone was determined. With Monte Carlo simulations, patient-specific dose distributions of chest CT scans were calculated for 50 female patients (mean age, 53.7 years ± 17.5; range, 20-80 years). The potential dose reduction with OBTCM was assessed. In addition, simulations of clinical OBTCM scans were made for 17 of the 50 female patients (mean age, 43.8 years ± 17.1; range, 20-69 years). Posterior organs in the field of view were analyzed and lifetime attributable risk (LAR) of cancer incidence and mortality was estimated. Image quality between standard CT and OBTCM scans was compared. Results No women had all breast tissue within the reduced tube current zone. Dose reductions of 18% in the thyroid and 9% in the breasts were observed, whereas the doses in lung, liver, and kidney were 17%, 11%, and 26% higher. Overall, the LAR for cancer incidence was not significantly different between conventional and OBTCM scanning (P = .06). Image quality improved with OBTCM (P < .002). Conclusion The potential benefit of OBTCM to the female breast in chest CT is overestimated because of a limited reduced tube current zone; despite a 9% dose reduction to the female breast, posterior organs will absorb up to 26% more radiation, resulting in no reduction in radiation-induced malignancies. RSNA, 2018.

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Section: Discussionmentioning

confidence: 91%

Estimating the Patient-specific Dose to the Thyroid and Breasts and Overall Risk in Chest CT When Using Organ-based Tube Current Modulation

et al. 2018

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“…The angular TCM, especially the organ-based TCM could potentially decrease dose to sensitive organs such as lens of eye in head scans or female breasts in chest scans by up to 38%, while at the same time increasing dose to other organs such as bone surface and bone marrow by about 10% [39–42]. However, female breast dose reduction was lower (only up to 19%) in clinical settings for patients than the reduction in experiments because of the lateral shift of breasts in supine position especially for elder patients [43]. Organ-based TCM was not used in any of the patient CT scans discussed in this study and based on literature we speculate using angular TCM the doses would be decreased by about 20% for superficial organs such as female breasts and the doses for bone surface and bone marrow would be increased by about 10% [43–46].…”

Section: Discussionmentioning

confidence: 99%

“…However, female breast dose reduction was lower (only up to 19%) in clinical settings for patients than the reduction in experiments because of the lateral shift of breasts in supine position especially for elder patients [43]. Organ-based TCM was not used in any of the patient CT scans discussed in this study and based on literature we speculate using angular TCM the doses would be decreased by about 20% for superficial organs such as female breasts and the doses for bone surface and bone marrow would be increased by about 10% [43–46]. Finally, our study provided very limited data on <1 y-olds and could not provide definitive findings toward these patients.…”

Section: Discussionmentioning

confidence: 99%

Patient-specific organ and effective dose estimates in pediatric oncology computed tomography

et al. 2018

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“…However, the breasts can be located beyond the 120-deg arc, and on average, extend to the dose-increase zone, compromising the overall breast dose reduction from TCM to OTCM. 13 Moreover, most of the breast tissue in the dose-increase zone is the outer quadrant, in which most breast carcinomas first develop. [14][15][16] Additionally, the posterior or distributed radiosensitive organs see dose increase with OTCM.…”

Section: Introductionmentioning

confidence: 99%

Breast dose reduction with organ-based, wide-angle tube current modulated CT

Sturgeon

Agasthya

et al. 2017

J. Med. Imag

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This study aimed to estimate the organ dose reduction potential for organ-dose-based tube current modulated (ODM) thoracic computed tomography (CT) with a wide dose reduction arc. Twenty-one computational anthropomorphic phantoms (XCAT) were used to create a virtual patient population with clinical anatomic variations. The phantoms were created based on patient images with normal anatomy (age range: 27 to 66 years, weight range: 52.0 to 105.8 kg). For each phantom, two breast tissue compositions were simulated: [Formula: see text] and [Formula: see text] (glandular-to-adipose ratio). A validated Monte Carlo program (PENELOPE, Universitat de Barcelona, Spain) was used to estimate the organ dose for standard tube current modulation (TCM) (SmartmA, GE Healthcare) and ODM (GE Healthcare) for a commercial CT scanner (Revolution, GE Healthcare) using a typical clinical thoracic CT protocol. Both organ dose and [Formula: see text]-to-organ dose conversion coefficients ([Formula: see text] factors) were compared between TCM and ODM. ODM significantly reduced all radiosensitive organ doses ([Formula: see text]). The breast dose was reduced by [Formula: see text]. For [Formula: see text] factors, organs in the anterior region (e.g., thyroid and stomach) exhibited substantial decreases, and the medial, distributed, and posterior region saw either an increase of less than 5% or no significant change. ODM significantly reduced organ doses especially for radiosensitive superficial anterior organs such as the breasts.

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Organ-based tube current modulation in a clinical context: Dose reduction may be largely overestimated in breast tissue

Abstract: • OBTCM results in significant dose reduction compared to constant tube current scans. • A substantial portion of glandular tissue lies outside the reduced dose zone. • Potential dose reduction using organ-based tube current modulation may be overestimated.

Cited by 17 publications

References 20 publications

Estimating the Patient-specific Dose to the Thyroid and Breasts and Overall Risk in Chest CT When Using Organ-based Tube Current Modulation

Estimating the Patient-specific Dose to the Thyroid and Breasts and Overall Risk in Chest CT When Using Organ-based Tube Current Modulation

Patient-specific organ and effective dose estimates in pediatric oncology computed tomography

Breast dose reduction with organ-based, wide-angle tube current modulated CT

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