Patient-specific Radiation Dose and Cancer Risk for Pediatric Chest CT

Li, Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Frush, Donald P.

doi:10.1148/radiol.11101900

Cited by 108 publications

(129 citation statements)

References 32 publications

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“…The quantitative justification for the scanner-averaged fits was based on results provided in the following section. The CTDI vol -normalized organ dose coefficients were further compared with those in two published studies (13,14).…”

Section: Discussionmentioning

confidence: 99%

“…To be precise, however, the Monte Carlo simulation requires detailed modeling of (a) the CT scanner and (b) patient anatomy (9)(10)(11). The modeling of the CT scanner requires access to detailed, sometimes proprietary, information about the scanner (12), which is difficult but doable (13,14). However, modeling patient anatomy has remained a particular challenge.…”

Section: Methodsmentioning

confidence: 99%

“…The simulations were performed by using the same tube potential and manufacturer-respective bow tie filters used for pediatric body CT and consistent collimation settings and pitch values ( Table 1). The overranging distances were either determined from scanner console parameters (14) or were measured by using a ready-pack x-ray film (PPL; Eastman Kodak, Rochester, NY).…”

Section: Advances In Knowledgementioning

confidence: 99%

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Pediatric Chest and Abdominopelvic CT: Organ Dose Estimation Based on 42 Patient Models

Tian¹,

Li²,

Segars³

et al. 2013

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Purpose:To estimate organ dose from pediatric chest and abdominopelvic computed tomography (CT) examinations and evaluate the dependency of organ dose coefficients on patient size and CT scanner models. Materials and Methods:The institutional review board approved this HIPAA-compliant study and did not require informed patient consent. A validated Monte Carlo program was used to perform simulations in 42 pediatric patient models (age range, 0-16 years; weight range, 2-80 kg; 24 boys, 18 girls).Multidetector CT scanners were modeled on those from two commercial manufacturers (LightSpeed VCT, GE Healthcare, Waukesha, Wis; SOMATOM Definition Flash, Siemens Healthcare, Forchheim, Germany). Organ doses were estimated for each patient model for routine chest and abdominopelvic examinations and were normalized by volume CT dose index (CTDI vol ). The relationships between CTDI vol -normalized organ dose coefficients and average patient diameters were evaluated across scanner models. Results:For organs within the image coverage, CTDI vol -normalized organ dose coefficients largely showed a strong exponential relationship with the average patient diameter (R 2 . 0.9). The average percentage differences between the two scanner models were generally within 10%. For distributed organs and organs on the periphery of or outside the image coverage, the differences were generally larger (average, 3%-32%) mainly because of the effect of overranging. Conclusion:It is feasible to estimate patient-specific organ dose for a given examination with the knowledge of patient size and the CTDI vol . These CTDI vol -normalized organ dose coefficients enable one to readily estimate patient-specific organ dose for pediatric patients in clinical settings. This dose information, and, as appropriate, attendant risk estimations, can provide more substantive information for the individual patient for both clinical and research applications and can yield more expansive information on dose profiles across patient populations within a practice.q RSNA, 2013

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Advances In Knowledgementioning

confidence: 99%

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Pediatric Chest and Abdominopelvic CT: Organ Dose Estimation Based on 42 Patient Models

Tian¹,

Li²,

Segars³

et al. 2013

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“…Existe um consenso na literatura sobre as altas doses que os pacientes pediátricos recebem a partir de um exame de tomografia computadorizada (TC), e que podem resultar em um aumento do risco de carcinogênese induzida por radiação [1][2][3] .…”

Section: Introductionunclassified

Doses em tomografia computadorizada de crânio: impacto do uso do controle automático de exposição

2017

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ResumoO uso de sistemas de redução de dose na tomografia computadorizada é particularmente importante para pacientes pediátricos, que possuem uma alta radiossensibilidade, pois estão em fase de crescimento. O objetivo deste estudo foi avaliar o impacto do uso do sistema AEC Care Dose da Siemens na estimativa de dose em exames de tomografia computadorizada de crânio em pacientes pediátricos. Foi realizado um estudo retrospectivo com 199 exames de tomografia computadorizada de crânio de pacientes pediátricos em diferentes faixas etárias, em um tomógrafo Siemens Emotion de 16 canais. Foi possível observar, para todas as faixas etárias, que o uso do sistema AEC Care Dose não apenas reduz o CTDIvol, mas também a amplitude interquartil, reduzindo a dose total na população investigada. Conclui-se que o sistema AEC Care Dose modela a corrente de tubo de acordo com as dimensões do paciente, sendo possível a redução da dose individual e coletiva, sem afetar a qualidade do diagnóstico. Palavras-chave: dosimetria; tomografia computadorizada; controle automático de exposição; Care Dose. Abstract The use of dose reduction systems in computed tomography is particularly important for pediatric patients IntroduçãoExiste um consenso na literatura sobre as altas doses que os pacientes pediátricos recebem a partir de um exame de tomografia computadorizada (TC), e que podem resultar em um aumento do risco de carcinogênese induzida por radiação 1-3 .Pesquisadores vem estudando uma forma mais realística de estimar a dose em TC, considerando o tamanho específico 4,5 e o peso do paciente 6 . Diversos estudos tem demostrado que o uso do controle automático de exposição ou AEC (Automatic Exposition Control) 7-9 e/ou modificações na tensão do tubo de raios X, pitch 10 e espessura do corte, podem reduzir a dose no paciente, sem afetar significativamente a qualidade da imagem 11 .O descritor CTDIvol (Volumetric Computed Tomography Dose Index) é uma estimativa de dose padronizada em exames de TC, que utiliza um simulador cilíndrico padrão de 32 cm ou 16 cm, dependendo da faixa etária e/ou região do corpo 12 . Tais valores, no entanto, representam apenas uma aproximação da dose absorvida pelo paciente e dependem dos parâmetros selecionados de aquisição, sem considerarem as características antropométricas dos pacientes.Atualmente, os equipamentos mais modernos de TC possuem sistemas de AEC, que possibilitam a modulação da corrente no tubo de raios X, conforme a variação de espessura do paciente. As diferenças de densidade dos tecidos que compõem a região imageada também interferem na qualidade do contraste da imagem. O sistema AEC busca determinar uma fluência de fótons ideal para cada paciente e cada região anatômica analisada 13 . Cada um dos sistemas AEC implementados pelos fabricantes possui especificações diferentes e opera de forma distinta 14 A fabricante Siemens desenvolveu um sistema AEC denominado Care Dose, que estima a atenuação dos raios X nos planos x e y em cada corte, durante uma rotação. O sistema utiliza tais informações para...

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“…[5][6][7][8] Lifetime risk of cancer incidence, sometimes referred to as lifetime biological risk is a concept that has been suggested by a number of authors as an alternative to effective dose (E) to allow a comparison of risk from non-uniform dose distributions. [5][6][7]9 Brenner 5-7 is arguably the strongest advocate for a move to what he terms "effective risk" as it is argued that E is based on "questionable science" as the tissue-specific weighting factors used, although based on research, are established by committee decisions and do not take into account differing age and gender dependencies. Wall et al 10 similarly state that E can and should play a role in radiation protection of radiation workers and members of the public and for the optimization of techniques involving changes in radiation quality.…”

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confidence: 99%

Comparison of effective dose and lifetime risk of cancer incidence of CT attenuation correction acquisitions and radiopharmaceutical administration for myocardial perfusion imaging

Tootell

Szczepura²,

Hogg³

2014

BJR

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Cite this article as: Tootell AK, Szczepura K, Hogg P. Comparison of effective dose and lifetime risk of cancer incidence of CT attenuation correction acquisitions and radiopharmaceutical administration for myocardial perfusion imaging. Br J Radiol 2014;87:20140110. FULL PAPERComparison of effective dose and lifetime risk of cancer incidence of CT attenuation correction acquisitions and radiopharmaceutical administration for myocardial perfusion imaging Objective: To measure the organ dose and calculate effective dose from CT attenuation correction (CTAC) acquisitions from four commonly used gamma camera single photon emission CT/CT systems. Methods: CTAC dosimetry data was collected using thermoluminescent dosemeters on GE Healthcare's Infinia™ Hawkeye™ (GE Healthcare, Buckinghamshire, UK) four-and single-slice systems, Siemens Symbia™ T6 (Siemens Healthcare, Erlangen, Germany) and the Philips Precedence (Philips Healthcare, Amsterdam, Netherlands). Organ and effective dose from the administration of 99m Tc-tetrofosmin and 99m Tc-sestamibi were calculated using International Commission of Radiological Protection reports 80 and 106. Using these data, the lifetime biological risk was calculated. Results: The Siemens Symbia gave the lowest CTAC dose (1.8 mSv) followed by the GE Infinia Hawkeye single-slice (1.9 mSv), GE Infinia Hawkeye four-slice (2.5 mSv) and Philips Precedence v. 3.0. Doses were significantly lower than the calculated doses from radiopharmaceutical administration (11 and 14 mSv for 99m Tc-tetrofosmin and 99m Tc-sestamibi, respectively). Overall lifetime biological risks were lower, which suggests that using CTAC data posed minimal risk to the patient. Comparison of data for breast tissue demonstrated a higher risk than that from the radiopharmaceutical administration. Conclusion: CTAC doses were confirmed to be much lower than those from radiopharmaceutical administration. The localized nature of the CTAC exposure compared to the radiopharmaceutical biological distribution indicated dose and risk to the breast to be higher. Advances in knowledge: This research proved that CTAC is a comparatively low-dose acquisition. However, it has been shown that there is increased risk for breast tissue especially in the younger patients. As per legislation, justification is required and CTAC should only be used in situations that demonstrate sufficient net benefit.Single-photon emission CT (SPECT)/CT has become common place in clinical imaging, and a major role for CT is for the attenuation correction (AC) of SPECT data in myocardial perfusion imaging (MPI). 1,2 The benefits of CT attenuation correction (CTAC) in MPI are well known and many national and international professional organizations recommend its use to improve SPECT MPI diagnostic accuracy. 3,4 Associated with the CT acquisition is an additional radiation dose that is often considered to be low, yet very few articles quantify the dose and the associated risk.Effective dose is a useful figure that allows for a comparison between different tech...

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Patient-specific Radiation Dose and Cancer Risk for Pediatric Chest CT

Cited by 108 publications

References 32 publications

Pediatric Chest and Abdominopelvic CT: Organ Dose Estimation Based on 42 Patient Models

Pediatric Chest and Abdominopelvic CT: Organ Dose Estimation Based on 42 Patient Models

Doses em tomografia computadorizada de crânio: impacto do uso do controle automático de exposição

Comparison of effective dose and lifetime risk of cancer incidence of CT attenuation correction acquisitions and radiopharmaceutical administration for myocardial perfusion imaging

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