Size-specific dose estimates in chest, abdomen, and pelvis CT examinations of pediatric patients

Özsoykal, İsmail; Yurt, Ayşegül; Akgüngör, K.

doi:10.5152/dir.2018.17450

Cited by 19 publications

(11 citation statements)

References 9 publications

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“…showed that the center-slice method results in a mean relative absolute error of 2–5% in pediatric and adult abdominal and chest CT compared with the slice-by-slice method ( 14 ) . For pediatric thoracic, abdominal and pelvic scans, Öszoykal et al determined a root-mean-squared error of 1.2–11% when comparing the \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}$\mathrm{SSDE}$\end{document} from the center-slice method with the slice-by-slice determination ( 26 ) . Furthermore, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}$\mathrm{SSDE}$\end{document} also depends on the positioning of the patient in the isocenter of the scanner gantry, which can lead to inaccuracies if performed incorrectly ( 7 , 27 , 28 ) .…”

Section: Discussionmentioning

confidence: 99%

Can the Size-Specific Dose Estimate Be Derived From the Body Mass Index? A Feasibility Study

Steiniger

Klippel

Teichgräber

et al. 2022

Radiation Protection Dosimetry

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Size-specific dose estimate ($\mathbf{SSDE}$) index appears to be more suitable than the commonly used volume computed tomography dose index ($\mathbf{C}{\mathbf{TDI}}_{\mathbf{vol}}$) to estimate the dose delivered to the patient during a computed tomography (CT) scan. We evaluated whether an ${\mathbf{SSDE}}_{\mathbf{BMI}}$ can be determined from the patient’s body mass index ($\mathbf{BMI}$) with sufficient reliability in the case that a $\mathbf{SSDE}$ is not given by the CT scanner. For each of the three most used examination types, CT examinations of 50 female and 50 male patients were analyzed. The $\mathbf{SSDE}$ values automatically provided by the scanner were compared with ${\mathbf{SSDE}}_{\mathbf{BMI}}$ determined from $\mathbf{C}{\mathbf{TDI}}_{\mathbf{vol}}$ and $\mathbf{BMI}$. A good accordance of ${\mathbf{SSDE}}_{\mathbf{BMI}}$ and $\mathbf{SSDE}$ was found for the chest and abdominal regions. A low correlation was observed for the head region. The presented method is a simple and practically useful surrogate approach for the chest and abdominal regions but not for the head.

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Section: Discussionmentioning

confidence: 99%

Can the Size-Specific Dose Estimate Be Derived From the Body Mass Index? A Feasibility Study

Steiniger

Klippel

Teichgräber

et al. 2022

Radiation Protection Dosimetry

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“…Many studies (16)(17)(18) proposed fully automated methods. Özsoykal et al (19) proposed an automated patient contour after the exclusion of irrelevant objects such as clothes and the CT table from the image. The threshold value was determined through trial and error until a complete successful segmentation of the body contour was obtained.…”

Section: Introductionmentioning

confidence: 99%

Real-time fully automated dosimetric computation for CT images in the clinical workflow: A feasibility study

Porzio

Anam

2022

Front. Oncol.

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BackgroundCurrently, the volume computed tomography dose index (CTDIvol), the most-used quantity to express the output dose of a computed tomography (CT) patient’s dose, is not related to the real size and attenuation properties of each patient. The size-specific dose estimates (SSDE), based on the water-equivalent diameter (DW) overcome those issues. The proposed methods found in the literature do not allow real-time computation of DW and SSDE.PurposeThis study aims to develop a software to compute DW and SSDE in a real-time clinical workflow.MethodIn total, 430 CT studies and scans of a water-filled funnel phantom were used to compute accuracy and evaluate the times required to compute the DW and SSDE. Two one-sided tests (TOST) equivalence test, Bland–Altman analysis, and bootstrap-based confidence interval estimations were used to evaluate the differences between actual diameter and DW computed automatically and between DW computed automatically and manually.ResultsThe mean difference between the DW computed automatically and the actual water diameter for each slice is −0.027% with a TOST confidence interval equal to [−0.087%, 0.033%]. Bland–Altman bias is −0.009% [−0.016%, −0.001%] with lower limits of agreement (LoA) equal to −0.0010 [−0.094%, −0.068%] and upper LoA equal to 0.064% [0.051%, 0.077%]. The mean difference between DW computed automatically and manually is −0.014% with a TOST confidence interval equal to [−0.056%, 0.028%] on phantom and 0.41% with a TOST confidence interval equal to [0.358%, 0.462%] on real patients. The mean time to process a single image is 13.99 ms [13.69 ms, 14.30 ms], and the mean time to process an entire study is 11.5 s [10.62 s, 12.63 s].ConclusionThe system shows that it is possible to have highly accurate DW and SSDE in almost real-time without affecting the clinical workflow of CT examinations.

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“…20 An accurate automated approach to finding D w , in order to obtain accurate patient dose, is in great demand. [24][25][26][27][28][29][30] Anam et al 25 proposed a fully automated method to calculate D w in a phantom and in human anatomic regions using a region of interest (ROI) automatically fitted to the patient border. The automated calculation produced an excellent correlation to the manual calculation (R 2 = 0.999).…”

Section: Introductionmentioning

confidence: 99%

“…The automated calculation produced an excellent correlation to the manual calculation (R 2 = 0.999). Özsoykal et al 26 designed a patient contour upon the exclusion of irrelevant objects such as the CT table or clothes from the original image. The threshold value was then determined via trial and error until a complete segmentation of the body contour F I G U R E 2 Flowchart of the proposed algorithm was achieved.…”

Section: Introductionmentioning

confidence: 99%

An improved method for automated calculation of the water‐equivalent diameter for estimating size‐specific dose in CT

Anam

Mahdani

Dewi

et al. 2021

J Applied Clin Med Phys

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The aim of this study is to propose an algorithm for the automated calculation of water-equivalent diameter (D w ) and size-specific dose estimation (SSDE) from clinical computed tomography (CT) images containing one or more substantial body part.Methods: All CT datasets were retrospectively acquired by the Toshiba Aquilion 128 CT scanner. The proposed algorithm consisted of a contouring stage for the D w calculation, carried out by taking the six largest objects in the cross-sectional image of the patient's body, followed by the removal of the CT table depending on the center position (y-axis) of each object. Validation of the proposed algorithm used images of patients who had undergone chest examination with both arms raised up, one arm placed down and both arms placed down, images of the pelvic region consisting of one substantial object, and images of the lower extremities consisting of two separated areas. Results:The proposed algorithm gave the same results for D w and SSDE as the previous algorithm when images consisted of one substantial body part. However, when images consisted of more than one substantial body part, the new algorithm was able to detect all parts of the patient within the image. The D w values from the proposed algorithm were 9.5%, 15.4%, and 39.6% greater than the previous algorithm for the chest region with one arm placed down, both arms placed down, and images with two legs, respectively. The SSDE values from the proposed algorithm were 8.2%, 11.2%, and 20.6% lower than the previous algorithm for the same images, respectively. Conclusions:We have presented an improved algorithm for automated calculation of D w and SSDE. The proposed algorithm is more general and gives accurate results for both D w and SSDE whether the CT images contain one or more than one substantial body part.How to cite this article: Anam C, Mahdani FR, Dewi WK, et al. An improved method for automated calculation of the water-equivalent diameter for estimating size-specific dose in CT.

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Size-specific dose estimates in chest, abdomen, and pelvis CT examinations of pediatric patients

Abstract: In pediatric CT exams involving CAP region, CTDIvol and the water equivalent diameter at the middle of the scan range can be used to provide a reasonable estimate of mean SSDE with an RMSD of 11% at most.

Cited by 19 publications

References 9 publications

Can the Size-Specific Dose Estimate Be Derived From the Body Mass Index? A Feasibility Study

Can the Size-Specific Dose Estimate Be Derived From the Body Mass Index? A Feasibility Study

Real-time fully automated dosimetric computation for CT images in the clinical workflow: A feasibility study

An improved method for automated calculation of the water‐equivalent diameter for estimating size‐specific dose in CT

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