Patient-Informed Organ Dose Estimation in Clinical CT: Implementation and Effective Dose Assessment in 1048 Clinical Patients.
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2021-01-21
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OBJECTIVE. The purpose of this study is to comprehensively implement a patient-informed organ dose monitoring framework for clinical CT and compare the effective dose (ED) according to the patient-informed organ dose with ED according to the dose-length product (DLP) in 1048 patients. MATERIALS AND METHODS. Organ doses for a given examination are computed by matching the topogram to a computational phantom from a library of anthropomorphic phantoms and scaling the fixed tube current dose coefficients by the examination volume CT dose index (CTDIvol) and the tube-current modulation using a previously validated convolution-based technique. In this study, the library was expanded to 58 adult, 56 pediatric, five pregnant, and 12 International Commission on Radiological Protection (ICRP) reference models, and the technique was extended to include multiple protocols, a bias correction, and uncertainty estimates. The method was implemented in a clinical monitoring system to estimate organ dose and organ dose-based ED for 647 abdomen-pelvis and 401 chest examinations, which were compared with DLP-based ED using a t test. RESULTS. For the majority of the organs, the maximum errors in organ dose estimation were 18% and 8%, averaged across all protocols, without and with bias correction, respectively. For the patient examinations, DLP-based ED was significantly different from organ dose-based ED by as much as 190.9% and 234.7% for chest and abdomen-pelvis scans, respectively (mean, 9.0% and 24.3%). The differences were statistically significant (p < .001) and exhibited overestimation for larger-sized patients and underestimation for smaller-sized patients. CONCLUSION. A patient-informed organ dose estimation framework was comprehensively implemented applicable to clinical imaging of adult, pediatric, and pregnant patients. Compared with organ dose-based ED, DLP-based ED may overestimate effective dose for larger-sized patients and underestimate it for smaller-sized patients.
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Fu, Wanyi, Francesco Ria, William Paul Segars, Kingshuk Roy Choudhury, Joshua M Wilson, Anuj J Kapadia and Ehsan Samei (2021). Patient-Informed Organ Dose Estimation in Clinical CT: Implementation and Effective Dose Assessment in 1048 Clinical Patients. AJR. American journal of roentgenology. pp. 1–11. 10.2214/ajr.19.22482 Retrieved from https://hdl.handle.net/10161/22242.
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Francesco Ria
Dr. Francesco Ria is a medical physicist and he serves as an Assistant Professor in the Department of Radiology. Francesco has an extensive expertise in the assessment of procedure performances in radiology. In particular, his research activities focus on the simultaneous evaluation of radiation dose and image quality in vivo in computed tomography providing a comprehensive evaluation of radiological exams. Moreover, Francesco is developing and investigating novel mathematical models that, uniquely in the radiology field, can incorporate a comprehensive and quantitative risk-to-benefit assessment of the procedures; he is continuing to apply his expertise towards the definition of new patient specific risk metrics, and in the assessment of image quality in vivo also using state-of-the-art imaging technology, such as photon counting computed tomography scanners, and machine learning reconstruction algorithms.
Dr. Ria is a member of the American Association of Physicists in Medicine task group 392 (Investigation and Quality Control of Automatic Exposure Control System in CT), of the American Association of Physicists in Medicine Public Education working group (WGATE), and of the Italian Association of Medical Physics task group Dose Monitoring in Diagnostic Imaging.
Joshua Wilson
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.