Literature DB >> 16134317

Patient-circumference-adapted dose regulation in body computed tomography. A practical and flexible formula.

U Nyman1, T L Ahl, M Kristiansson, L Nilsson, S Wettemark.   

Abstract

PURPOSE: To illustrate that the attenuation formula based on monochromatic radiation in homogeneous objects may be used for dose regulation in body computed tomography (CT) based on patient circumference and using a simple cloth measuring tape.
MATERIAL AND METHODS: Based on the attenuation formula for monochromatic radiation the following Microsoft Excel equation was derived: mAs(x) = mAs(n)*EXP((0.693/ HVT)*(O(x)-O(n))/PI()), where mAs(x) (milliampere second) in a patient with circumference O(x) is calculated based on the nominal mAs(n) set for a reference patient with the circumference O(n) with regard to indication, scan protocol, and available CT scanner. The HVT = half-value thickness (object thickness change in cm affecting mAs setting by a factor of 2) resulting in the least mAs difference compared with published studies investigating the mAs needed for constant image noise in abdominal CT phantoms at 80-140 kVp was evaluated. Clinically recommended HVT values were applied to 20 patients undergoing abdominal CT using 130 effective mAs and 94 cm circumference as nominal settings, and an HVT of 9 cm.
RESULTS: The object-sized dependent mAs for constant image noise at 80-140 kVp in 10-47 cm diameter abdominal phantoms (31-148 cm in circumference) differed, with few exceptions, by no more than 10% from those obtained with our formula using an HVT of 3.2-3.8 cm. An HVT of 9 cm in the patient study resulted in the same image noise-patient circumference relation as a phantom study using a "clinically adapted mAs" resulting in an acceptable noise according to diagnostic requirements. Clinical experiences recommend an HVT of about 8 cm for abdominal CT and 12 cm in thoracic CT. Changing the kVp from 120 to 80, 100, or 140 requires a mAs change roughly by factors of 4, 2, and 0.6, respectively, for constant image noise.
CONCLUSION: Until fully automatic automatic exposure control systems have been introduced, applying the formula in a computer program provides the radiologist with an easy, quick, flexible, and practical instrument for reasonably good patient-sized adjusted exposure levels in clinical practice.

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Year:  2005        PMID: 16134317     DOI: 10.1080/02841850510021193

Source DB:  PubMed          Journal:  Acta Radiol        ISSN: 0284-1851            Impact factor:   1.990


  9 in total

1.  Radiation dose reduction in computed tomography: techniques and future perspective.

Authors:  Lifeng Yu; Xin Liu; Shuai Leng; James M Kofler; Juan C Ramirez-Giraldo; Mingliang Qu; Jodie Christner; Joel G Fletcher; Cynthia H McCollough
Journal:  Imaging Med       Date:  2009-10

2.  Automatic exposure control systems designed to maintain constant image noise: effects on computed tomography dose and noise relative to clinically accepted technique charts.

Authors:  Christopher P Favazza; Lifeng Yu; Shuai Leng; James M Kofler; Cynthia H McCollough
Journal:  J Comput Assist Tomogr       Date:  2015 May-Jun       Impact factor: 1.826

3.  Individualized volume CT dose index determined by cross-sectional area and mean density of the body to achieve uniform image noise of contrast-enhanced pediatric chest CT obtained at variable kV levels and with combined tube current modulation.

Authors:  Hyun Woo Goo
Journal:  Pediatr Radiol       Date:  2011-06-07

4.  Eighty-peak kilovoltage 16-channel multidetector computed tomography and reduced contrast-medium doses tailored to body weight to diagnose pulmonary embolism in azotaemic patients.

Authors:  Fredrik Holmquist; Ulf Nyman
Journal:  Eur Radiol       Date:  2006-01-27       Impact factor: 5.315

5.  Radiation dose estimates in dual-source computed tomography coronary angiography.

Authors:  Paul Stolzmann; Hans Scheffel; Thomas Schertler; Thomas Frauenfelder; Sebastian Leschka; Lars Husmann; Thomas G Flohr; Borut Marincek; Philipp A Kaufmann; Hatem Alkadhi
Journal:  Eur Radiol       Date:  2007-10-02       Impact factor: 5.315

6.  In defense of body CT.

Authors:  Cynthia H McCollough; Luís Guimarães; Joel G Fletcher
Journal:  AJR Am J Roentgenol       Date:  2009-07       Impact factor: 3.959

7.  Ultralow contrast medium doses at CT to diagnose pulmonary embolism in patients with moderate to severe renal impairment: a feasibility study.

Authors:  Mattias Kristiansson; Fredrik Holmquist; Ulf Nyman
Journal:  Eur Radiol       Date:  2009-12-24       Impact factor: 5.315

Review 8.  CT radiation dose optimization and estimation: an update for radiologists.

Authors:  Hyun Woo Goo
Journal:  Korean J Radiol       Date:  2011-12-23       Impact factor: 3.500

9.  Radiation dose reduction at a price: the effectiveness of a male gonadal shield during helical CT scans.

Authors:  Lawrence T Dauer; Kevin A Casciotta; Yusuf E Erdi; Lawrence N Rothenberg
Journal:  BMC Med Imaging       Date:  2007-03-16       Impact factor: 1.930

  9 in total

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