Dose quantities for measurement and comparison of doses to individual patients in computed tomography (CT)

The dose quantities displayed routinely on CT scanners, the volume averaged CT dose index (CTDIvol) and dose length product (DLP), provide measures of doses calculated for standard phantoms. The American Association of Medical Physics (AAPM) has published conversion factors for the adjustment of CTDIvol to take account of variations in patient size, the results being termed size-specific dose estimate (SSDE). However, CTDIvol and SSDE, while useful in comparing and optimising doses from a set procedure, do not provide risk-related information that takes account of the organs and tissues irradiated and associated cancer risks. A derivative of effective dose that takes account of differences in body and organ sizes and masses, referred to here as size-specific effective dose (SED), can provide such information. Data on organ doses from NCICT software that is based on Monte Carlo simulations of CT scans for 193 adult phantoms have been used to compute values of SED for CT examinations of the trunk and results compared with corresponding values of SSDE. Relationships within 8% were observed between SED and SSDE for scans extending over similar regions for phantoms with a wide range of sizes. Coefficients have been derived from fits of the data to estimate SED values from SSDEs for different regions of the body for scans of standard lengths based on patient height. A method developed to take account of differences in scan length gave SED results within 5% of values calculated using the NCI phantom library. This approach could potentially be used to estimate SED from SSDE values, allowing their display at the time a CT scan is performed.