Management and Reporting of Imaging Procedure Dose Computed Tomography

2013 AAPM Annual Meeting
John Boone, PhD, UC Davis Medical Center, Sacramento, CA, 95817 UNITED STATES
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Computed tomography has experienced rapid growth in utilization over the past 10 years, due in part to the dramatic increase in image quality and decrease in scan time that helical and multi-slice CT scanners have allowed. This increased utilization has raised legitimate concerns about the radiation dose levels in CT. Traditional dose metrics such as the volume computed tomography index (CTDIvol) and the dose length product (DLP) will be discussed. The limitations of these metrics in the context of individual patient dosimetry will also be explained. In recent years, a number of new CT dose concepts have been introduced in the peer-reviewed literature, in task group reports, and in other documents. A number of these new dose metrics will be discussed, including the rise-to-equilibrium-dose, H(L), and the size-specific dose estimate (SSDE). CT dosimetry has historically been performed used integrating ion chambers. In light of the dynamic scanning capabilities of modern CT scanners, the utility of a real-time radiation meter will be discussed. Real-time dose meters can substantially reduce the time required by the physicist in the CT scanner suite, while increasing the quantity and quality of the dose information that is measured. Niche applications include the rapid assessment of beam quality (half value layer) and the characterization of the beam shaping filters used in CT. In summary, this presentation will discuss existing CT dose parameters, and will then review a number of proposed new CT dose parameters which will likely be useful for CT dose assessment in the future. The recent growth of CT technology has outgrown the simple dose metrics of the past, and there is a need for the CT community to embrace new and more accurate CT dose metrics.

Learning Objectives:
1. Identify and discuss the standard parameters used for reporting dose in computed tomography, including the volume CTDI, DLP, and effective dose using the k-coefficients.
2. Identify and discuss parameters which influence the radiation dose to the patient, including patient size, dose modulation protocols, and scan length.
3. Discuss the limitations of using effective dose in describing radiation dose levels to individual patients.