title: A method to evaluate the dose increase in CT with iodinated contrast medium.
abstract: OBJECTIVE
  The objective of this study is to develop a method to calculate the relative dose increase when a computerized tomography scan (CT) is carried out after administration of iodinated contrast medium, with respect to the same CT scan in absence of contrast medium.
  
  
  METHODS
  A Monte Carlo simulation in GEANT4 of anthropomorphic neck and abdomen phantoms exposed to a simplified model of CT scanner was set up in order to calculate the increase of dose to thyroid, liver, spleen, kidneys, and pancreas as a function of the quantity of iodine accumulated; a series of experimental measurements of Hounsfield unit (HU) increment for known concentrations of iodinated contrast medium was carried out on a Siemens Sensation 16 CT scanner in order to obtain a relationship between the increment in HU and the relative dose increase in the organs studied. The authors applied such a method to calculate the average dose increase in three patients who underwent standard CT protocols consisting of one native scan in absence of contrast, followed by a contrast-enhanced scan in venous phase.
  
  
  RESULTS
  The authors validated their GEANT4 Monte Carlo simulation by comparing the resulting dose increases for iodine solutions in water with the ones presented in literature and with their experimental data obtained through a Roentgen therapy unit. The relative dose increases as a function of the iodine mass fraction accumulated and as a function of the Hounsfield unit increment between the contrast-enhanced scan and the native scan are presented. The data shown for the three patients exhibit an average relative dose increase between 22% for liver and 74% for kidneys; also, spleen (34%), pancreas (28%), and thyroid (48%) show a remarkable average increase.
  
  
  CONCLUSIONS
  The method developed allows a simple evaluation of the dose increase when iodinated contrast medium is used in CT scans, basing on the increment in Hounsfield units observed on the patients' organs. Since many clinical protocols employ multiple scans at different circulatory phases after administration of contrast medium, such a method can be useful to evaluate the total dose to the patient, also in view of potential clinical protocol optimizations.
authors.affiliation: Department of Radiological Sciences, University of Messina, Italy. eamato@unime.it
authors.forename: Ernesto
authors.initials: E
authors.lastname: Amato
authors.forename: Domenico
authors.initials: D
authors.lastname: Lizio
authors.forename: Nicola
authors.initials: N
authors.lastname: Settineri
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Pasquale
authors.forename: Ignazio
authors.initials: I
authors.lastname: Salamone
authors.forename: Ignazio
authors.initials: I
authors.lastname: Pandolfo
mesh_terms: D003198:Computer Simulation; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007457:Iodine Radioisotopes / Q000032:analysis* / Q000493:pharmacokinetics*; D008657:Metabolic Clearance Rate; D008954:Models, Biological; D015233:Models, Statistical; D009928:Organ Specificity; D011829:Radiation Dosage; D019275:Radiopharmaceuticals / Q000032:analysis / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014018:Tissue Distribution; D014915:Whole-Body Counting / Q000379:methods*
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals