title: Size-specific, scanner-independent organ dose estimates in contiguous axial and helical head CT examinations.
abstract: OBJECTIVE
  AAPM Task Group 204 introduced size-specific dose estimates for pediatric and adult patients undergoing body CT examinations. This investigation extends that work to head CT exams by using Monte Carlo simulations to develop size-specific, scanner-independent CTDIvol-to-organ-dose conversion coefficients.
  
  
  METHODS
  Using eight patient models from the GSF family of voxelized phantoms, dose to the brain and lens of the eye was estimated using Monte Carlo simulations of contiguous axial and helical scans for 64-slice multidetector CT scanners from four major manufacturers. For each patient model and scan mode, scanner-independent CTDIvol-to-organ-dose conversion coefficients were calculated by normalizing organ dose by scanner-specific 16 cm CTDIvol values and averaging across all scanners. Head size was measured using both geometric and attenuation-based size metrics. Head perimeter and effective diameter (ED), both geometric size metrics, were measured directly from the GSF data at the first slice superior to the eyes. Because the GSF models' pixel data are provided in terms of organ identification numbers instead of CT numbers, an indirect estimate of water equivalent diameter (WED), an attenuation-based size metric, was determined based on the relationships between WED and both ED and perimeter for a sample of patient data. Correlations between CTDIvol-to-organ-dose conversion coefficients and the various patient size metrics were then explored.
  
  
  RESULTS
  The analysis of the patient data revealed a best-fit linear relationship (R(2) of 0.87) between ED and WED across a wide variety of patient sizes. Using this relationship along with ED determined from the GSF data, WED was estimated for each GSF model. An exponential relationship between CTDIvol normalized organ dose and WED was observed for both contiguous axial and helical scanning. For head perimeter and ED measured directly from the GSF data, an exponential relationship between CTDIvol normalized organ dose and patient size was also observed for each scan mode. For all patient size metrics and scan modes, R(2) of the exponential fits ranged from 0.92 to 0.93 and 0.73 to 0.85 for the brain and lens of the eye, respectively.
  
  
  CONCLUSIONS
  For all scan modes, strong correlation exists between CTDIvol normalized brain dose and both geometric and attenuation-based patient size metrics. A slightly lower correlation between CTDIvol normalized organ dose and patient size was observed for the lens of the eye. This may be due to the combination of the eye lens being a small peripheral organ and the presence of surface dose variation in both contiguous axial and helical scanning. Results indicate that robust estimates of patient-specific head CT dose may be provided using the size-specific, scanner-independent CTDIvol-to-organ-dose conversion coefficients described in this work.
authors.affiliation: Biomedical Physics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90024.
authors.forename: Kyle
authors.initials: K
authors.lastname: McMillan
authors.affiliation: Biomedical Physics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90024 and Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90024.
authors.forename: Maryam
authors.initials: M
authors.lastname: Bostani
authors.affiliation: Biomedical Physics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90024 and Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90024.
authors.forename: Chris
authors.initials: C
authors.lastname: Cagnon
authors.affiliation: Helmholtz Zentrum Müchen, German Research Center for Environmental Health (GmBH), Research Unit Medical Radiation Physics and Diagnostics, Ingolstaedter Landstrasse 1, Neuherberg 85764, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Zankl
authors.affiliation: Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90024.
authors.forename: Ali R
authors.initials: AR
authors.lastname: Sepahdari
authors.affiliation: Biomedical Physics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90024 and Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90024.
authors.forename: Michael
authors.initials: M
authors.lastname: McNitt-Gray
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging; D002648:Child; D003198:Computer Simulation; D005260:Female; D006257:Head / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D007908:Lens, Crystalline / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009010:Monte Carlo Method; D009929:Organ Size; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011874:Radiometry / Q000295:instrumentation / Q000379:methods*; D015898:Tomography Scanners, X-Ray Computed; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods