title: Influence of the X-ray beam quality on the dose increment in CT with iodinated contrast medium.
abstract: BACKGROUND
  In computed tomography (CT), the image contrast is given by the difference in X-ray attenuation in the various tissues of the patient and contrast media are used to enhance image contrast in anatomic regions characterized by similar attenuation coefficients.
  
  
  OBJECTIVE
  Aim of the present work is to enlarge the range of applicability of the method previously introduced for organ dosimetry in contrast-enhanced CT, by studying the effects of X-ray beam quality on the parameters of the model. Furthermore, an experimental method for the evaluation of the attenuation properties of iodinated solutions is proposed.
  
  
  METHODS
  Monte Carlo simulations of anthropomorphic phantoms were carried out to determine a bi-parametrical (a and b) analytical relationship between iodine concentration and dose increase in organs of interest as a function of the tube kilo-voltage peak potential (kVp) and filtration. Experimental measurements of increments in Hounsfield Units (HU) were conducted in several CT scanners, at all the kVp available, in order to determine the parameter γ which relates the HU increment with the iodine mass fraction. A cylindrical phantom that can be filled with iodine solutions provided with an axial housing for a pencil ionization chamber was designed and assembled in order to measure the attenuation properties of iodine solutions under irradiation of a CT scanner and to obtain a further validation of Monte Carlo simulations.
  
  
  RESULTS
  The simulation-derived parameters of the model, a and b, are only slightly dependent upon the tube kilo-voltage peak potential and filtration, while such scanner-dependent features influence mainly the experimentally-derived γ parameter. Relative dose variations registered by the ionization chamber inside the iodine-filled cylindrical phantom decrease when the X-ray mean energy increases, and reaches about 50% for 10 mg/ml of iodine.
  
  
  CONCLUSIONS
  The dosimetric method for contrast-enhanced CT can be applied to all CT scanners by adopting average simulative parameters and by carrying out a simple measurement with a series of iodine contrast solutions. The novel experimental methodology introduced can provide a direct measurement of iodine attenuation properties.
authors.affiliation: Department of Biomedical Sciences and of Morphologic and Functional Imaging, Section of Radiological Sciences, University of Messina, Messina, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Amato
authors.affiliation: PH3DRA (Physics for Dating Diagnostic Dosimetry Research and Applications) Laboratories, Department of Physics and Astronomy, University of Catania, Catania, Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: Asero
authors.affiliation: Department of Physics and Earth Sciences, University of Messina, Messina, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Leotta
authors.affiliation: Department of Physics and Earth Sciences, University of Messina, Messina, Italy.
authors.forename: Lucrezia
authors.initials: L
authors.lastname: Auditore
authors.affiliation: Department of Biomedical Sciences and of Morphologic and Functional Imaging, Section of Radiological Sciences, University of Messina, Messina, Italy.|University Hospital "Policlinico Gaetano Martino", Messina, Italy.
authors.forename: Ignazio
authors.initials: I
authors.lastname: Salamone
authors.affiliation: University Hospital "Policlinico - Vittorio Emanuele", Catania, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mannino
authors.affiliation: PH3DRA (Physics for Dating Diagnostic Dosimetry Research and Applications) Laboratories, Department of Physics and Astronomy, University of Catania, Catania, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Privitera
authors.affiliation: PH3DRA (Physics for Dating Diagnostic Dosimetry Research and Applications) Laboratories, Department of Physics and Astronomy, University of Catania, Catania, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Gueli
mesh_terms: D003198:Computer Simulation; D003287:Contrast Media / Q000737:chemistry*; D006801:Humans; D007455:Iodine / Q000737:chemistry*; D009010:Monte Carlo Method; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods*
chemical_list: D003287:Contrast Media; D007455:Iodine
keywords: Computed tomography; X-ray tube; contrast medium; dose; iodine