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Title: Dosimetry and Image Quality in Control Studies in Computerised Tomography Realized to Paediatric Patients

Abstract

Computerised tomography (CT) is a favourite method of medical diagnosis. Its use has thus increased rapidly throughout the world, particularly in studies relating to children. However to avoid administering unnecessarily high doses of radiation to paediatric patients it is important to have correct dose reference levels to minimize risk. The research is being developed within the public health sector at the Hospital Infantil de Mexico 'Dr. Federico Gomez.' We measured the entrance surface air kerma (K{sub P}) in paediatric patients, during the radiological studies of control in CT (studies of head, thorax and abdomen). Phantom was used to evaluate image quality as the tomograph requires a high resolution image in order to operate at its optimum level.

Authors:
;  [1];  [2]; ;  [3]
  1. Instituto de Ciencias Nucleares, Universidad Nacional Autonoma de Mexico, A.P. 70-543, Mexico 04510 DF (Mexico)
  2. Hospital Infantil de Mexico 'Dr. Federico Gomez', Dr.Marquez 162, Mexico 06720 DF (Mexico)
  3. Instituto de Fisica, Universidad Nacional Autonoma de Mexico, A.P. 20-364, Mexico 01000 DF (Mexico)
Publication Date:
OSTI Identifier:
21149261
Resource Type:
Journal Article
Resource Relation:
Journal Name: AIP Conference Proceedings; Journal Volume: 1032; Journal Issue: 1; Conference: 10. Mexican symposium on medical physics, Mexico City (Mexico), 17-19 Mar 2008; Other Information: DOI: 10.1063/1.2979258; (c) 2008 American Institute of Physics; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; ABDOMEN; CHEST; CHILDREN; COMPUTERIZED TOMOGRAPHY; DIAGNOSIS; DOSES; DOSIMETRY; HEAD; IMAGES; KERMA; PATIENTS; PHANTOMS; QUALITY CONTROL; RADIOTHERAPY; RESOLUTION

Citation Formats

Hernandez, M. R., Gamboa-deBuen, I., Dies, P., Rickards, J., and Ruiz, C. Dosimetry and Image Quality in Control Studies in Computerised Tomography Realized to Paediatric Patients. United States: N. p., 2008. Web. doi:10.1063/1.2979258.
Hernandez, M. R., Gamboa-deBuen, I., Dies, P., Rickards, J., & Ruiz, C. Dosimetry and Image Quality in Control Studies in Computerised Tomography Realized to Paediatric Patients. United States. doi:10.1063/1.2979258.
Hernandez, M. R., Gamboa-deBuen, I., Dies, P., Rickards, J., and Ruiz, C. 2008. "Dosimetry and Image Quality in Control Studies in Computerised Tomography Realized to Paediatric Patients". United States. doi:10.1063/1.2979258.
@article{osti_21149261,
title = {Dosimetry and Image Quality in Control Studies in Computerised Tomography Realized to Paediatric Patients},
author = {Hernandez, M. R. and Gamboa-deBuen, I. and Dies, P. and Rickards, J. and Ruiz, C.},
abstractNote = {Computerised tomography (CT) is a favourite method of medical diagnosis. Its use has thus increased rapidly throughout the world, particularly in studies relating to children. However to avoid administering unnecessarily high doses of radiation to paediatric patients it is important to have correct dose reference levels to minimize risk. The research is being developed within the public health sector at the Hospital Infantil de Mexico 'Dr. Federico Gomez.' We measured the entrance surface air kerma (K{sub P}) in paediatric patients, during the radiological studies of control in CT (studies of head, thorax and abdomen). Phantom was used to evaluate image quality as the tomograph requires a high resolution image in order to operate at its optimum level.},
doi = {10.1063/1.2979258},
journal = {AIP Conference Proceedings},
number = 1,
volume = 1032,
place = {United States},
year = 2008,
month = 8
}
  • Computed Tomography (CT) is a high dose X ray imaging procedure and its use has rapidly increased in the last two decades fueled by the development of helical CT. The aim of this study is to present values of the dosimetric quantities for CT paediatric examinations of thoracic and abdominal regions. The protocols studied were those of chest, lung-mediastine, chest-abdomen, pulmonary high resolution and mediastine-abdomen, which are the more common examinations performed at ''Hospital Infantil de Mexico Federico Gomez'' in the thoracic-abdominal region. The measurements were performed on a Siemens SOMATOM Sensation 16 CT Scanner and the equipment used wasmore » a CT pencil ionization chamber, connected to an electrometer. This system was calibrated for RQT9 CT beam quality. A PMMA head phantom with diameter of 16 cm and length of 15 cm was also used. The dosimetric quantities measured were the weighted air kerma index (C{sub w}), the volumetric dose index (C{sub vol}) and the CT air kerma-length product. It was found that the pulmonary high resolution examination presented the highest values for the C{sub w}(31.1 mGy) and C{sub vol}(11.1 mGy). The examination with the lowest values of these two quantities was the chest-abdomen protocol with 10.5 mGy for C{sub w} and 5.5 mGy for C{sub vol}. However, this protocol presented the highest value for P{sub KL,CT}(282.2 mGy cm) when considering the average clinical length of the examinations.« less
  • Purpose: Integrated positron emission tomography/magnetic resonance (PET/MR) systems derive the PET attenuation correction (AC) from dedicated MR sequences. While MR-AC performs reasonably well in clinical patient imaging, it may fail for phantom-based quality control (QC). The authors assess the applicability of different protocols for PET QC in multicenter PET/MR imaging. Methods: The National Electrical Manufacturers Association NU 2 2007 image quality phantom was imaged on three combined PET/MR systems: a Philips Ingenuity TF PET/MR, a Siemens Biograph mMR, and a GE SIGNA PET/MR (prototype) system. The phantom was filled according to the EANM FDG-PET/CT guideline 1.0 and scanned for 5more » min over 1 bed. Two MR-AC imaging protocols were tested: standard clinical procedures and a dedicated protocol for phantom tests. Depending on the system, the dedicated phantom protocol employs a two-class (water and air) segmentation of the MR data or a CT-based template. Differences in attenuation- and SUV recovery coefficients (RC) are reported. PET/CT-based simulations were performed to simulate the various artifacts seen in the AC maps (μ-map) and their impact on the accuracy of phantom-based QC. Results: Clinical MR-AC protocols caused substantial errors and artifacts in the AC maps, resulting in underestimations of the reconstructed PET activity of up to 27%, depending on the PET/MR system. Using dedicated phantom MR-AC protocols, PET bias was reduced to −8%. Mean and max SUV RC met EARL multicenter PET performance specifications for most contrast objects, but only when using the dedicated phantom protocol. Simulations confirmed the bias in experimental data to be caused by incorrect AC maps resulting from the use of clinical MR-AC protocols. Conclusions: Phantom-based quality control of PET/MR systems in a multicenter, multivendor setting may be performed with sufficient accuracy, but only when dedicated phantom acquisition and processing protocols are used for attenuation correction.« less
  • Purpose: The aim of this study was to evaluate radiation doses to pediatric patients undergoing standard radiographic examinations using Direct Digital Radiography (DDR) in Paediatric emergency center of Hamad General Hospital (HGH) in state of Qatar and compared with regional and international Dose Reference Levels (DRLs). Methods: Entrance Skin Dose (ESD) was measured for 2739 patients for two common X-ray examinations namely: Chest AP/PA, Abdomen. Exposure factors such as kV, mAs and Focal to Skin Distance (FSD) were recorded for each patient. Tube Output was measured for a range of selected kV values. ESD for each individual patient was calculatedmore » using the tube output and the technical exposure factors for each examination. The ESD values were compared with the some international Dose Reference Levels (DRL) for all types of examinations. Results: The most performed procedure during the time of this study was chest PA/PA (85%). The mean ESD values obtained from AP chest, PA chest and AP abdomen ranged 91–120, 80–84 and 209 – 659 µGy per radiograph for different age’s groups respectively. Two protocols have been used for chest AP and PA using different radiological parameters, and the different of ESD values for chest PA and were 41% for 1 years old child, 57% for 5 years old for chest AP. Conclusion: The mean ESD were compared with those found in literature and were found to be comparable. The radiation dose can be reduced more for Chest AP and PA examination by optimization of each investigation and hence more studies are required for this task. The results presented will serve as a baseline data needed for deriving local reference doses for pediatric X-ray examinations in this local department and hence it can be applied in the whole Qatar.« less
  • Purpose: In image-guided radiation therapy (IGRT), different computed tomography (CT) modalities with varying image quality are being used to correct for interfractional variations in patient set-up and anatomy changes, thereby reducing clinical target volume to the planning target volume (CTV-to-PTV) margins. We explore how CT image quality affects patient repositioning and CTV-to-PTV margins in soft tissue registration-based IGRT for prostate cancer patients. Methods and Materials: Four CT-based IGRT modalities used for prostate RT were considered in this study: MV fan beam CT (MVFBCT) (Tomotherapy), MV cone beam CT (MVCBCT) (MVision; Siemens), kV fan beam CT (kVFBCT) (CTVision, Siemens), and kVmore » cone beam CT (kVCBCT) (Synergy; Elekta). Daily shifts were determined by manual registration to achieve the best soft tissue agreement. Effect of image quality on patient repositioning was determined by statistical analysis of daily shifts for 136 patients (34 per modality). Inter- and intraobserver variability of soft tissue registration was evaluated based on the registration of a representative scan for each CT modality with its corresponding planning scan. Results: Superior image quality with the kVFBCT resulted in reduced uncertainty in soft tissue registration during IGRT compared with other image modalities for IGRT. The largest interobserver variations of soft tissue registration were 1.1 mm, 2.5 mm, 2.6 mm, and 3.2 mm for kVFBCT, kVCBCT, MVFBCT, and MVCBCT, respectively. Conclusions: Image quality adversely affects the reproducibility of soft tissue-based registration for IGRT and necessitates a careful consideration of residual uncertainties in determining different CTV-to-PTV margins for IGRT using different image modalities.« less
  • Purpose: To investigate the accuracy and robustness, against image noise and artifacts (typical of CBCT images), of a commercial algorithm for deformable image registration (DIR), to propagate regions of interest (ROIs) in computational phantoms based on real prostate patient images. Methods: The Anaconda DIR algorithm, implemented in RayStation was tested. Two specific Deformation Vector Fields (DVFs) were applied to the reference data set (CTref) using the ImSimQA software, obtaining two deformed CTs. For each dataset twenty-four different level of noise and/or capping artifacts were applied to simulate CBCT images. DIR was performed between CTref and each deformed CTs and CBCTs.more » In order to investigate the relationship between image quality parameters and the DIR results (expressed by a logit transform of the Dice Index) a bilinear regression was defined. Results: More than 550 DIR-mapped ROIs were analyzed. The Statistical analysis states that deformation strenght and artifacts were significant prognostic factors of DIR performances, while noise appeared to have a minor role in DIR process as implemented in RayStation as expected by the image similarity metric built in the registration algorithm. Capping artifacts reveals a determinant role for the accuracy of DIR results. Two optimal values for capping artifacts were found to obtain acceptable DIR results (DICE> 075/ 0.85). Various clinical CBCT acquisition protocol were reported to evaluate the significance of the study. Conclusion: This work illustrates the impact of image quality on DIR performance. Clinical issues like Adaptive Radiation Therapy (ART) and Dose Accumulation need accurate and robust DIR software. The RayStation DIR algorithm resulted robust against noise, but sensitive to image artifacts. This result highlights the need of robustness quality assurance against image noise and artifacts in the commissioning of a DIR commercial system and underlines the importance to adopt optimized protocols for CBCT image acquisitions in ART clinical implementation.« less