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Patient-circumference-adapted dose regulation in body computed tomography. A practical and flexible formula

Nyman, Ulf LU ; Ahl, TL; Kristiansson, M; Nilsson, L and Wettemark, S (2005) In Acta Radiologica 46(4). p.396-406
Abstract
Purpose: To illustrate that the attenuation formula based on monochromatic radiation in homogeneous objects may be used for dose regulation in body computed tomography (CT) based on patient circumference and using a simple cloth measuring tape. Material and Methods: Based on the attenuation formula for monochromatic radiation, the following Microsoft Excel equation was derived: mAs(x)=mAs(n)* EXP(( 0.693/ HVT)*(empty set(x)-empty set(n))/ PI()), where mAs(x) (milliampere second) in a patient with circumference Ox is calculated based on the nominal mAs(n) set for a reference patient with the circumference On with regard to indication, scan protocol, and available CT scanner. The HVT=half-value thickness ( object thickness change in cm... (More)
Purpose: To illustrate that the attenuation formula based on monochromatic radiation in homogeneous objects may be used for dose regulation in body computed tomography (CT) based on patient circumference and using a simple cloth measuring tape. Material and Methods: Based on the attenuation formula for monochromatic radiation, the following Microsoft Excel equation was derived: mAs(x)=mAs(n)* EXP(( 0.693/ HVT)*(empty set(x)-empty set(n))/ PI()), where mAs(x) (milliampere second) in a patient with circumference Ox is calculated based on the nominal mAs(n) set for a reference patient with the circumference On with regard to indication, scan protocol, and available CT scanner. The HVT=half-value thickness ( object thickness change in cm affecting mAs setting by a factor of 2) resulting in the least mAs difference compared with published studies investigating the mAs needed for constant image noise in abdominal CT phantoms at 80 140 kVp was evaluated. Clinically recommended HVT values were applied to 20 patients undergoing abdominal CT using 130 effective mAs and 94 cm circumference as nominal settings, and an HVT of 9 cm. Results: The object-sized dependent mAs for constant image noise at 80 - 140 kVp in 10 47 cm diameter abdominal phantoms ( 31 - 148 cm in circumference) differed, with few exceptions, by no more than 10% from those obtained with our formula using an HVT of 3.2 - 3.8 cm. An HVT of 9 cm in the patient study resulted in the same image noise patient circumference relation as a phantom study using a "clinically adapted mAs'' resulting in an acceptable noise according to diagnostic requirements. Clinical experiences recommend an HVT of about 8 cm for abdominal CT and 12 cm in thoracic CT. Changing the kVp from 120 to 80, 100, or 140 requires a mAs change roughly by factors of 4, 2, and 0.6, respectively, for constant image noise. Conclusion: Until fully automatic automatic exposure control systems have been introduced, applying the formula in a computer program provides the radiologist with an easy, quick, flexible, and practical instrument for reasonably good patient-sized adjusted exposure levels in clinical practice. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
aspects, technical, image quality, dose reduction, abdomen, computed tomography
in
Acta Radiologica
volume
46
issue
4
pages
396 - 406
publisher
John Wiley & Sons
external identifiers
  • pmid:16134317
  • wos:000230680600014
  • scopus:26044445862
ISSN
1600-0455
DOI
10.1080/02841850510021193
language
English
LU publication?
yes
id
12d6fc1f-8bc0-43e0-9ced-f022b4cb0e95 (old id 232429)
date added to LUP
2007-08-22 14:05:10
date last changed
2017-03-05 04:07:32
@article{12d6fc1f-8bc0-43e0-9ced-f022b4cb0e95,
  abstract     = {Purpose: To illustrate that the attenuation formula based on monochromatic radiation in homogeneous objects may be used for dose regulation in body computed tomography (CT) based on patient circumference and using a simple cloth measuring tape. Material and Methods: Based on the attenuation formula for monochromatic radiation, the following Microsoft Excel equation was derived: mAs(x)=mAs(n)* EXP(( 0.693/ HVT)*(empty set(x)-empty set(n))/ PI()), where mAs(x) (milliampere second) in a patient with circumference Ox is calculated based on the nominal mAs(n) set for a reference patient with the circumference On with regard to indication, scan protocol, and available CT scanner. The HVT=half-value thickness ( object thickness change in cm affecting mAs setting by a factor of 2) resulting in the least mAs difference compared with published studies investigating the mAs needed for constant image noise in abdominal CT phantoms at 80 140 kVp was evaluated. Clinically recommended HVT values were applied to 20 patients undergoing abdominal CT using 130 effective mAs and 94 cm circumference as nominal settings, and an HVT of 9 cm. Results: The object-sized dependent mAs for constant image noise at 80 - 140 kVp in 10 47 cm diameter abdominal phantoms ( 31 - 148 cm in circumference) differed, with few exceptions, by no more than 10% from those obtained with our formula using an HVT of 3.2 - 3.8 cm. An HVT of 9 cm in the patient study resulted in the same image noise patient circumference relation as a phantom study using a "clinically adapted mAs'' resulting in an acceptable noise according to diagnostic requirements. Clinical experiences recommend an HVT of about 8 cm for abdominal CT and 12 cm in thoracic CT. Changing the kVp from 120 to 80, 100, or 140 requires a mAs change roughly by factors of 4, 2, and 0.6, respectively, for constant image noise. Conclusion: Until fully automatic automatic exposure control systems have been introduced, applying the formula in a computer program provides the radiologist with an easy, quick, flexible, and practical instrument for reasonably good patient-sized adjusted exposure levels in clinical practice.},
  author       = {Nyman, Ulf and Ahl, TL and Kristiansson, M and Nilsson, L and Wettemark, S},
  issn         = {1600-0455},
  keyword      = {aspects,technical,image quality,dose reduction,abdomen,computed tomography},
  language     = {eng},
  number       = {4},
  pages        = {396--406},
  publisher    = {John Wiley & Sons},
  series       = {Acta Radiologica},
  title        = {Patient-circumference-adapted dose regulation in body computed tomography. A practical and flexible formula},
  url          = {http://dx.doi.org/10.1080/02841850510021193},
  volume       = {46},
  year         = {2005},
}