|
1
|
Rao S, Sharan K, Chandraguthi SG, Dsouza RN, David LR, Ravichandran S, Mustapha MT, Shettigar D, Uzun B, Kadavigere R, Sukumar S, Ozsahin DU. Advanced Computational Methods for Radiation Dose Optimization in CT. Diagnostics (Basel) 2024; 14:921. [PMID: 38732335 PMCID: PMC11083136 DOI: 10.3390/diagnostics14090921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/18/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND In planning radiotherapy treatments, computed tomography (CT) has become a crucial tool. CT scans involve exposure to ionizing radiation, which can increase the risk of cancer and other adverse health effects in patients. Ionizing radiation doses for medical exposure must be kept "As Low As Reasonably Achievable". Very few articles on guidelines for radiotherapy-computed tomography scans are available. This paper reviews the current literature on radiation dose optimization based on the effective dose and diagnostic reference level (DRL) for head, neck, and pelvic CT procedures used in radiation therapy planning. This paper explores the strategies used to optimize radiation doses, and high-quality images for diagnosis and treatment planning. METHODS A cross-sectional study was conducted on 300 patients with head, neck, and pelvic region cancer in our institution. The DRL, effective dose, volumetric CT dose index (CTDIvol), and dose-length product (DLP) for the present and optimized protocol were calculated. DRLs were proposed for the DLP using the 75th percentile of the distribution. The DLP is a measure of the radiation dose received by a patient during a CT scan and is calculated by multiplying the CT dose index (CTDI) by the scan length. To calculate a DRL from a DLP, a large dataset of DLP values obtained from a specific imaging procedure must be collected and can be used to determine the median or 75th-percentile DLP value for each imaging procedure. RESULTS Significant variations were found in the DLP, CTDIvol, and effective dose when we compared both the standard protocol and the optimized protocol. Also, the optimized protocol was compared with other diagnostic and radiotherapy CT scan studies conducted by other centers. As a result, we found that our institution's DRL was significantly low. The optimized dose protocol showed a reduction in the CTDIvol (70% and 63%), DLP (60% and 61%), and effective dose (67% and 62%) for both head, neck, and pelvic scans. CONCLUSIONS Optimized protocol DRLs were proposed for comparison purposes.
Collapse
Affiliation(s)
- Shreekripa Rao
- Department of Radiotherapy and Oncology, Manipal College of Health Professions, Manipal 576104, India (R.N.D.)
| | - Krishna Sharan
- Department of Radiotherapy and Oncology, Kasturba Medical College and Hospital, Manipal 576104, India; (K.S.); (S.G.C.)
| | | | - Rechal Nisha Dsouza
- Department of Radiotherapy and Oncology, Manipal College of Health Professions, Manipal 576104, India (R.N.D.)
| | - Leena R. David
- Department of Medical Imaging Technology, Manipal College of Health Professions, Manipal 576104, India; (L.R.D.); (S.R.); (D.S.)
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Sneha Ravichandran
- Department of Medical Imaging Technology, Manipal College of Health Professions, Manipal 576104, India; (L.R.D.); (S.R.); (D.S.)
| | - Mubarak Taiwo Mustapha
- Operational Research Centre in Healthcare, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey; (M.T.M.); (B.U.)
- Department of Biomedical Engineering, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey
| | - Dilip Shettigar
- Department of Medical Imaging Technology, Manipal College of Health Professions, Manipal 576104, India; (L.R.D.); (S.R.); (D.S.)
| | - Berna Uzun
- Operational Research Centre in Healthcare, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey; (M.T.M.); (B.U.)
- Department of Mathematics, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey
| | - Rajagopal Kadavigere
- Department of Radiodiagnosis and Imaging, Kasturba Medical College and Hospital, Manipal 576104, India;
| | - Suresh Sukumar
- Department of Medical Imaging Technology, Manipal College of Health Professions, Manipal 576104, India; (L.R.D.); (S.R.); (D.S.)
| | - Dilber Uzun Ozsahin
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Operational Research Centre in Healthcare, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey; (M.T.M.); (B.U.)
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| |
Collapse
|
|
2
|
Patient size as a parameter for determining Diagnostic Reference Levels for paediatric Computed Tomography (CT) procedures. Phys Med 2022; 102:55-65. [PMID: 36126468 DOI: 10.1016/j.ejmp.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 08/28/2022] [Accepted: 09/12/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The paediatric radiation dose has never been studied in Sri Lanka, nor has a national diagnostic reference level (NDRL) established. Therefore, the primary aim of this study was to propose diagnostic reference levels (DRL) and achievable dose (AD) values for paediatric CT examinations based on size. METHODS A total of 658 paediatric (0-15 years) non-contrast-enhanced (NC) studies of head, chest and abdomen regions performed during six months in two dedicated paediatric hospitals (out of the three such institutions in the country) were included. For head examinations, the dose indexes were analysed based on age, while for body examinations, both age and effective diameter (Deff) were used. The median and the third quartile of the pooled dose distribution were given as AD and NDRL, respectively. RESULTS The AD ranges for the head, chest and abdomen regions based on CTDIvol were 45.8-57.2 mGy, 2.9-10.0 mGy and 3.8-10.3 mGy. The corresponding NDRL ranges were 45.8-95.8 mGy, 3.5-14.1 mGy and 4.5-11.9 mGy. The AD ranges based on SSDEdeff and deff were 3.5-9.6 mGy and 4.1-10.3 mGy in chest and abdomen regions. The corresponding NDRL were 4.5-14.1 mGy and 6.1-10.6 mGy. CONCLUSION Other institutions can use the present study DRLs as a reference dose for paediatric CT. The AD values can be used as a baseline for target dose optimisations, reducing doses up to 90%.
Collapse
|