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Organ Dose in Abdomen-Pelvis CT: Does TG 111 Equilibrium Dose Concept Better Accounts for KVp Dependence Than Conventional CTDI?


X Li

X Li1*, A Morgan1,2 , F Dong2 , A Primak3 , W Davros1,2 , W Segars4 , (1) Cleveland State University, Cleveland, OH, (2) Cleveland Clinic, Cleveland, Ohio, (3) Siemens Medical Solutions USA, Inc., (4) Duke University, Durham, North Carolina

Presentations

MO-E-17A-6 Monday 1:45PM - 3:45PM Room: 17A

Purpose:
In CT imaging, a desirable quality assurance (QA) dose quantity should account for the dose variability across scan parameters and scanner models. Recently, AAPM TG 111 proposed to use equilibrium dose-pitch product, in place of CT dose index (CTDI100), for scan modes involving table translation. The purpose of this work is to investigate whether this new concept better accounts for the kVp dependence of organ dose than the conventional CTDI concept.

Methods:
The adult reference female extended cardiac-torso (XCAT) phantom was used for this study. A Monte Carlo program developed and validated for a 128-slice CT system (Definition Flash, Siemens Healthcare) was used to simulate organ dose for abdomen-pelvis scans at five tube voltages (70, 80, 100, 120, 140 kVp) with a pitch of 0.8 and a detector configuration of 2x64x0.6 mm. The same Monte Carlo program was used to simulate CTDI100 and equilibrium dose-pitch product. For both metrics, the central and peripheral values were used together with helical pitch to calculate a volume-weighted average, i.e., CTDIvol and (Deq)vol, respectively.

Results:
While other scan parameters were kept constant, organ dose depended strongly on kVp; the coefficient of variation (COV) across the five kVp values ranged between 70-75% for liver, spleen, stomach, pancreas, kidneys, colon, small intestine, bladder, and ovaries, all of which were inside the primary radiation beam. One-way analysis of variance (ANOVA) for the effect of kVp was highly significant (p=3e-30). When organ dose was normalized by CTDIvol, the COV across the five kVp values reduced to 7-16%. The effect of kVp was still highly significant (p=4e-4). When organ dose was normalized by (Deq)vol, the COV further reduced to 4-12%. The effect of kVp was borderline significant (p=0.04).

Conclusion:
In abdomen-pelvis CT, TG 111 equilibrium dose concept better accounts for kVp dependence than the conventional CTDI.

Funding Support, Disclosures, and Conflict of Interest: This work is supported by a faculty startup fund from the Cleveland State University.


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