Beyond CTDIvol: Patient-specific SSDE and organ dose assessment in routine adult CT practice

IF 3.5 3区物理与天体物理 Q3 CHEMISTRY, PHYSICAL

Radiation Physics and Chemistry Pub Date : 2026-06-01 Epub Date: 2026-01-21 DOI:10.1016/j.radphyschem.2026.113658

Omar Bentiane, Omaima Khettabi, Omar Berradi, El Mehdi Sadiki, Fatimaezzahra Bouzzit, Rodouan Touti

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引用次数: 0

Abstract

Computed Tomography (CT) is a key diagnostic tool in medical imaging, but concerns persist regarding radiation exposure, particularly in repeat or high-dose examinations. The CTDI_vol quantifies scanner output but does not accurately represent the patient dose. The Size-Specific Dose Estimate (SSDE) provides a more clinically relevant patient-specific dose estimate by accounting for body size and composition. This study aims to quantify the differences between CTDI_vol and SSDE in adult thoraco-abdominopelvic and abdominopelvic CT scans, compare manual and automatic methods of patient size estimation, and evaluate organ doses. A retrospective review was conducted on 52 adult CT scans (thoraco-abdominopelvic and abdominopelvic). Four patient-size metrics were collected: the manually measured effective diameter (D_eff-M), the automatically averaged z-axis effective diameter (D_eff-AZ), and two water-equivalent diameters (D_w-E and D_w-AZ). The SSDE values were calculated according to AAPM TG-204 and TG-220. The organ doses were estimated with IndoseCT based on Monte Carlo-derived correlations. The mean CTDI_vol was 13.0 ± 3.6 mGy, with SSDE values 31–37 % higher across all methods. D_eff-AZ was 4.7 % greater than D_eff-M, while D_w-E and D_w-AZ showed near-perfect agreement. The liver, kidneys, and bladder received the highest doses (>15 mGy) as they are directly irradiated, whereas radiosensitive organs outside the primary scan field, such as the thyroid and eyes, received measurable scatter doses. SSDE provides a more accurate representation of patient radiation dose than CTDI_vol and should be integrated into routine CT protocols. Among the evaluated size metrics, attenuation-based D_w proved to be the most robust and reproducible. Incorporating organ-dose estimations and SSDE into clinical practice can enhance patient safety, optimize imaging protocols, and support compliance with radiation protection regulations.

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超越CTDIvol：常规成人CT实践中患者特异性SSDE和器官剂量评估

计算机断层扫描（CT）是医学成像中的关键诊断工具，但对辐射暴露的担忧持续存在，特别是在重复或高剂量检查中。CTDIvol量化扫描仪输出，但不能准确代表患者剂量。尺寸特异性剂量估计（SSDE）通过考虑身体尺寸和组成提供了更具临床相关性的患者特异性剂量估计。本研究旨在量化CTDIvol和SSDE在成人胸腹骨盆和腹部骨盆CT扫描中的差异，比较人工和自动估计患者大小的方法，并评估器官剂量。回顾性分析了52例成人CT扫描（胸腹骨盆和腹部骨盆）。收集4个患者尺寸指标：人工测量的有效直径（def - m）、自动平均z轴有效直径（def - az）和两个水当量直径（Dw-E和Dw-AZ）。根据AAPM TG-204和TG-220计算SSDE值。使用IndoseCT根据蒙特卡罗导出的相关性估计器官剂量。CTDIvol平均值为13.0±3.6 mGy， SSDE值比所有方法高31 - 37%。def - az比def - m高4.7%，而Dw-E和Dw-AZ表现出近乎完美的一致性。肝脏、肾脏和膀胱受到的辐射剂量最高（15毫戈瑞），因为它们直接受到辐射，而初级扫描场外的辐射敏感器官，如甲状腺和眼睛，则受到可测量的散射剂量。SSDE提供比CTDIvol更准确的患者辐射剂量表示，应纳入常规CT方案。在评估的尺寸指标中，基于衰减的Dw被证明是最稳健和可重复性的。将器官剂量评估和SSDE纳入临床实践可以提高患者安全，优化成像方案，并支持遵守辐射防护法规。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiation Physics and Chemistry 化学-核科学技术

CiteScore

5.60

自引率

17.20%

发文量

574

审稿时长

12 weeks

期刊介绍： Radiation Physics and Chemistry is a multidisciplinary journal that provides a medium for publication of substantial and original papers, reviews, and short communications which focus on research and developments involving ionizing radiation in radiation physics, radiation chemistry and radiation processing. The journal aims to publish papers with significance to an international audience, containing substantial novelty and scientific impact. The Editors reserve the rights to reject, with or without external review, papers that do not meet these criteria. This could include papers that are very similar to previous publications, only with changed target substrates, employed materials, analyzed sites and experimental methods, report results without presenting new insights and/or hypothesis testing, or do not focus on the radiation effects.