Automated patient centering of computed tomography images and its implementation to evaluate clinical practices in three hospitals in Indonesia

Abstract Purpose: This study aims to develop a software tool for investigating patient centering profiles of axial CT images and to implement it to evaluate practices in three hospitals in Indonesia. Methods: The evaluation of patient centering accuracy was conducted by comparing the center coordinate of the patient’s image to the center coordinates of the axial CT image. This process was iterated for all slices to yield an average patient mis-centering in both the x- and y-axis. We implemented the software to evaluate the profile of centering on 268 patient images from the head, thorax, and abdomen examinations taken from three hospitals. Results: We found that 82% of patients were mis-centered in the y-axis (i.e., placed more than 5 mm from the iso-center), with 49% of patients placed 10–35 mm from the iso-center. Most of the patients had a tendency to be placed below the iso-centers. In head examinations, patients were more precisely positioned than in the other examinations. We did not find any significant difference in mis-centering between males and females. We found that there was a slight difference between mis-centering in adult and pediatric patients. Conclusion: Software for automated patient centering was successfully developed. Patients in three hospitals in Indonesia had a tendency to be placed under the iso-center of the gantry.