AbstractsBiology & Animal Science

Reduction of radiation dose to radiosensitive organs and its tradeoff with image quality in Computed Tomography

by Di Zhang




Institution: UCLA
Department: Biomedical Physics
Year: 2012
Keywords: Medical imaging and radiology; Biophysics; computed tomography; diagnostic performance; image quality; Monte Carlo; organ dose; radiation dose
Record ID: 1970493
Full text PDF: http://www.escholarship.org/uc/item/5rg24453


Abstract

Computed Tomography (CT) has been used for medical diagnosis for the past four decades and has made significant contributions to patient healthcare by providing fast and accurate diagnostic information. Besides the extraordinary medical benefits it has brought to society, it delivers radiation dose to the patients, which can be potentially hazardous. Therefore, it has been a significant interest in both scientific research and clinical practice to reduce radiation dose to the patients during CT scans, while still maintaining the diagnostic performance, so that the information provided through this procedure is not compromised and appropriate medical determinations can be made at the minimum cost.In this research work, a Monte Carlo based simulation package was used to estimate radiation dose to individual radiosensitive organs of patients with a range of body habitus. This package is exam and protocol specific, and it takes into account technical details of CT scanners such as spectra, bowtie filtration, and beam geometry. Modifications were made to the Monte Carlo simulation package to perform detailed radiation dose assessments for both patients and phantoms. These include the estimate of radiation dose to individual organs, the peak radiation dose to a wide spread tissue (such as peak skin dose), and surface dose distribution in a complex CT irradiation environment. Meanwhile, the effect of a variety of traditional dose reduction methods, such as tilting the gantry in brain perfusion scans, was also investigated.In addition to the traditional dose reduction techniques that are already being utilized in the clinic, an innovative method to reduce organ dose while maintaining image quality was investigated. The distribution of radiation dose within the scan volume was demonstrated to be dependent on the Tube Start Angle (TSA). A change of TSA can cause a shift of dose distribution along the longitudinal axis. This results in variations in the measurement of surface dose during helical scans. This dose variation along the longitudinal direction for patients in CT imaging inspired a novel innovation to reduce organ dose while maintaining image quality by adjusting the TSA and table height in CT exams. Monte Carlo simulations were performed to demonstrate the effectiveness of this method for different patients under various scenarios, including conventional fixed tube current CT scans, and tube current modulated (TCM) scans. Besides the dose benefit this new method brings, its effect on image quality was investigated and demonstrated that there was no significant compromise on the image quality.Despite the efforts to reduce radiation dose while maintaining image quality, the ultimate tradeoff in the goal of maximizing the benefit to risk ratio in CT examinations is the tradeoff between radiation dose and diagnostic outcome. As radiation dose is decreased, the image quality may be degraded. However, the diagnostic outcome does not necessarily have to be compromised. In other words, the image quality used for specific CT…