A Study to Determine Whether the Volume-Weighted Computed Tomography Dose Index Gives Reasonable Estimates of Organ Doses for Thai Patients Undergoing Abdomen and Pelvis Computed Tomography Examinations

INTRODUCTION: Values for the CTDI(vol), which is displayed on scanner consoles, give doses relative to a phantom much larger than most Thai patients, and the CTDI(vol) does not take account of differences in patient size, which affect organ doses. OBJECTIVE: The purpose of this study was to evaluate relationships for size specific dose estimate (SSDE) and volume weighted computed tomography (CT) dose index (CTDI(vol)) with patient size for CT scanners operating under automatic tube current modulation (ATCM). METHODS: Retrospective data from 244 patients who had undergone abdomen and pelvis examination on GE and Siemens CT scanners were included in this study. The combination of anteroposterior (AP) and lateral dimensions at the level of the first lumbar vertebra (L1) was used to represent patient size. Image noise within the liver was measured, and values of the absorbed dose for organs covered by the primary beam such as the liver, stomach and kidney were calculated using methods described in the literature. Values of CTDI(vol) were recorded and SSDE calculated according to the American Association of Physics in Medicine (AAPM) Report No.204. Linear regression models were used to evaluate the relationship between SSDE, CTDI(vol), image noise and patient size. RESULTS: SSDE is 20%-50% larger than the CTDI(vol), with values for larger patients being more representative. Both the CTDI(vol) and image noise decreased with patient size for Siemens scanners, but the decline in SSDE was less significant. For the GE scanner, the CTDI(vol) was a factor of 3-4 lower in small patients compared to larger ones, while the SSDE only decreased by a factor of two. Noise actually decreased slightly with patient size. CONCLUSION: Values of SSDE were similar to the doses calculated for the liver, stomach and kidney, which are covered by the primary beam, confirming that it provides a good estimate of organ-absorbed dose.