Multisection CT protocols: sex- and age-specific conversion factors used to determine effective dose from dose-length product.

PURPOSE: To determine conversion factors for the new International Commission on Radiological Protection (ICRP) publication 103 recommendations for adult and pediatric patients and to compare the effective doses derived from Monte Carlo calculations with those derived from dose-length product (DLP) for different body regions and computed tomographic (CT) scanning protocols. MATERIALS AND METHODS: Effective dose values for the Oak Ridge National Laboratory phantom series, including phantoms for newborns; 1-, 5-, and 10-year-old children; and adults were determined by using Monte Carlo methods for a 64-section multidetector CT scanner. For each phantom, five anatomic regions (head, neck, chest, abdomen, and pelvis) were considered. Monte Carlo simulations were performed for spiral scanning protocols with different voltages. Effective dose was computed by using ICRP publication 60 and publication 103 recommendations. The calculated effective doses were compared with those derived from the DLP by using previously published conversion factors. RESULTS: In general, conversion factors determined on the basis of Monte Carlo calculations led to lower values for adults with both ICRP publications. Values up to 33% and 32% lower than previously published data were found for ICRP publication 60 and ICRP publication 103, respectively. For pediatric individuals, effective doses based on the Monte Carlo calculations were higher than those obtained from DLP and previously published conversion factors (eg, for chest CT scanning in 5-year-old children, an increase of about 76% would be expected). For children, a variation in conversion factors of up to 15% was observed when the tube voltage was varied. For adult individuals, no dependence on voltage was observed. CONCLUSION: Conversion factors from DLP to effective dose should be specified separately for both sexes and should reflect the new ICRP recommendations. For pediatric patients, new conversion factors specific for the spectrum used should be established.

Effects of adaptive section collimation on patient radiation dose in multisection spiral CT.

PURPOSE: To evaluate the potential effectiveness of adaptive collimation in reducing computed tomographic (CT) radiation dose owing to z-overscanning by using dose measurements and Monte Carlo (MC) dose simulations. MATERIALS AND METHODS: Institutional review board approval was not necessary. Dose profiles were measured with thermoluminescent dosimeters in CT dose index phantoms and in an Alderson-Rando phantom without and with adaptive section collimation for spiral cardiac and chest CT protocols and were compared with the MC simulated dose profiles. Additional dose measurements were performed with an ionization chamber for scan ranges of 5-50 cm and pitch factors of 0.5-1.5. RESULTS: The measured and simulated dose profiles agreed to within 3%. By using adaptive section collimation, a substantial dose reduction of up to 10% was achieved for cardiac and chest CT when measurements were performed free in air and of 7% on average when measurements were performed in phantoms. For scan ranges smaller than 12 cm, ionization chamber measurements and simulations indicated a dose reduction of up to 38%. CONCLUSION: Adaptive section collimation allows substantial reduction of unnecessary exposure owing to z-overscanning in spiral CT. It can be combined in synergy with other means of dose reduction, such as spectral optimization and automatic exposure control.