Multicentric characterization of organ-based tube current modulation in head computed tomography: A dosimetric and image quality study.

PURPOSE: To evaluate the efficiency of organ-based tube current modulation (OBTCM) in head Computed Tomography (CT) for different radiology departments and manufacturers. MATERIALS AND METHODS: Five CT scanners from four radiology departments were evaluated in this study. All scans were performed using a standard and a routine head protocol. A scintillating fiber optic detector was placed directly on the gantry to measure the tube exit kerma. Image quality was quantified on a 16-cm HEAD phantom by measuring the signal-to-noise ratio (SNR) and the standard deviation of the Hounsfield units (HU) of circular regions of interest placed in the phantom. The Noise Power Spectrum (NPS) was also studied. Measured values were compared on images with and without OBTCM. RESULTS: The reduction rates in tube exit kerma, on the anterior part, vary between 11 % and 74 % depending on the CT scanner and the protocol used. The tube exit kerma on the posterior part remains unchanged in GE and Canon CT scanners. On the contrary, the tube exit kerma to the posterior part increases by up to 39 % in Siemens CT scanner. Image noise and SNR increase by up to 10 % in the five CT scanners. Nonetheless, the differences in noise and SNR are statistically significant (p-value < 0.05).The analysis of the NPS indicates that the noise texture remains unchanged. CONCLUSION: OBTCM reduces the tube exit kerma to the anterior part of the gantry without reducing substantially image quality for head protocols.

Impact of different models based on blood samples and images for bone marrow dosimetry after 177Lu-labeled somatostatin-receptor therapy.

BACKGROUND: Peptide receptor radionuclide therapy with 177Lu-DOTATATE is a recognized option for treating neuroendocrine tumors and has few toxicities, except for the kidneys and bone marrow. The bone marrow dose is generally derived from a SPECT/CT image-based method with four timepoints or from a blood-based method with up to 9 timepoints, but there is still no reference method. This retrospective single-center study on the same cohort of patients compared the calculated bone marrow dose administered with both methods using mono, bi- or tri-exponential models. For the image-based method, the dose was estimated using Planetdose© software. Pearson correlation coefficients were calculated. We also studied the impact of late timepoints for both methods. RESULTS: The bone marrow dose was calculated for 131 treatments with the blood-based method and for 17 with the image-based method. In the former, the median absorbed dose was 15.3, 20.5 and 28.3 mGy/GBq with the mono-, bi- and tri-exponential model, respectively. With the image-based method, the median absorbed dose was 63.9, 41.9 and 60.8 with the mono-, bi- and tri-exponential model, respectively. Blood samples after 24h post-injection did not evidence any change in the absorbed bone marrow dose with the bi-exponential model. On the contrary, the 6-day post-injection timepoint was more informative with the image-based model. CONCLUSION: This study confirms that the estimated bone marrow dose is significantly lower with the blood-based method than with the image-based method. The blood-based method with a bi-exponential model proved particularly useful, without the need for blood samples after 24h post-injection. Nevertheless, this blood-based method is based on an assumption that needs to be more validated. The important difference between the two methods does not allow to determine the optimal one to estimate the true absorbed dose and further studies are necessary to compare with biological effects.

Validation of a New Scintillating Fiber Dosimeter for Radiation Dose Quality Control in Computed Tomography.

(1) Background: The IVIscan is a commercially available scintillating fiber detector designed for quality assurance and in vivo dosimetry in computed tomography (CT). In this work, we investigated the performance of the IVIscan scintillator and associated method in a wide range of beam width from three CT manufacturers and compared it to a CT chamber designed for Computed Tomography Dose Index (CTDI) measurements. (2) Methods: We measured weighted CTDI (CTDIw) with each detector in accordance with the requirements of regulatory tests and international recommendations for the minimum, maximum and the most used beam width in clinic and investigated the accuracy of the IVIscan system based on the assessment of the CTDIw deviation from the CT chamber. We also investigated the IVIscan accuracy for the whole range of the CT scans kV. (3) Results: We found excellent agreement between the IVIscan scintillator and the CT chamber for the whole range of beam widths and kV, especially for wide beams used on recent technology of CT scans. (4) Conclusions: These findings highlight that the IVIscan scintillator is a relevant detector for CT radiation dose assessments, and the method associated with calculating the CTDIw saves a significant amount of time and effort when performing tests, especially with regard to new CT technologies.