A patient-centric approach to quality control and dosimetry in CT including CBCT |
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| Institution: | 1. QUART (Quality Assurance in Radiological Technologies) GmbH, Kirchenweg 7, 85604 Zorneding, Germany;2. Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany;3. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), C/ Profesor Martín Lagos s/n, 28040 Madrid, Spain;4. Zervides Radiation Protection Services, 5A Onisilou Street, 3075 Limassol, Cyprus;5. University of Nicosia Medical School, 93 Agiou Nikolaou Street, Engomi, 2408 Nicosia, Cyprus;6. Strahlentheraptie Süd, Robert-Weixler-Straße 50, 87439 Kempten, Germany;7. AIKAmed, Wasfi Al-Tal St. 217, 11953 Amman, Jordan;8. University Hospital Rechts der Isar, Ismaninger Str. 22, 81675 Munich, Germany;1. Medical Physics and Radiation Protection Department, Clinical Hospital Centre Rijeka, Kre?imirova 42, Rijeka, Croatia;2. Medical Physics and Biophysics Department, Medical Faculty, University of Rijeka, Bra?e Branchetta 20, Rijeka, Croatia;3. Radiology Department, General Hospital Pula, Santiorova 24a, Pula, Croatia;4. Department of Medical Physics, The University Hospital Centre Zagreb, Ki?pati?eva 12, Zagreb, Croatia;5. University Clinical Hospital Center Sestre Milosrdnice, Department of Medical Physics, Vinogradska 29, Zagreb, Croatia;6. Osijek University Hospital, Department of Medical Physics, Osijek, Josipa Huttlera 4, Croatia;7. Department of Medical Physics, University Hospital of Split, Spin?i?eva 1, Split, Croatia;8. Radiology Department, University Hospital Rijeka, Kre?imirova 42, Rijeka, Croatia;9. Radiology Department, Medical Faculty, University of Rijeka, Bra?e Branchetta 20, Rijeka, Croatia;10. Department of Medical Physics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy;11. Massachusetts General Hospital, Boston, MA, USA;12. Harvard Medical School, Boston, MA, USA;1. Future Industries Institute, University of South Australia, SA, Australia;2. Division of ITEE, University of South Australia, SA, Australia;3. Department of Medical Physics, Royal Adelaide Hospital, SA, Australia;4. Department of Physics, University of Adelaide, SA, Australia;5. Sansom Institute for Health Research and School of Health Sciences, University of South Australia, SA, Australia;1. Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology Cracow Branch, ul.Garncarska 11, 31-115 Kraków, Poland;2. Cracow University of Technology, Faculty of Physics, Mathematics and Computer Science, ul. Warszawska 24, 31-155 Kraków, Poland;3. Department of Mathematics and Statistics, Masaryk University, Brno, Czech Republic;4. Cracow University of Technology, Faculty of Mechanical Engineering, al. Jana Paw?a II 37, 30-001 Kraków, Poland |
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| Abstract: | One measurement and an algebraic formula are used to calculate the incident air kerma (Ka,i) at the skin after any CT examination, including cone-beam CT (CBCT) and multi-slice CT (MSCT).Empty scans were performed with X-ray CBCT systems (dental, C-arm and linac guidance scanners) as well as two MSCT scanners. The accumulated Ka,i at the flat panel (in CBCT) or the maximum incident air kerma at the isocentre (in MSCT) were measured using a solid-state probe. The average Ka,i(skin), at the skin of a hypothetical patient, was calculated using the proposed formula. Additional measurements of dose at the isocentre (DFOV) and kerma-area product (KAP), as well as Ka,i(skin) from thermoluminiscence dosimeters (TLDs) and size-specific dose estimates are presented for comparison.The Ka,i(skin) for the standard head size in the dental scanner, the C-arm (high dose head protocol) and the linac (head protocol) were respectively 3.33 ± 0.19 mGy, 15.15 ± 0.76 mGy and 3.23 ± 0.16 mGy. For the first MSCT, the calculated Ka,i(skin) was 13.1 ± 0.7 mGy and the TLDs provided a Ka,i(skin) between 10.3 ± 1.1 mGy and 13.8 ± 1.4 mGy.Estimation of patient air kerma in tomography with an uncertainty below 7% is thus feasible using an empty scan and conventional measurement tools. The provided equations and website can be applied to a standard size for the sake of quality control or to several sizes for the definition of diagnostic reference levels (DRLs). The obtained incident air kerma can be directly compared to the Ka,i from other X-ray modalities as recommended by ICRU and IAEA. |
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| Keywords: | CT CBCT Quality control Patient dosimetry Air kerma DRLs Radiation monitoring systems |
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