The role of Size-Specific Dose Estimate (SSDE) in patient-specific organ dose and cancer risk estimation in paediatric chest and abdominopelvic CT examinations

Objectives To develop a clinically applicable method to estimate patient-specific organ and blood doses and lifetime attributable risks (LAR) from paediatric torso CT examinations. Methods Individualized voxel models were created from full-body CT data of 10 paediatric patients (2–18 years). Patient...

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Vydáno v:	European radiology Ročník 26; číslo 8; s. 2646 - 2655
Hlavní autoři:	Franck, Caro, Vandevoorde, Charlot, Goethals, Ingeborg, Smeets, Peter, Achten, Eric, Verstraete, Koenraad, Thierens, Hubert, Bacher, Klaus
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2016 Springer Nature B.V
Témata:	Abdomen - diagnostic imaging Adolescent Cancer Child Child, Preschool Computer Simulation Diagnostic Radiology Dosimetry Drug dosages Female Humans Imaging Internal Medicine Interventional Radiology Male Medical imaging Medicine Medicine & Public Health Models, Theoretical Monte Carlo Method Neoplasms, Radiation-Induced - epidemiology Neoplasms, Radiation-Induced - etiology Neuroradiology Organs at Risk Patients Pediatrics Pelvis - diagnostic imaging Physics Radiation Radiation Dosage Radiology Thorax - diagnostic imaging Tomography Tomography, X-Ray Computed - adverse effects Tomography, X-Ray Computed - methods Ultrasound Belgium X-Ray computed tomography Monte Carlo method Radiation dosimetry Patient-specific computational modelling Paediatrics
ISSN:	0938-7994, 1432-1084, 1432-1084
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Abstract	Objectives To develop a clinically applicable method to estimate patient-specific organ and blood doses and lifetime attributable risks (LAR) from paediatric torso CT examinations. Methods Individualized voxel models were created from full-body CT data of 10 paediatric patients (2–18 years). Patient-specific dose distributions of chest and abdominopelvic CT scans were simulated using Monte Carlo methods. Blood dose was calculated as a weighted sum of simulated organ doses. LAR of cancer incidence and mortality were estimated, according to BEIR-VII. A second simulation and blood dose calculation was performed using only the thoracic and abdominopelvic region of the original voxel models. For each simulation, the size-specific dose estimate (SSDE) was calculated. Results SSDE showed a significant strong linear correlation with organ dose (r > 0.8) and blood dose (r > 0.9) and LAR (r > 0.9). No significant differences were found between blood dose calculations with the full-body voxel models and the thoracic or abdominopelvic models. Conclusion Even though clinical CT images mostly do not cover the whole body of the patient, they can be used as a voxel model for blood dose calculation. In addition, SSDE can estimate patient-specific organ and blood doses and LAR in paediatric torso CT examinations. Key Points • Blood dose can be simulated using the patient’s clinical CT images. • SSDE estimates patient-specific organ/blood dose and LAR in paediatric CAP CT-examinations. • SSDE makes on-the-spot dose and LAR estimations possible in routine clinical practice.
AbstractList	Objectives To develop a clinically applicable method to estimate patient-specific organ and blood doses and lifetime attributable risks (LAR) from paediatric torso CT examinations. Methods Individualized voxel models were created from full-body CT data of 10 paediatric patients (2–18 years). Patient-specific dose distributions of chest and abdominopelvic CT scans were simulated using Monte Carlo methods. Blood dose was calculated as a weighted sum of simulated organ doses. LAR of cancer incidence and mortality were estimated, according to BEIR-VII. A second simulation and blood dose calculation was performed using only the thoracic and abdominopelvic region of the original voxel models. For each simulation, the size-specific dose estimate (SSDE) was calculated. Results SSDE showed a significant strong linear correlation with organ dose (r > 0.8) and blood dose (r > 0.9) and LAR (r > 0.9). No significant differences were found between blood dose calculations with the full-body voxel models and the thoracic or abdominopelvic models. Conclusion Even though clinical CT images mostly do not cover the whole body of the patient, they can be used as a voxel model for blood dose calculation. In addition, SSDE can estimate patient-specific organ and blood doses and LAR in paediatric torso CT examinations. Key Points • Blood dose can be simulated using the patient’s clinical CT images. • SSDE estimates patient-specific organ/blood dose and LAR in paediatric CAP CT-examinations. • SSDE makes on-the-spot dose and LAR estimations possible in routine clinical practice. To develop a clinically applicable method to estimate patient-specific organ and blood doses and lifetime attributable risks (LAR) from paediatric torso CT examinations. Individualized voxel models were created from full-body CT data of 10 paediatric patients (2-18 years). Patient-specific dose distributions of chest and abdominopelvic CT scans were simulated using Monte Carlo methods. Blood dose was calculated as a weighted sum of simulated organ doses. LAR of cancer incidence and mortality were estimated, according to BEIR-VII. A second simulation and blood dose calculation was performed using only the thoracic and abdominopelvic region of the original voxel models. For each simulation, the size-specific dose estimate (SSDE) was calculated. SSDE showed a significant strong linear correlation with organ dose (r > 0.8) and blood dose (r > 0.9) and LAR (r > 0.9). No significant differences were found between blood dose calculations with the full-body voxel models and the thoracic or abdominopelvic models. Even though clinical CT images mostly do not cover the whole body of the patient, they can be used as a voxel model for blood dose calculation. In addition, SSDE can estimate patient-specific organ and blood doses and LAR in paediatric torso CT examinations. • Blood dose can be simulated using the patient's clinical CT images. • SSDE estimates patient-specific organ/blood dose and LAR in paediatric CAP CT-examinations. • SSDE makes on-the-spot dose and LAR estimations possible in routine clinical practice. To develop a clinically applicable method to estimate patient-specific organ and blood doses and lifetime attributable risks (LAR) from paediatric torso CT examinations. Individualized voxel models were created from full-body CT data of 10 paediatric patients (2-18 years). Patient-specific dose distributions of chest and abdominopelvic CT scans were simulated using Monte Carlo methods. Blood dose was calculated as a weighted sum of simulated organ doses. LAR of cancer incidence and mortality were estimated, according to BEIR-VII. A second simulation and blood dose calculation was performed using only the thoracic and abdominopelvic region of the original voxel models. For each simulation, the size-specific dose estimate (SSDE) was calculated. SSDE showed a significant strong linear correlation with organ dose (r>0.8) and blood dose (r>0.9) and LAR (r>0.9). No significant differences were found between blood dose calculations with the full-body voxel models and the thoracic or abdominopelvic models. Even though clinical CT images mostly do not cover the whole body of the patient, they can be used as a voxel model for blood dose calculation. In addition, SSDE can estimate patient-specific organ and blood doses and LAR in paediatric torso CT examinations. times Blood dose can be simulated using the patient's clinical CT images. times SSDE estimates patient-specific organ/blood dose and LAR in paediatric CAP CT-examinations. times SSDE makes on-the-spot dose and LAR estimations possible in routine clinical practice. To develop a clinically applicable method to estimate patient-specific organ and blood doses and lifetime attributable risks (LAR) from paediatric torso CT examinations.OBJECTIVESTo develop a clinically applicable method to estimate patient-specific organ and blood doses and lifetime attributable risks (LAR) from paediatric torso CT examinations.Individualized voxel models were created from full-body CT data of 10 paediatric patients (2-18 years). Patient-specific dose distributions of chest and abdominopelvic CT scans were simulated using Monte Carlo methods. Blood dose was calculated as a weighted sum of simulated organ doses. LAR of cancer incidence and mortality were estimated, according to BEIR-VII. A second simulation and blood dose calculation was performed using only the thoracic and abdominopelvic region of the original voxel models. For each simulation, the size-specific dose estimate (SSDE) was calculated.METHODSIndividualized voxel models were created from full-body CT data of 10 paediatric patients (2-18 years). Patient-specific dose distributions of chest and abdominopelvic CT scans were simulated using Monte Carlo methods. Blood dose was calculated as a weighted sum of simulated organ doses. LAR of cancer incidence and mortality were estimated, according to BEIR-VII. A second simulation and blood dose calculation was performed using only the thoracic and abdominopelvic region of the original voxel models. For each simulation, the size-specific dose estimate (SSDE) was calculated.SSDE showed a significant strong linear correlation with organ dose (r > 0.8) and blood dose (r > 0.9) and LAR (r > 0.9). No significant differences were found between blood dose calculations with the full-body voxel models and the thoracic or abdominopelvic models.RESULTSSSDE showed a significant strong linear correlation with organ dose (r > 0.8) and blood dose (r > 0.9) and LAR (r > 0.9). No significant differences were found between blood dose calculations with the full-body voxel models and the thoracic or abdominopelvic models.Even though clinical CT images mostly do not cover the whole body of the patient, they can be used as a voxel model for blood dose calculation. In addition, SSDE can estimate patient-specific organ and blood doses and LAR in paediatric torso CT examinations.CONCLUSIONEven though clinical CT images mostly do not cover the whole body of the patient, they can be used as a voxel model for blood dose calculation. In addition, SSDE can estimate patient-specific organ and blood doses and LAR in paediatric torso CT examinations.• Blood dose can be simulated using the patient's clinical CT images. • SSDE estimates patient-specific organ/blood dose and LAR in paediatric CAP CT-examinations. • SSDE makes on-the-spot dose and LAR estimations possible in routine clinical practice.KEY POINTS• Blood dose can be simulated using the patient's clinical CT images. • SSDE estimates patient-specific organ/blood dose and LAR in paediatric CAP CT-examinations. • SSDE makes on-the-spot dose and LAR estimations possible in routine clinical practice. Objectives To develop a clinically applicable method to estimate patient-specific organ and blood doses and lifetime attributable risks (LAR) from paediatric torso CT examinations. Methods Individualized voxel models were created from full-body CT data of 10 paediatric patients (2-18 years). Patient-specific dose distributions of chest and abdominopelvic CT scans were simulated using Monte Carlo methods. Blood dose was calculated as a weighted sum of simulated organ doses. LAR of cancer incidence and mortality were estimated, according to BEIR-VII. A second simulation and blood dose calculation was performed using only the thoracic and abdominopelvic region of the original voxel models. For each simulation, the size-specific dose estimate (SSDE) was calculated. Results SSDE showed a significant strong linear correlation with organ dose (r>0.8) and blood dose (r>0.9) and LAR (r>0.9). No significant differences were found between blood dose calculations with the full-body voxel models and the thoracic or abdominopelvic models. Conclusion Even though clinical CT images mostly do not cover the whole body of the patient, they can be used as a voxel model for blood dose calculation. In addition, SSDE can estimate patient-specific organ and blood doses and LAR in paediatric torso CT examinations. Key Points * Blood dose can be simulated using the patient's clinical CT images. * SSDE estimates patient-specific organ/blood dose and LAR in paediatric CAP CT-examinations. * SSDE makes on-the-spot dose and LAR estimations possible in routine clinical practice.
Author	Verstraete, Koenraad Achten, Eric Goethals, Ingeborg Vandevoorde, Charlot Thierens, Hubert Franck, Caro Bacher, Klaus Smeets, Peter
Author_xml	– sequence: 1 givenname: Caro surname: Franck fullname: Franck, Caro email: caro.franck@ugent.be organization: Department of Basic Medical Sciences, Ghent University – sequence: 2 givenname: Charlot surname: Vandevoorde fullname: Vandevoorde, Charlot organization: Department of Basic Medical Sciences, Ghent University – sequence: 3 givenname: Ingeborg surname: Goethals fullname: Goethals, Ingeborg organization: Nuclear Medicine Department, Ghent University Hospital – sequence: 4 givenname: Peter surname: Smeets fullname: Smeets, Peter organization: Radiology Department, Ghent University Hospital – sequence: 5 givenname: Eric surname: Achten fullname: Achten, Eric organization: Radiology Department, Ghent University Hospital – sequence: 6 givenname: Koenraad surname: Verstraete fullname: Verstraete, Koenraad organization: Radiology Department, Ghent University Hospital – sequence: 7 givenname: Hubert surname: Thierens fullname: Thierens, Hubert organization: Department of Basic Medical Sciences, Ghent University – sequence: 8 givenname: Klaus surname: Bacher fullname: Bacher, Klaus organization: Department of Basic Medical Sciences, Ghent University
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A report of age- and gender-related differences in the anatomical and physiological characteristics of reference individuals. ICRP publication 89Ann ICRP200232526510.1016/S0146-6453(02)00021-0 KrilleLZeebHJahnenAComputed tomographies and cancer risk in children: a literature overview of CT practices, risk estimations and an epidemiologic cohort study proposalRadiat Environ Biophys20125110311110.1007/s00411-012-0405-122310909 (2012) IEC 60601-2-44-am1 ed3.0 Medical electrical equipment - part2-44: particular requirements for the basic safety and essential performance of X-ray equipment for computed tomography KhatonabadiMKimHJLuPThe feasibility of a regional CTDIvol to estimate organ dose from tube current modulated CT examsMed Phys20134005190310.1118/1.4798561236352734108725 HSE (2009) Population dose from CT scanning, Ireland LiXSameiESegarsWPPatient-specific radiation dose and cancer risk estimation in CT: part II. Application to patientsMed Phys20113840841910.1118/1.351586421361209 BrennerDHallECurrent concepts - computed tomography - an increasing source of radiation exposureN Engl J Med2007357227722841:CAS:528:DC%2BD2sXhsVSlurfF10.1056/NEJMra07214918046031 LiXSameiESegarsWPSturgeonGMColsherJGFrushDPPatient-specific radiation dose and cancer risk for pediatric chest CTRadiology201125986287410.1148/radiol.11101900214672513099041 AAPM (2011) Size-Specific Dose Estimates (SSDE) in pediatric and adult body ct examinations (Task Group 204). American Association of Physicists in Medicine, College Park AAPM (2014) Use of water equivalent diameter for calculating patient size and Size-Specific Dose Estimate (SSDE) in CT (Task Group 220). 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References_xml	– reference: Petoussi-HenssNZanklMFillURegullaDThe GSF family of voxel phantomsPhys Med Biol2002478910610.1088/0031-9155/47/1/30711814230 – reference: HSE (2009) Population dose from CT scanning, Ireland – reference: BrennerDJSlowing the increase in the population dose resulting from CT scansRadiat Res20101748098151:CAS:528:DC%2BC3cXhsFCntLfM10.1667/RR1859.120731591 – reference: UNSCEARSources and effects of ionizing radiation. Report to the General Assembly of the United Nations2013New YorkUnited Nations – reference: SeuntjensJThierensHVan der PlaetsenASegaertOConversion factor f for X-ray beam qualities, specified by peak tube potential and HVL valuePhys Med Biol1987325956031:CAS:528:DyaL2sXkt12rtb0%3D10.1088/0031-9155/32/5/0053588672 – reference: (2012) IEC 60601-2-44-am1 ed3.0 Medical electrical equipment - part2-44: particular requirements for the basic safety and essential performance of X-ray equipment for computed tomography – reference: RothkammKBalroopSShekhdarJFerniePGohVLeukocyte DNA damage after multi-detector row CT: a quantitative biomarker of low-level radiation exposureRadiology200724224425110.1148/radiol.242106017117185671 – reference: NCRP (2009) Ionizing radiation exposure of the population of the United States. NCRP Report 160, Bethesda MD – reference: LobrichMRiefNKuhneMIn vivo formation and repair of DNA double-strand breaks after computed tomography examinationsProc Natl Acad Sci U S A20051028984898910.1073/pnas.0501895102159562031150277 – reference: ICRPThe 2007 recommendations of the International Commission on Radiological Protection. ICRP publication 103Ann ICRP200737133210.1016/j.icrp.2007.12.007 – reference: Moore BM, Brady SL, Mirro AE, Kaufman RA (2014) Size-Specific Dose Estimate (SSDE) provides a simple method to calculate organ dose for pediatric CT examinations. Med Phys 41 – reference: TurnerACZhangDKhatonabadiMThe feasibility of patient size-corrected, scanner-independent organ dose estimates for abdominal CT examsMed Phys20113882082910.1118/1.3533897214527193037972 – reference: LiXSameiESegarsWPPatient-specific radiation dose and cancer risk estimation in CT: part II. Application to patientsMed Phys20113840841910.1118/1.351586421361209 – reference: HalmBMFrankeAALaiJFγ-H2AX foci are increased in lymphocytes in vivo in young children 1 h after very low-dose X-irradiation: a pilot studyPediatr Radiol2014441310131710.1007/s00247-014-2983-3247562544175172 – reference: EPAEPA radiogenic cancer risk models and projections for the U.S. population2011Washington DCU.S. Environmental Protection Agency – reference: VandevoordeCFranckCBacherKγ-H2AX foci as in vivo effect biomarker in children emphasize the importance to minimize x-ray doses in paediatric CT imagingEur Radiol2014253545564328121 – reference: ICRPAdult reference computational phantoms. 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The National Academies Press – reference: LiXSameiESegarsWPSturgeonGMColsherJGFrushDPPatient-specific radiation dose and cancer risk for pediatric chest CTRadiology201125986287410.1148/radiol.11101900214672513099041 – reference: PHE (2010) Frequency and collective dose for medical and dental x-ray examinations in the UK (HPA-CRCE-012), United Kingdom – reference: BradyZCainTMJohnstonPNComparison of organ dosimetry methods and effective dose calculation methods for paediatric CTAustralas Phys Eng Sci Med2012351171341:STN:280:DC%2BC38rjvFKhsw%3D%3D10.1007/s13246-012-0134-422492218 – reference: BeelsLBacherKSmeetsPVerstraeteKVralAThierensHDose-length product of scanners correlates with DNA damage in patients undergoing contrast CTEur J Radiol2012811495149910.1016/j.ejrad.2011.04.06321596504 – reference: AAPM (2014) Use of water equivalent diameter for calculating patient size and Size-Specific Dose Estimate (SSDE) in CT (Task Group 220). 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Snippet	Objectives To develop a clinically applicable method to estimate patient-specific organ and blood doses and lifetime attributable risks (LAR) from paediatric... To develop a clinically applicable method to estimate patient-specific organ and blood doses and lifetime attributable risks (LAR) from paediatric torso CT... Objectives To develop a clinically applicable method to estimate patient-specific organ and blood doses and lifetime attributable risks (LAR) from paediatric...
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SubjectTerms	Abdomen - diagnostic imaging Adolescent Cancer Child Child, Preschool Computer Simulation Diagnostic Radiology Dosimetry Drug dosages Female Humans Imaging Internal Medicine Interventional Radiology Male Medical imaging Medicine Medicine & Public Health Models, Theoretical Monte Carlo Method Neoplasms, Radiation-Induced - epidemiology Neoplasms, Radiation-Induced - etiology Neuroradiology Organs at Risk Patients Pediatrics Pelvis - diagnostic imaging Physics Radiation Radiation Dosage Radiology Thorax - diagnostic imaging Tomography Tomography, X-Ray Computed - adverse effects Tomography, X-Ray Computed - methods Ultrasound
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Title	The role of Size-Specific Dose Estimate (SSDE) in patient-specific organ dose and cancer risk estimation in paediatric chest and abdominopelvic CT examinations
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