SIZE-specific dose estimate for lower-limb CT

The Computed Tomography Dose Index (CTDI) is an indicator for dose management in computed tomography (CT), but has limited use for patient dosimetry. To evaluate the patient dose, the size-specific dose estimate (SSDE), reported by the American Association of Physics in Medicine task groups 204, 220, and 293, must be calculated by the CTDI_vol(z) displayed on the CT console, and the conversion factor f(D(z)) from the effective diameter (D_Eff) or water equivalent diameter (D_w). However, no reports have verified the appropriateness of using the 320-mm diameter phantom for dose assessment in CT examinations involving the lower limbs. Therefore, we validated a new method for evaluating the SSDE(z) of the lower limbs, using two 160-mm diameter phantoms instead of the 320-mm diameter phantom. The CTDI_vol(z) obtained from Monte Carlo (MC) simulation study was reliable because they were almost the same as obtained in a dosimetry study. The conversion factor f (D (z_l.l.)) for the lower limbs was evaluated based on the CTDI_vol(z) obtained by MC simulation performed using two polymethyl methacrylate cylinder phantoms of 160-mm diameter. The MC simulation was performed by the International Commission on Radiological Protection publication 135 reference adult phantom and was used to evaluate the absorbed dose of the pelvis, thighs, knees, and ankles. The dose showing the greatest difference was the thighs, which was 8.3 mGy (16%) lower than the absorbed dose. Thus, the SSDE (z_l.l.) could be estimated from the CTDIvol320(z) displayed on the CT scanner console.