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基于蒙特卡罗模拟计算的参考小儿和青少年患者 CT 检查器官剂量。

Organ doses for reference pediatric and adolescent patients undergoing computed tomography estimated by Monte Carlo simulation.

机构信息

Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Bethesda, MD 20852, USA.

出版信息

Med Phys. 2012 Apr;39(4):2129-46. doi: 10.1118/1.3693052.

Abstract

PURPOSE

To establish an organ dose database for pediatric and adolescent reference individuals undergoing computed tomography (CT) examinations by using Monte Carlo simulation. The data will permit rapid estimates of organ and effective doses for patients of different age, gender, examination type, and CT scanner model.

METHODS

The Monte Carlo simulation model of a Siemens Sensation 16 CT scanner previously published was employed as a base CT scanner model. A set of absorbed doses for 33 organs∕tissues normalized to the product of 100 mAs and CTDI(vol) (mGy∕100 mAs mGy) was established by coupling the CT scanner model with age-dependent reference pediatric hybrid phantoms. A series of single axial scans from the top of head to the feet of the phantoms was performed at a slice thickness of 10 mm, and at tube potentials of 80, 100, and 120 kVp. Using the established CTDI(vol)- and 100 mAs-normalized dose matrix, organ doses for different pediatric phantoms undergoing head, chest, abdomen-pelvis, and chest-abdomen-pelvis (CAP) scans with the Siemens Sensation 16 scanner were estimated and analyzed. The results were then compared with the values obtained from three independent published methods: CT-Expo software, organ dose for abdominal CT scan derived empirically from patient abdominal circumference, and effective dose per dose-length product (DLP).

RESULTS

Organ and effective doses were calculated and normalized to 100 mAs and CTDI(vol) for different CT examinations. At the same technical setting, dose to the organs, which were entirely included in the CT beam coverage, were higher by from 40 to 80% for newborn phantoms compared to those of 15-year phantoms. An increase of tube potential from 80 to 120 kVp resulted in 2.5-2.9-fold greater brain dose for head scans. The results from this study were compared with three different published studies and∕or techniques. First, organ doses were compared to those given by CT-Expo which revealed dose differences up to several-fold when organs were partially included in the scan coverage. Second, selected organ doses from our calculations agreed to within 20% of values derived from empirical formulae based upon measured patient abdominal circumference. Third, the existing DLP-to-effective dose conversion coefficients tended to be smaller than values given in the present study for all examinations except head scans.

CONCLUSIONS

A comprehensive organ∕effective dose database was established to readily calculate doses for given patients undergoing different CT examinations. The comparisons of our results with the existing studies highlight that use of hybrid phantoms with realistic anatomy is important to improve the accuracy of CT organ dosimetry. The comprehensive pediatric dose data developed here are the first organ-specific pediatric CT scan database based on the realistic pediatric hybrid phantoms which are compliant with the reference data from the International Commission on Radiological Protection (ICRP). The organ dose database is being coupled with an adult organ dose database recently published as part of the development of a user-friendly computer program enabling rapid estimates of organ and effective dose doses for patients of any age, gender, examination types, and CT scanner model.

摘要

目的

利用蒙特卡罗模拟为儿科和青少年参考个体进行计算机断层扫描(CT)检查建立器官剂量数据库。该数据将允许快速估算不同年龄、性别、检查类型和 CT 扫描仪型号的患者的器官和有效剂量。

方法

使用先前发表的西门子 Sensation 16 CT 扫描仪的蒙特卡罗模拟模型作为基本 CT 扫描仪模型。通过将 CT 扫描仪模型与年龄相关的参考儿科混合体模耦合,建立了一组归一化为 100 mAs 和 CTDI(vol)乘积(mGy/100 mAs mGy)的 33 个器官/组织的吸收剂量。在 10 毫米的层厚和 80、100 和 120 kVp 的管电压下,对体模的头部至脚部进行一系列单轴扫描。使用建立的 CTDI(vol)和 100 mAs 归一化剂量矩阵,估算并分析了不同儿科体模进行头部、胸部、腹部-骨盆和胸部-腹部-骨盆(CAP)扫描时的器官剂量。然后将结果与三种独立发表的方法的结果进行比较:CT-Expo 软件、从患者腹部周长得出的腹部 CT 扫描的器官剂量经验公式以及每剂量-长度乘积(DLP)的有效剂量。

结果

为不同的 CT 检查计算并归一化为 100 mAs 和 CTDI(vol)的器官和有效剂量。在相同的技术设置下,与 15 岁体模相比,完全包含在 CT 光束覆盖范围内的器官的剂量要高 40%至 80%。从 80 千伏增加到 120 千伏会使头部扫描的脑剂量增加 2.5-2.9 倍。本研究的结果与三种不同的已发表研究和/或技术进行了比较。首先,与 CT-Expo 进行了器官剂量比较,结果表明当器官部分包含在扫描覆盖范围内时,剂量差异可达数倍。其次,我们的计算中选定的器官剂量与基于实测患者腹部周长的经验公式得出的剂量值相差不超过 20%。第三,现有的 DLP 到有效剂量转换系数对于除头部扫描以外的所有检查都倾向于小于本研究中给出的值。

结论

建立了一个全面的器官/有效剂量数据库,可方便地计算给定患者进行不同 CT 检查的剂量。我们的结果与现有研究的比较表明,使用具有真实解剖结构的混合体模对于提高 CT 器官剂量测量的准确性非常重要。本研究开发的全面儿科剂量数据是第一个基于符合国际辐射防护委员会(ICRP)参考数据的真实儿科混合体模的特定儿科 CT 扫描数据库。该器官剂量数据库与最近发表的成人器官剂量数据库相结合,作为开发用户友好的计算机程序的一部分,该程序能够快速估算任何年龄、性别、检查类型和 CT 扫描仪型号的患者的器官和有效剂量。

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