Trattner Sigal, Cheng Bin, Pieniazek Radoslaw L, Hoffmann Udo, Douglas Pamela S, Einstein Andrew J
Department of Medicine, Division of Cardiology, Columbia University Medical Center and New York-Presbyterian Hospital, New York, New York 10032.
Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York 10032.
Med Phys. 2014 Apr;41(4):042102. doi: 10.1118/1.4868693.
Effective dose (ED) is a widely used metric for comparing ionizing radiation burden between different imaging modalities, scanners, and scan protocols. In computed tomography (CT), ED can be estimated by performing scans on an anthropomorphic phantom in which metal-oxide-semiconductor field-effect transistor (MOSFET) solid-state dosimeters have been placed to enable organ dose measurements. Here a statistical framework is established to determine the sample size (number of scans) needed for estimating ED to a desired precision and confidence, for a particular scanner and scan protocol, subject to practical limitations.
The statistical scheme involves solving equations which minimize the sample size required for estimating ED to desired precision and confidence. It is subject to a constrained variation of the estimated ED and solved using the Lagrange multiplier method. The scheme incorporates measurement variation introduced both by MOSFET calibration, and by variation in MOSFET readings between repeated CT scans. Sample size requirements are illustrated on cardiac, chest, and abdomen-pelvis CT scans performed on a 320-row scanner and chest CT performed on a 16-row scanner.
Sample sizes for estimating ED vary considerably between scanners and protocols. Sample size increases as the required precision or confidence is higher and also as the anticipated ED is lower. For example, for a helical chest protocol, for 95% confidence and 5% precision for the ED, 30 measurements are required on the 320-row scanner and 11 on the 16-row scanner when the anticipated ED is 4 mSv; these sample sizes are 5 and 2, respectively, when the anticipated ED is 10 mSv.
Applying the suggested scheme, it was found that even at modest sample sizes, it is feasible to estimate ED with high precision and a high degree of confidence. As CT technology develops enabling ED to be lowered, more MOSFET measurements are needed to estimate ED with the same precision and confidence.
有效剂量(ED)是一种广泛用于比较不同成像模式、扫描仪和扫描协议之间电离辐射负担的指标。在计算机断层扫描(CT)中,有效剂量可通过对放置了金属氧化物半导体场效应晶体管(MOSFET)固态剂量计以进行器官剂量测量的人体模型进行扫描来估算。在此建立了一个统计框架,以确定在特定扫描仪和扫描协议下,在实际限制条件下,将有效剂量估算到所需精度和置信度所需的样本量(扫描次数)。
该统计方案涉及求解方程,以最小化将有效剂量估算到所需精度和置信度所需的样本量。它受到有效剂量估计值的约束变化,并使用拉格朗日乘数法求解。该方案纳入了由MOSFET校准引入的测量变化,以及重复CT扫描之间MOSFET读数的变化。在320排扫描仪上进行的心脏、胸部和腹部-骨盆CT扫描以及在16排扫描仪上进行的胸部CT扫描中说明了样本量要求。
估算有效剂量所需的样本量在不同扫描仪和协议之间差异很大。样本量随着所需精度或置信度的提高以及预期有效剂量的降低而增加。例如,对于螺旋胸部协议,对于有效剂量的95%置信度和5%精度,当预期有效剂量为4 mSv时, 在多排探测器CT扫描仪上需要进行30次测量,在16排探测器CT扫描仪上需要进行11次测量;当预期有效剂量为10 mSv时,这些样本量分别为5次和2次。
应用所建议的方案发现,即使在样本量适中的情况下,高精度和高置信度地估算有效剂量也是可行的。随着CT技术的发展使有效剂量降低,需要更多的MOSFET测量来以相同的精度和置信度估算有效剂量。