Zhang Da, Padole Atul, Li Xinhua, Singh Sarabjeet, Khawaja Ranish Deedar Ali, Lira Diego, Liu Tianyu, Shi Jim Q, Otrakji Alexi, Kalra Mannudeep K, Xu X George, Liu Bob
Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts 02114.
Nuclear Engineering Program, Rensselaer Polytechnic Institute, Troy, New York 12180.
Med Phys. 2014 Sep;41(9):091911. doi: 10.1118/1.4893499.
To present a study of radiation dose measurements with a human cadaver scanned on a clinical CT scanner.
Multiple point dose measurements were obtained with high-accuracy Thimble ionization chambers placed inside the stomach, liver, paravertebral gutter, ascending colon, left kidney, and urinary bladder of a human cadaver (183 cm in height and 67.5 kg in weight) whose abdomen/pelvis region was scanned repeatedly with a multidetector row CT. The flat energy response and precision of the dosimeters were verified, and the slight differences in each dosimeter's response were evaluated and corrected to attain high accuracy. In addition, skin doses were measured for radiosensitive organs outside the scanned region with OSL dosimeters: the right eye, thyroid, both nipples, and the right testicle. Three scan protocols were used, which shared most scan parameters but had different kVp and mA settings: 120-kVp automA, 120-kVp 300 mA, and 100-kVp 300 mA. For each protocol three repeated scans were performed.
The tube starting angle (TSA) was found to randomly vary around two major conditions, which caused large fluctuations in the repeated point dose measurements: for the 120-kVp 300 mA protocol this angle changed from approximately 110° to 290°, and caused 8%-25% difference in the point dose measured at the stomach, liver, colon, and urinary bladder. When the fluctuations of the TSA were small (within 5°), the maximum coefficient of variance was approximately 3.3%. The soft tissue absorbed doses averaged from four locations near the center of the scanned region were 27.2±3.3 and 16.5±2.7 mGy for the 120 and 100-kVp fixed-mA scans, respectively. These values were consistent with the corresponding size specific dose estimates within 4%. The comparison of the per-100-mAs tissue doses from the three protocols revealed that: (1) dose levels at nonsuperficial locations in the TCM scans could not be accurately deduced by simply scaling the fix-mA doses with local mA values; (2) the general power law relationship between dose and kVp varied from location to location, with the power index ranged between 2.7 and 3.5. The averaged dose measurements at both nipples, which were about 0.6 cm outside the prescribed scan region, ranged from 23 to 27 mGy at the left nipple, and varied from 3 to 20 mGy at the right nipple over the three scan protocols. Large fluctuations over repeated scans were also observed, as a combined result of helical scans of large pitch (1.375) and small active areas of the skin dosimeters. In addition, the averaged skin dose fell off drastically with the distance to the nearest boundary of the scanned region.
This study revealed the complexity of CT dose fluctuation and variation with a human cadaver.
介绍一项关于在临床CT扫描仪上对人体尸体进行辐射剂量测量的研究。
使用高精度指形电离室在一名身高183厘米、体重67.5千克的人体尸体的胃、肝脏、椎旁沟、升结肠、左肾和膀胱内进行多点剂量测量,该尸体的腹部/盆腔区域用多层螺旋CT进行反复扫描。对剂量计的能量响应和精度进行了验证,并评估和校正了每个剂量计响应中的微小差异以实现高精度。此外,使用光释光剂量计测量扫描区域外的放射敏感器官的皮肤剂量:右眼、甲状腺、双侧乳头和右侧睾丸。使用了三种扫描方案,它们共享大多数扫描参数,但具有不同的千伏峰值(kVp)和毫安值(mA)设置:120-kVp自动毫安、120-kVp 300 mA和100-kVp 300 mA。对每个方案进行了三次重复扫描。
发现管起始角度(TSA)在两个主要条件附近随机变化,这导致重复点剂量测量出现较大波动:对于120-kVp 300 mA方案,该角度从约110°变化到290°,并导致在胃、肝脏、结肠和膀胱处测量的点剂量有8%-25%的差异。当TSA的波动较小时(在5°以内),最大方差系数约为3.3%。对于120和100-kVp固定毫安扫描,扫描区域中心附近四个位置的软组织吸收剂量平均值分别为27.2±3.3和16.5±2.7毫戈瑞。这些值与相应的尺寸特定剂量估计值在4%以内一致。对三种方案每100毫安秒的组织剂量进行比较发现:(1)不能简单地通过将固定毫安剂量与局部毫安值进行缩放来准确推断中医扫描中非浅表位置的剂量水平;(2)剂量与kVp之间的一般幂律关系因位置而异,幂指数在2.7至3.5之间。在三个扫描方案中,位于规定扫描区域外约0.6厘米处的双侧乳头的平均剂量测量值,左乳头为23至27毫戈瑞,右乳头为3至20毫戈瑞。在重复扫描中也观察到较大波动,这是大螺距(1.375)螺旋扫描和皮肤剂量计小有效面积的综合结果。此外,平均皮肤剂量随着到扫描区域最近边界的距离急剧下降。
本研究揭示了使用人体尸体进行CT剂量波动和变化的复杂性。