• Korean Journal of Radiology
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• v.19 no.6
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• pp.1179-1186
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• 2018

Objective: The purposes of this study were to evaluate size-specific dose estimate (SSDE) of low-dose CT (LDCT) in the Korean Lung Cancer Screening (K-LUCAS) project and to determine whether CT protocols from Western countries are appropriate for lung cancer screening in Korea. Materials and Methods: For participants (n = 256, four institutions) of K-LUCAS pilot study, volume CT dose index ($CTDI_{vol}$) using a 32-cm diameter reference phantom was compared with SSDE, which was recalculated from $CTDI_{vol}$ using size-dependent conversion factor (f-size) based on the body size, as described in the American Association of Physicists in Medicine Report 204. This comparison was subsequently assessed by body mass index (BMI) levels (underweight/normal vs. overweight/obese), and automatic exposure control (AEC) adaptation (yes/no). Results: Size-specific dose estimate was higher than $CTDI_{vol}$ ($2.22{\pm}0.75mGy$ vs. $1.67{\pm}0.60mGy$, p < 0.001), since the f-size was larger than 1.0 for all participants. The ratio of SSDE to $CTDI_{vol}$ was higher in lower BMI groups; 1.26, 1.37, 1.43, and 1.53 in the obese (n = 103), overweight (n = 70), normal (n = 75), and underweight (n = 4), respectively. The ratio of SSDE to $CTDI_{vol}$ was greater in standard-sized participants than in large-sized participants independent of AEC adaptation; with AEC, SSDE/$CTDI_{vol}$ in large- vs. standard-sized participants: $1.30{\pm}0.08$ vs. $1.44{\pm}0.08$ (p < 0.001) and without AEC, $1.32{\pm}0.08$ vs. $1.42{\pm}0.06$ (p < 0.001). Conclusion: Volume CT dose index based on a reference phantom underestimates radiation exposure of LDCT in standard-sized Korean participants. The optimal radiation dose limit needs to be verified for standard-sized Korean participants.

• Journal of the Korean Society of Radiology
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• v.15 no.4
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• pp.445-453
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• 2021

CT scan is reported to have a high risk of cancer due to a relatively high dose among medical radiological examinations. In particular, exposure to radiation to the breast, which is sensitive to radiation, is inevitable during a chest CT scan for female patient. In this study, the dose reduction effect of wearing a compression band during chest CT scans in women was evaluated, and the lifetime attributable risk due to the effective dose exposed during the CT scan was estimated. As a result, when the compression band was used, the effective tube current decreased as the outer perimeter of the chest became smaller, and it was analyzed that the CT dose index and effective dose were also reduced. In addition, the lifetime attributable risk by chest CT scan was found to reduce the cancer risk by 3.2 per 100,000 for all cancers, 0.2 per 100,000 for solid cancer, and 0.8 per 100,000 for breast cancer, based on women in their 30s when using a compression band. It is judged that the risk of cancer can be reduced through the use of appropriate scan parameters and dose optimization measures such as compression bands for future CT examinations.

• Journal of radiological science and technology
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• v.44 no.4
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• pp.367-373
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• 2021

A quality assurance of computed tomography(CT) have done seven items that were water attenuation coefficient, noise, homogeneity, spatial resolution, contrast resolution, slice thickness, artifact using by standard phantom. But there is no quality assurance items and methods for CT simulator at domestic institutions yet. Therefore the study aimed to access the CT dose index(CTDI), table tilting, image distortion, laser accuracy, table movement accuracy and CT seven items for CT simulator quality assurance. The CTDI at the center of the head phantom was 0.81 for 80 kVp, 1.55 for 100 kVp, 2.50 for 120 mm, 0.22 for 80 kVp at the center of the body phantom, 0.469 for 100 kVp, and 0.81 for 120 kVp. The table tilting was within the tolerance range of ±1.0° or less. Image distortion had 1 mm distortion in the left and right images based on the center, and the laser accuracy was measured within ±2 mm tolerance. The purpose of this study is to improve the quality assurance items suitable for the current situation in Korea in order to protect the normal tissues during the radiation treatment process and manage the CT simulator that is implemented to find the location of the tumor more clearly. In order to improve the accuracy of the CT simulator when looking at the results, the error range of each item should be small. It is hoped that the quality assurance items of the CT simulator will be improved by suggesting the quality assurance direction of the CT simulator in this study, and the results of radiation therapy will also improve.

• Journal of radiological science and technology
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• v.34 no.4
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• pp.315-321
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• 2011

The goal of this study is to reduce patient exposure dose by providing image quality and radiation dose according to inspection methods. Volume Computed Tomography Dose Index(CTDIvol) and Dose Length Product(DLP) of prospective and retrospective ECG gating snapshot segment of Coronary CT angiography(CTA) were measured each snapshot segment methods. CT number, noise, uniformity, and resolution were also measured using phantom under the same condition of coronary CTA. The results showed that CT number, noise, uniformity and resolution are similar to each other. In terms of CTDIvol and DLP, however, measurement dose of prospective ECG gating snapshot segment was lower than the retrospective case by 37.5% and 40.3%. Therefore, it is highly recommended that in the coronary CTA, prospective ECG gating scan mode should be chosen to reduce patient dose.

• Journal of Radiation Protection and Research
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• v.37 no.2
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• pp.84-89
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• 2012

The purpose of this study was to compare radiation dose and image quality between low-dose (LDP) and standard-dose protocol (SDP). LDP (120 kVp, 30 mAs, 2-mm thickness) and SDP (120 kVp, 180 mAs, 1.2-mm thickness) images obtained from 61 subjects were retrospectively evaluated at level of carina bifurcation, using multi-detector CT (Brilliance 16, Philips Medical Systems). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated at ascending aorta and infraspinatus muscle, from CT number and back-ground noise. Radiation dose from two protocols measured at 5-point using acrylic-phantom, and CT number and noise measured at 4-point using water-phantom. All statistical analysis were performed using SPSS 19.0 program. LDP images showed significantly more noise and a significantly lower SNR and CNR than did SDP images at ascending aorta and infraspinatus muscle. Noise, SNR and CNR were significantly correlated with body mass index (p<0.001). Radiation dose, SNR and CNR from phantom were significant differences between two protocols. LDP showed a significant reduction of radiation dose with a significant change in SNR and CNR compared with SDP. Therefore, exposure dose on LDP in clinical applications needs resetting highly more considering image quality.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.819-825
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• 2023

In this study, among chest CT examination conditions, the tube voltage was changed to 100 and 80 kVp and the reconstruction algorithm was changed to FBP, ASIR-V, and DLIR to compare and analyze changes in examination dose and image quality. As a result, when applying ASIR-V and DLIR at a tube voltage of 100 kVp, which is lower than the existing tube voltage, the dose is lowered while achieving image quality most similar to that when applying 120 kVp and FBP. especially, DLIR reconstructed images had excellent SNR and CNR at all tube voltages. In addition, the SSIM index was analyzed to be closest to 1, showing the highest similarity to the original image. Therefore, when performing repeated chest CT examinations, the application of DLIR can reduce the examination dose by about 29.7%, which is expected to help solve some of the biggest problems with CT examinations, namely radiation exposure due to the examination.

• Progress in Medical Physics
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• v.21 no.3
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• pp.246-252
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• 2010

The purpose of this study provides measurements of radiation dose from MDCT of head, chest, abdomen and pelvic examinations. A series of dose quantities that are measured of patient weight to compare the dose received during MDCT examinations. Data collected included: weight together with CT dose descriptors, volume CT dose index (CTDIvol) and dose length product (DLP). The effective dose was also estimated and served as collective dose estimation data. Data from 1,774 adult patients attending for a CT examination of the head (n=520) or chest (n=531) or abdomen (n=724) was obtained from spiral CT units using a same CT protocol. Mean values of CTDIvol was a range of 48.6 mGy for head and 6.9, 10.5 mGy for chest, abdomen examinations, respectively. And mean values of DLP was range of 1,604 $mGy{\cdot}cm$ for head, 250 $mGy{\cdot}cm$ for chest, 575 $mGy{\cdot}cm$ for abdomen examinations, respectively. Mean effective dose values for head, chest, abdominal CT were 3.6, 4.2, and 8.6 mSv, respectively. The degree of CTDIvol and DLP was a positive correlation with weight. And there was a positive correlation for weight versus CTDIvol ($r^2$=0.62), DLP ($r^2$=0.694) in chest. And head was also positive correlation with weight versus CTDIvol ($r^2$=0.691), DLP ($r^2$=0.741). We conclude that CTDIvol and DLP is an important determinant of weight within the CT examinations. The results for this study suggest that CT protocol should be tailored according to patient weight.

• The Korean Journal of Food & Health Convergence
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• v.4 no.1
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• pp.23-31
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• 2018

The main issue of CT is radiation dose reduction to patient. The purpose of this study was to estimate the image quality and dose by iterative reconstruction (IR) for adults and pediatrics. Adult and pediatric images of phantom were obtained with 120 and 140 kV, respectively, in accordance with radiation dose in terms of volume CT dose index ($CTDI_{vol}$): 10, 15, 20, 25, 30, 35 mGy. Then, the adult and the pediatric images are reconstructed by filtered-backprojection (FBP) and iterative reconstruction (IR). The images were analyzed by signal-to-noise ratio (SNR). SNR is improved when IR and 140 kV are applied to acquire adult and pediatric images. In the adult abdomen, according to diagnostic reference level, the SNR values of bone were increased about 27.84 % and 27.77 % at 120 kV and 140 kV, and the tissue's SNR values of the IR were increased about 29.84 % and 33.46 % 120 and 140 kV, respectively. Dose is reduced to 40% in adults abdomen images when using IR reconstruction. In pediatric images, the bone's SNR were also increased about 17.70% and 18.17 % at 120 kV and 140 kV. The tissue's SNR were increased about 26.73 % and 26.15 % at 120 kV and 140 kV. Radiation dose is reduced from 30% to 50% for bone and tissue images. In the case of examinations for adult and pediatric CT, IR technique reduces radiation dose to patient, and it could be applied to adult and pediatric imaging.

• The Journal of the Korea Contents Association
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• v.17 no.6
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• pp.81-85
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• 2017

The aim of this study was to evaluate the usability of applied Low dose Computed Tomography(LDCT) protocol in examining urinary calculus using computed tomography. The subjects of this study were urological patients who visited a medical institution located in Busan from June to December 2016 and the protocol used in this study was Adaptive Statistical Iterative Reconstruction: low-dose CT with 50% Adaptive Statistical Iterative Reconstruction (ASIR). As results of quantitative analysis, the mean pixel value and standard deviation within kidney region of image(ROI)of the axial image were $26.21{\pm}7.08$ in abdomen CT pre scan and $20.03{\pm}8.16$ in low-dose CT. Also the mean pixel value and standard deviation within kidney ROI of the coronal image were $22.07{\pm}7.35$ in abdomen CT pre scan and $21.67{\pm}6.11$ in low dose CT. The results of qualitative analysis showed that four raters' mean values of observed kidney artifacts were $19.14{\pm}0.36$ when using abdomen CT protocol and $19.17{\pm}0.43$ in low-dose CT, and the mean value of resolution and contrast was $19.35{\pm}0.70$ when using abdomen CT protocol and $19.29{\pm}0.58$ in low-dose CT. Also the results of a exposure dose analysis showed that the mean values of CTDIvol and DLP in abdomen CT pre scan were 18.02 mGy and $887.51mGy{\cdot}cm$ respectively and the mean values of CTDIvol and DLP when using low-dose CT protocol were 7.412 mGy and $361.22mGy{\cdot}cm$ respectively. The resulting dose reduction rate was 58.82% and 59.29%, respectively.

• Progress in Medical Physics
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• v.25 no.1
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• pp.37-45
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• 2014

The accuracy and uniformity of CT numbers are the main causes of radiation dose calculation error. Especially, for the dose calculation based on kV-Cone Beam Computed Tomography (CBCT) image, the scatter affecting the CT number is known to be quite different by the object sizes, densities, exposure conditions, and so on. In this study, the scatter impact on the CBCT based dose calculation was evaluated to provide the optimal condition minimizing the error. The CBCT images was acquired under three scatter conditions ("Under-scatter", "Over-scatter", and "Full-scatter") by adjusting amount of scatter materials around a electron density phantom (CIRS062, Tissue Simulation Technology, Norfolk, VA, USA). The CT number uniformities of CBCT images for water-equivalent materials of the phantom were assessed, and the location dependency, either "inner" or "outer" parts of the phantom, was also evaluated. The electron density correction curves were derived from CBCT images of the electron density phantom in each scatter condition. The electron density correction curves were applied to calculate the CBCT based doses, which were compared with the dose based on Fan Beam Computed Tomography (FBCT). Also, 5 prostate IMRT cases were enrolled to assess the accuracy of dose based on CBCT images using gamma index analysis and relative dose differences. As the CT number histogram of phantom CBCT images for water equivalent materials was fitted with a gaussian function, the FHWM (146 HU) for "Full-scatter" condition was the smallest among the FHWM for the three conditions (685 HU for "under scatter" and 264 HU for "over scatter"). Also, the variance of CT numbers was the smallest for the same ingredients located in the center and periphery of the phantom in the "Full-scatter" condition. The dose distributions calculated with FBCT and CBCT images compared in a gamma index evaluation of 1%/3 mm criteria and in the dose difference. With the electron density correction acquired in the same scatter condition, the CBCT based dose calculations tended to be the most accurate. In 5 prostate cases in which the mean equivalent diameter was 27.2 cm, the averaged gamma pass rate was 98% and the dose difference confirmed to be less than 2% (average 0.2%, ranged from -1.3% to 1.6%) with the electron density correction of the "Full-scatter" condition. The accuracy of CBCT based dose calculation could be confirmed that closely related to the CT number uniformity and to the similarity of the scatter conditions for the electron density correction curve and CBCT image. In pelvic cases, the most accurate dose calculation was achievable in the application of the electron density curves of the "Full-scatter" condition.