• Journal of Radiation Protection and Research
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• v.46 no.4
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• pp.151-159
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• 2021

Background: Computed tomography (CT) is one of the crucial diagnostic tools in modern medicine. However, careful monitoring of radiation dose for CT patients is essential since the procedure involves ionizing radiation, a known carcinogen. Materials and Methods: The most desirable CT dose descriptor for risk analysis is the organ absorbed dose. A variety of CT organ dose calculators currently available were reviewed in this article. Results and Discussion: Key common elements included in CT dose calculators were discussed and compared, such as computational human phantoms, CT scanner models, organ dose database, effective dose calculation methods, tube current modulation modeling, and user interface platforms. Conclusion: It is envisioned that more research needs to be conducted to more accurately map CT coverage on computational human phantoms, to automatically segment organs and tissues for patient-specific dose calculations, and to accurately estimate radiation dose in the cone beam computed tomography process during image-guided radiation therapy.

• Journal of radiological science and technology
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• v.38 no.1
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• pp.51-61
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• 2015

Computed tomography(CT) using radiation have potential risks. All medical radiographic examinations should require the justification of medical imaging examinations and optimization of the image quality and radiation exposure. The CT examination was higher radiation dose then general radiography. Especially pediatric CT examinations need to great caution of radiation risk. Because of pediatric patient was more sensitive of radiation exposure. Therefore, physician should consider the knowledge of CT radiation exposure indicator information for reduce a needless radiation exposure. This article was aim to understanding of CT exposure indicator, size-specific dose estimates by American Association of Physicists in Medicine (AAPM) report 204, XR 25 and understanding of CT dose reduction technique.

• Journal of the Korean Society of Radiology
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• v.9 no.2
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• pp.109-115
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• 2015

In case of a CT examinations, there is a difference in the distribution of radiation dose from that of general X-ray equipments, and it has been known to cause a great radiation exposure during the examinations. However, owing to its high reliability on the accuracy of a examinations result, its use has increased continuously. In consideration of such a circumstance, the CT equipment, radiation dose during CT examinations, diagnostic reference level, and solutions to reduce radiation dose were mentioned on the basis of previously reported data.

• Progress in Medical Physics
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• v.28 no.1
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• pp.27-32
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• 2017

We investigated the effect of a commercial iterative reconstruction technique (iDose, Philips) on the image quality and the dose calculation for the treatment plan. Using the electron density phantom, the 3D CT images with five different protocols (50, 100, 200, 350 and 400 mAs) were obtained. Additionally, the acquired data was reconstructed using the iDose with level 5. A lung phantom was used to acquire the 4D CT with the default protocol as a reference and the low dose (one third of the default protocol) 4D CT using the iDose for the spine and lung plans. When applying the iDose at the same mAs, the mean HU value was changed up to 85 HU. Although the 1 SD was increased with reducing the CT dose, it was decreased up to 4 HU due to the use of iDose. When using the low dose 4D CT with iDose, the dose change relative to the reference was less than 0.5% for the target and OARs in the spine plan. It was also less than 1.1% in the lung plan. Therefore, our results suggests that this dose reduction technique is applicable to the 4D CT image acquisition for the radiation treatment planning.

• Journal of radiological science and technology
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• v.42 no.2
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• pp.105-111
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• 2019

A medical personnel could be placed beside a patient together in CT room to do Ambu-bag for a seriously ill patients or emergency patient. At this time, the medical personnel can be exposed indirect radiation unnecessarily. In this case, it is necessary to recognize indirect radiation dose levels and methods to reduce them using actual clinical CT protocols such as Chest, Abdomen, and Brain CT. We researched surface radiation dose with or without radiation protectors such as apron and goggles according to different distances far from gantry using two different CT scanners (Fixed MDCT and mobile CT). As a result, for Chest, Abdomen, and Brain CT with Fixed MDCT, indirect radiation dose on thorax portion were 0.047, 0.089, 0.034 mSv without apron. Also, those with apron were 0.007, 0.012, 0.006 mSv. In case of mobile CT, it was 0.014 mSv without apron and 0.005 mSv with apron. By using protectors and increasing the distance, we could reduce it to 97%. Systematic management is necessary based on the measured data in order to minimize radiation damage due to indirect exposure dose.

• Progress in Medical Physics
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• v.32 no.1
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• pp.18-24
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• 2021

Purpose: Kilovoltage computed tomography (kV-CT) is essential for radiation treatment planning. However, kV-CT images are significantly distorted by artifacts when a metallic prosthesis is present in the patient's body. Thus, the accuracies of target delineation and treatment dose calculation are inevitably lowered. We evaluated the accuracy of the calculated doses using an image restoration method with hybrid CT, which was introduced in our previous study. Methods: A cylindrical phantom containing four metals, namely, silver, copper, tin, and tungsten, was scanned using kV-CT and megavoltage CT to produce hybrid CT images. We created six verification plans for three head and neck patients on kV-CT and hybrid CT images of the phantom and calculated their doses. The actual doses were measured with film patches during beam delivery using tomotherapy. We used the gamma evaluation method to compare dose distribution between kV-CT and hybrid CT with three gamma criteria, namely, 3%/3 mm, 2%/2 mm, and 1%/1 mm. Results: The gamma pass rates decreased as the gamma criteria were strengthened, and the pass rate of hybrid CT was higher than that of kV-CT in all cases. When the 1%/1 mm criterion was used, the difference in gamma pass rates between them was up to 13%p. Conclusions: According to our findings, we expect that the use of hybrid CT can be a suitable approach to avoid the effect of severe metal artifacts on the accuracy of dose calculation and contouring.

• Journal of Radiation Protection and Research
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• v.40 no.1
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• pp.17-24
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• 2015

To improve accuracy of dose calculation on kilovoltage cone beam computed tomography (kV CBCT) images, a custom-made phantom was fabricated to acquire an accurate CT number to electron density curve by full scatter of cone beam x-ray. To evaluate the dosimetric accuracy, 9 volumetric modulated arc therapy (VMAT) plans for head and neck (HN) cancer and 9 VMAT plans for lung cancer were generated with an anthropomorphic phantom. Both CT and CBCT images of the anthropomorphic phantom were acquired and dose-volumetric parameters on the CT images with CT density curve (CTCT), CBCT images with CT density curve ($CBCT_{CT}$) and CBCT images with CBCT density curve ($CBCT_{CBCT}$) were calculated for each VMAT plan. The differences between $CT_{CT}$ vs. $CBCT_{CT}$ were similar to those between $CT_{CT}$ vs. $CBCT_{CBCT}$ for HN VMAT plans. However, the differences between $CT_{CT}$ vs. $CBCT_{CT}$ were larger than those between $CT_{CT}$ vs. $CBCT_{CBCT}$ for lung VMAT plans. Especially, the differences in $D_{98%}$ and $D_{95%}$ of lung target volume were statistically significant (4.7% vs. 0.8% with p = 0.033 for $D_{98%}$ and 4.8% vs. 0.5% with p = 0.030 for $D_{95%}$). In order to calculate dose distributions accurately on the CBCT images, CBCT density curve generated with full scatter condition should be used especially for dose calculations in the region of large inhomogeneity.

• Journal of the Korean Society of Radiology
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• v.6 no.4
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• pp.281-290
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• 2012

The difference of radiation dose of MDCT due to different protocols between hospitals was analyzed by CTDI, DLP, the number of Slice and the number of DLP/Slice in 30 cases of the head, the abdomen and the chest that have 10 cases each from MDCT examination of the department of diagnostic imaging of three general hospitals in Gyeongsangbuk-do. The difference of image quality, CTDI, DLP, radiation dose in the eye and radiation dose in thyroid was analyzed after both helical scan and normal scan for head CT were performed because a protocol of head CT is relatively simple and head CT is the most frequent case. Head CT was significantly higher in two-thirds of hospitals compared to A hospital that does not exceed a CTDI diagnostic reference level (IAEA 50mGy, Korea 60mGy) (p<0.001). DLP was higher in one-third of hospitals than a diagnostic reference level of IAEA 1,050mGy.cm and Korea 1,000mGy.cm and two-thirds exceeded the recommendation of Korea and those were significantly higher than A hospital that does not exceed a diagnostic reference level (p<0.001). Abdomen CT showed 119mGy that was higher than a diagnostic reference level of IAEA 25mGy and Korea 20mGy in one-third. DLP in all hospitals was higher that Korea recommendation of 700mGy.cm. Among target hospitals, C hospital showed high radiation dose in all tests because MPR and 3D were of great importance due to low pitch and high Tube Curren. To analyze the difference of radiation dose by scan methods, normal scan and helical scan for head CT of the same patient were performed. In the result, CTDI and DLP of helical CT were higher 63.4% and 93.7% than normal scan (p<0.05, p<0.01). However, normal scan of radiation dose in thyroid was higher 87.26% (p<0.01). Beam of helical CT looked like a bell in the deep part and the marginal part so thyroid was exposed with low radiation dose deviated from central beam. In addition, helical scan used Gantry angle perpendicularly and normal scan used it parallel to the orbitomeatal line. Therefore, radiation dose in thyroid decreased in helical scan. However, a protocol in this study showed higher radiation dose than diagnostic reference level of KFDA. To obey the recommendation of KFDA, low Tube Curren and high pitch were demanded. In this study, the difference of image quality between normal scan and helical scan was not significant. Therefore, a standardized protocol of normal scan was generally used and protective gear for thyroid was needed except a special case. We studied a part of CT cases in the local area. Therefore, the result could not represent the entire cases. However, we confirmed that patient's radiation dose in some cases exceeded the recommendation and the deviation between hospitals was observed. To improve this issue, doctors of diagnostic imaging or technologists of radiology should perform CT by the optimized protocol to decrease a level of CT radiation and also reveal radiation dose for the right to know of patients. However, they had little understanding of the situation. Therefore, the effort of relevant agencies with education program for CT radiation dose, release of radiation dose from CT examination and addition of radiation dose control and open CT contents into evaluation for hospital services and certification, and also the effort of health professionals with the best protocol to realize optimized CT examination.

• Journal of Radiation Protection and Research
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• v.46 no.3
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• pp.98-105
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• 2021

Background: In recent events of the coronavirus disease 2019 (COVID-19) pandemic, computed tomography (CT) scans are being globally used as a complement to the reverse-transcription polymerase chain reaction (RT-PCR) tests. It will be important to be aware of major organ dose levels, which are more relevant quantity to derive potential long-term adverse effect, for Korean pediatric and adult patients undergoing CT for COVID-19. Materials and Methods: We calculated organ dose conversion coefficients for Korean pediatric and adult CT patients directly from Korean pediatric and adult computational phantoms combined with Monte Carlo radiation transport techniques. We then estimated major organ doses delivered to the Korean child and adult patients undergoing CT for COVID-19 combining the dose conversion coefficients and the international survey data. We also compared our Korean dose conversion coefficients with those from Caucasian reference pediatric and adult phantoms. Results and Discussion: Based on the dose conversion coefficients we established in this study and the international survey data of COVID-19-related CT scans, we found that Korean 7-year-old child and adult males may receive about 4-32 mGy and 3-21 mGy of lung dose, respectively. We learned that the lung dose conversion coefficient for the Korean child phantom was up to 1.5-fold greater than that for the Korean adult phantom. We also found no substantial difference in dose conversion coefficients between Korean and Caucasian phantoms. Conclusion: We estimated radiation dose delivered to the Korean child and adult phantoms undergoing COVID-19-related CT examinations. The dose conversion coefficients derived for different CT scan types can be also used universally for other dosimetry studies concerning Korean CT scans. We also confirmed that the Caucasian-based CT organ dose calculation tools may be used for the Korean population with reasonable accuracy.

• Journal of Radiation Protection and Research
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• v.37 no.4
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• pp.231-236
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• 2012

This study derived measures to reduce exposure doses by identifying factors which affect the external radiation dose rate of patients treated with radiopharmaceuticals for PET-CT tests. The external radiation dose rates were measured on three parts of head, thorax and abdomen at a distance of 50cm from the surface of 60 PET-CT patients. It showed there are changes in factors affecting the external radiation dose rate over time after the administration of F-18 FDG. The external radiation dose rate was lower in the patients with more water intake than those with less water intake before the injection of radiopharmaceuticals at all three points: right after the injection of radiopharmaceuticals (average 4.17 mins), after the pre-PEET-CT urination step (average 77.47 mins), and right after the PET-CT test (average 114.15 mins). The study also found there is a need to increase the amount of water intake before the injection of radiopharmaceuticals in order to maintain a low external radiation dose rate in patients. This strategy is only possible under the assumption that the quality of the video has not changed after conducting this study on the relations between the image and quality. This study also found a need to use radiopharmaceuticals with the minimum amount needed for each patient because F-FDG doses affects the external radiation dose rate at the point right after the injection of radiopharmaceuticals. Urination frequency was the most significant factor to affect the external radiation dose rates at the point right after the PET-CT test and the point after the pre-PET-CT urination step. There is a need to realize the strategy to increase the urination frequency of patients to maintain the external radiation dose rate low (average 77.47 mins) before and after the injection of radiopharmaceuticals. In addition, at this point, there is a need to take advantage of personal strategies because the external radiation dose rate is lower if the fasting time is shorter, the contrast medium is used, and the amount of water intake is increased after the administration of radiopharmaceuticals. Finally this study found the need to be able to generalize these findings through an in-depth research on the factors affecting the external radiation dose rate, which includes radiopharmaceutical dose, urination frequency, the amount of water intake, fasting time and the use of contrast medium.