Converting dose-length product to effective dose at CT

To determine effective dose (ED) per unit dose-length product (DLP) conversion factors for computed tomographic (CT) dosimetry.

A CT dosimetry spreadsheet was used to compute patient ED values and corresponding DLP values. The ratio of ED to DLP was determined with 16-section CT scanners from four vendors, as well as with five models from one manufacturer that spanned more than 25 years. ED-to-DLP ratios were determined for 2-cm scan lengths along the patient axis, as well as for typical scan lengths encountered at head and body CT examinations. The dependence of the ratio of ED to DLP on x-ray tube voltage (in kilovolts) was investigated, and the values obtained with the spreadsheet were compared with those obtained by using two other commercially available CT dosimetry software packages.

For 2-cm scan lengths, changes in the scan region resulted in differences to ED of a factor of 30, but much lower variation was obtained for typical scan lengths at clinical head and body imaging. Inter- and intramanufacturer differences for ED/DLP were generally small. Representative values of ED/DLP at 120 kV were 2.2 microSv/mGy x cm (head scans), 5.4 microSv/mGy x cm (cervical spine scans), and 18 microSv/mGy x cm (body scans). For head scans, ED/DLP was approximately independent of x-ray tube voltage, but for body scans, the increase from 80 to 140 kV increased the ratio of ED to DLP by approximately 25%. Agreement in ED/DLP data for all three software packages was generally very good, except for cervical spine examinations where one software package determined an ED/DLP ratio that was approximately double that of the other two.

This article describes a method of providing CT users with a practical and reliable estimate of adult patient EDs by using the DLP displayed on the CT console at the end of any given examination.