Computed tomography dose index and dose length product for cone-beam CT: Monte Carlo simulations

Dosimetry in kilovoltage cone beam computed tomography (CBCT) is a challenge due to the limitation of physical measurements. To address this, we used a Monte Carlo (MC) method to estimate the CT dose index (CTDI) and the dose length product (DLP) for a commercial CBCT system. As Dixon and Boone showed that CTDI concept can be applicable to both CBCT and conventional CT, we evaluated weighted CT dose index (CTDI(w)) and DLP for a commercial CBCT system. Two extended CT phantoms were created in our BEAMnrc/EGSnrc MC system. Before the simulations, the beam collimation of a Varian On-Board Imager (OBI) system was measured with radiochromic films (model: XR-QA). The MC model of the OBI X-ray tube, validated in a previous study, was used to acquire the phase space files of the full-fan and half-fan cone beams. Then, DOSXYZnrc user code simulated a total of 20 CBCT scans for the nominal beam widths from 1 cm to 10 cm. After the simulations, CBCT dose profiles at center and peripheral locations were extracted and integrated (dose profile integral, DPI) to calculate the CTDI per each beam width. The weighted cone-beam CTDI (CTDI(w,l)) was calculated from DPI values and mean CTDI(w,l) (CTDI(w,l)) and DLP were derived. We also evaluated the differences of CTDI(w) values between MC simulations and point dose measurements using standard CT phantoms. In results, it was found that CTDI(w,600) was 8.74 ± 0.01 cGy for head and CTDI(w,900) was 4.26 ± 0.01 cGy for body scan. The DLP was found to be proportional to the beam collimation. We also found that the point dose measurements with standard CT phantoms can estimate the CTDI within 3% difference compared to the full integrated CTDI from the MC method. This study showed the usability of CTDI as a dose index and DLP as a total dose descriptor in CBCT scans.