Patient-Informed Organ Dose Estimation in Clinical CT: Implementation and Effective Dose Assessment in 1048 Clinical...

Area of Science:

• Medical Physics
• Radiological Sciences
• Diagnostic Imaging

Background:

• Accurate patient organ dose monitoring is crucial in computed tomography (CT).
• Current methods using dose-length product (DLP) may not precisely reflect individual organ doses.
• Developing patient-specific dose estimation is essential for radiation safety.

Purpose of the Study:

• To implement and validate a patient-informed organ dose monitoring framework for clinical CT.
• To compare effective dose (ED) derived from patient-informed organ doses with ED calculated from DLP.
• To assess the accuracy and applicability of the framework across various patient demographics and scan types.

Main Methods:

• Organ doses computed using anthropomorphic phantoms, CTDIvol, and tube-current modulation.
• Expanded phantom library (58 adult, 56 pediatric, 5 pregnant, 12 ICRP models).
• Implemented in a clinical system for 1048 patients (647 abdomen-pelvis, 401 chest), comparing organ dose-based ED with DLP-based ED.

Main Results:

• Bias correction reduced organ dose estimation errors to 8% on average.
• DLP-based ED significantly differed from organ dose-based ED (up to 234.7% difference).
• DLP-based ED overestimated dose in larger patients and underestimated in smaller patients.

Conclusions:

• A comprehensive patient-informed organ dose estimation framework is now clinically applicable.
• Patient-informed organ dose monitoring offers a more accurate assessment of effective dose than DLP.
• This framework improves radiation dose assessment for adult, pediatric, and pregnant patients.