Real-time estimation of patient-specific dose distributions for medical CT using the deep dose estimation

With the rising number of computed tomography (CT) examinations and the trend toward personalized medicine, patient-specific dose estimates are becoming more and more important in CT imaging. However, current approaches are often too slow or too inaccurate to be applied routinely. Therefore, we propose the so-called deep dose estimation (DDE) to provide highly accurate patient dose distributions in real time METHODS: To combine accuracy and computational performance, the DDE algorithm uses a deep convolutional neural network to predict patient dose distributions. To do so, a U-net like architecture is trained to reproduce Monte Carlo simulations from a two-channel input consisting of a CT reconstruction and a first-order dose estimate. Here, the corresponding training data were generated using CT simulations based on 45 whole-body patient scans. For each patient, simulations were performed for different anatomies (pelvis, abdomen, thorax, head), different tube voltages (80 kV, 100 kV, 120 kV), different scan trajectories (circle, spiral), and with and without bowtie filtration and tube current modulation. Similar simulations were performed using a second set of eight whole-body CT scans from the Visual Concept Extraction Challenge in Radiology (Visceral) project to generate testing data. Finally, the DDE algorithm was evaluated with respect to the generalization to different scan parameters and the accuracy of organ dose and effective dose estimates based on an external organ segmentation.

DDE dose distributions were quantified in terms of the mean absolute percentage error (MAPE) and a gamma analysis with respect to the ground truth Monte Carlo simulation. Both measures indicate that DDE generalizes well to different scan parameters and different anatomical regions with a maximum MAPE of 6.3% and a minimum gamma passing rate of 91%. Evaluating the organ dose values for all organs listed in the International Commission on Radiological Protection (ICRP) recommendation, shows an average error of 3.1% and maximum error of 7.2% (bone surface).

The DDE algorithm provides an efficient approach to determine highly accurate dose distributions. Being able to process a whole-body CT scan in about 1.5 s, it provides a valuable alternative to Monte Carlo simulations on a graphics processing unit (GPU). Here, the main advantage of DDE is that it can be used on top of any existing Monte Carlo code such that real-time performance can be achieved without major adjustments. Thus, DDE opens up new options not only for dosimetry but also for scan and protocol optimization.