Dose, dose, dose, but where is the patient dose?

Area of Science:

• Medical Imaging
• Radiological Physics
• Computational Dosimetry

Background:

• Current radiation dose metrics in medical imaging are reviewed, highlighting their strengths and weaknesses.
• Traditional metrics rely on population-average phantoms, which may not accurately reflect individual patient risks.
• There is a growing need for more personalized and accurate methods for radiation dose assessment.

Purpose of the Study:

• To analyze the historical evolution of radiation dose metrics in medical imaging.
• To propose a shift from generalized (ICRP Reference Man) to patient-specific computational phantoms for dose assessment.
• To discuss the feasibility and benefits of utilizing advanced technologies for personalized dosimetry.

Main Methods:

• Review of historical developments in radiation dose metrology.
• Analysis of current radiation dose metrics, identifying limitations and advantages.
• Discussion of technological advancements, including AI-based organ segmentation and Monte Carlo simulations.
• Exploration of patient-specific computational phantom approaches.

Main Results:

• Current dose metrics have both beneficial and detrimental aspects.
• Patient-specific computational phantoms offer a more accurate representation of individual radiation exposure.
• AI and near real-time Monte Carlo calculations make personalized organ dose estimation feasible.
• Existing metrics may need to be complemented or replaced by patient-specific risk-representing quantities.

Conclusions:

• The adoption of patient-specific computational phantoms for radiation dose assessment is timely and advantageous.
• International organizations like ICRP should consider embracing patient-specific dose quantities for risk evaluation.
• Emphasis should also be placed on improving the understandability of radiation units for the medical community.