Radiation Dose of Abdominal and Lung Computed Tomography Based on Body Mass Index as an Indicator
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Abstract
Background: Radiation dose generated from computed tomography (CT) has drawn more attention to diagnostic radiology. It is a known fact that the risk of radiation-induced cancer is increasing, thereby necessitating the optimisation of dose in CT protocols. This study focused on determining the radiation dose of CT scans for the abdomen and lung using a 64-slice CT scanner to evaluate their correlation with body mass index (BMI). The objective of the study was to critically evaluate the relationship between BMI and radiation dose metrics in both CT lung and CT abdomen examinations.
Methods: Data from 106 patients who underwent CT lung and CT abdomen examinations at an advanced diagnostic center were retrospectively analysed. The volume CT dose index (CTDIvol), dose-length product (DLP), the scan range, and cranium diameter [antero-posterior (AP) and lateral (LAT)] of the patients were documented for further analysis. Effective dose (E) and size-specific dose estimate (SSDE) were also computed.
Results: The mean BMI for CT lung was recorded as 24.85 (5.65). However, the correlation between BMI and the dose metrics (SSDE, E, DLP, and CTDIvol) was not significant, with correlation coefficients of 0.1278, 0.047, 0.047, and 0.1147, respectively. In contrast, the BMI for CT abdomen scans showed a moderate correlation with E (0.5898), SSDE (0.6288), DLP (0.5898), and CTDIvol (0.612). The results demonstrate that BMI can be used as a radiation dose metric in the case of CT abdomen scans, but has no influence on CT lung scans.
Conclusion: These results further suggest that BMI could provide radiation dose analysis, which in turn leads to optimisation of CT scan parameters.
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References
Schulz RA, Stein JA, Pelc NJ. How CT happened: the early development of medical computed tomography. J Med Imaging. 2021;8(5):052110. https://doi.org/10.1117/1.JMI.8.5.052110
Deevband MR, Hosseini Nasab SMB, Mohammadi H, Salimi Y, Mostaar A, Deravi N, et al. Body-mass index-based effective dose determination in commonly performed computed tomography examinations in adults. Frontiers Biomed Technol. 2022;9(4):316–322. https://doi.org/10.18502/fbt.v9i4.10425
Karim MKA, Hashim S, Sabarudin A, Bradley DA, Bahruddin NA. Evaluating organ dose and radiation risk of routine CT examinations in Johor Malaysia. Sains Malays. 2016;45(4):567–573.
El Mansouri M, Choukri A, Semghouli S, Talbi M, Eddaoui K, Saga Z. Size-specific dose estimates for thoracic and abdominal computed tomography examinations at two Moroccan hospitals. J Digit Imaging. 2022;35(6):1648–1653. https://doi.org/10.1007/s10278-022-00657-0
International Commission on Radiological Protection (ICRP). The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP. 2007;37(2–4):9–34. Ontario, Canada: ICRP. https://doi.org/10.1016/j.icrp.2007.11.001
AlShurbaji M, El Haout S, Chanchal A, Dhou S, Dalah E. Investigating the effect of patient-related factors on computed tomography radiation dose using regression and correlation analysis. Appl Sci. 2024;14(3):1071. https://doi.org/10.3390/app14031071
Saltybaeva N, Jafari ME, Hupfer M, Kalender WA. Estimates of effective dose for CT scans of the lower extremities. Radiology. 2014;273(1):153–159. https://doi.org/10.1148/radiol.14132903
Binta YI, Suryani S, Abdullah B. The comparison of size-specific dose estimate (SSDE) in chest CT examination calculated based on volumetric CT dose index (CTDIvol) reference phantom and dose length product (DLP). J Phys: Conf Ser. 2021;1763(1):012065. https://doi.org/10.1088/1742-6596/1763/1/012065
Mettler FA, Huda W, Yoshizumi TT, Mahesh M. Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology. 2008;248(1):254–263. https://doi.org/10.1148/radiol.2481071451
Tsalafoutas IA, Koukourakis GV. Patient dose considerations in computed tomography examinations. World J Radiol. 2010;2(7):262–268. https://doi.org/10.4329/wjr.v2.i7.262
Garba I, Zarb F, McEntee MF, Fabri SG. Computed tomography diagnostic reference levels for adult brain, chest and abdominal examinations: a systematic review. Radiography. 2021;27(2):673–681. https://doi.org/10.1016/j.radi.2020.08.011
Atlı E, Uyanık SA, Öğüşlü U, Çevik Cenkeri H, Yılmaz B, Gümüş B. Radiation doses from head, neck, chest and abdominal CT examinations: an institutional dose report. Diagn Interv Radiol. 2021;27(1):147–151. https://doi.org/10.5152/dir.2020.19560
Brat H, Zanca F, Montandon S, Racine D, Rizk B, Meicher E, et al. Local clinical diagnostic reference levels for chest and abdomen CT examinations in adults as a function of body mass index and clinical indication: a prospective multicenter study. Eur
Radiol. 2019;29(12):6794–6804. https://doi.org/10.1007/s00330-019-06257-x
Ebrahiminia A, Asadinezhad M, Mohammadi F, Khoshgard K. Eye lens dose optimization through gantry tilting in brain CT scan: the potential effect of the radiological technologists’ training. Radiat Prot Dosim. 2020;189(4):527–533. https://doi.org/10.1093/rpd/ncaa073
O’Neill S, Kavanagh RG, Carey BW, Moore N, Maher M, O’Connor OJ. Using body mass index to estimate individualised patient radiation dose in abdominal computed tomography. Eur Radiol Exp. 2018;2(1):38. https://doi.org/10.1186/s41747-018-0070-5
Sebelego I, Acho S, van der Merwe B, Rae WID. Size based dependence of patient dose metrics, and image quality metrics for clinical indicator-based imaging protocols in abdominal CT procedures. Radiography. 2023;29(6):961–974. https://doi.org/10.1016/j.radi.2023.07.011
Heston TF, Jiang JY. Concordance of chest x-ray with chest CT by body mass index.
PeerJ. 2023;11:e15090. https://doi.org/10.7717/peerj.15090
Lee S, Kim KW, Kwon HJ, Lee J, Koo K, Song GW, et al. Relationship of body mass index and abdominal fat with radiation dose received during preoperative liver CT in potential living liver donors: a cross-sectional study. Quant Imaging Med Surg. 2022;12(4):2206–2212. https://doi.org/10.21037/qims-21-977
Dolenc L, Petrinjak B, Mekiš N, Škrk D. The impact of body mass index on patient radiation dose in general radiography. J Radiol Prot. 2022;42(4):041505. https://doi.org/10.1088/1361-6498/ac9f1f
Sebelego I-K, Acho S, van der Merwe B, Rae WID. Factors influencing size-specific dose estimates of selected computed tomography protocols at two clinical practices in South Africa. Radiat Prot Dosim. 2023;199(7):588–602. https://doi.org/10.1093/rpd/ncad059
Almohammed HI, Elshami W, Hamd ZY, Abuzaid M. Optimizing CT abdomen-pelvis scan radiation dose: examining the role of body metrics (waist circumference, hip circumference, abdominal fat, and body mass index) in dose efficiency. Tomography. 2024;10(5):643–653. https://doi.org/10.3390/tomography10050049
Brix G, Nagel HD, Stamm G, Veit R, Lechel U, Griebel J, et al. Radiation exposure in multi-slice versus single-slice spiral CT: results of a nationwide survey. Eur Radiol. 2003;13(8):1979–1991. https://doi.org/10.1007/s00330-003-1883-y
Zarb F, Foley S, Holm S, Toomey R, Evanoff MG, Rainford L. An investigation into CT radiation dose variations for head examinations on matched equipment. Radiat Prot Dosim. 2016;172(4):466–474. https://doi.org/10.1093/rpd/ncv549
Lin C, Shen X, Gu Y, Qiao Z, Peng W. A cross-sectional study on the correlation of image quality, effective dose, and body composition with thyroid, chest, and abdominal computed tomography scans. Quant Imaging Med Surg. 2024;14(6):4031–4040. https://doi.org/10.21037/qims-23-1731
Kalra MK, Maher MM, Toth TL, Schmidt B, Westerman BL, Morgan HT, et al. Techniques and applications of automatic tube current modulation for CT. Radiology. 2004;233(3):649–657. https://doi.org/10.1148/radiol.2333031150
Alias NA, Mustafa WA, Jamlos MA, Ismail S, Alquran H, Rohani MNKH. Pap smear image analysis based on nucleus segmentation and deep learning – a recent review. J Adv Res Appl Sci Eng Technol. 2023;29(3):37–47. https://doi.org/10.37934/araset.29.3.3747
Rajaraman V, Ponnusamy M, Halanaik D. Size specific dose estimate (SSDE) for estimating patient dose from CT used in myocardial perfusion SPECT/CT. Asia Ocean J Nucl Med Biol. 2020;8(1):58–63. https://doi.org/10.22038/aojnmb.2019.40863.1276