Estimation of Peak Skin Dose and Its Relation to the Size Specific Dose Estimate
The CT Dose Index (CTDIvol) was originally designed as an index of dose associated with various CT diagnostic procedures not as a direct dosimetry method for individual patient dose assessments. There is no current method for calculating peak skin dose (PSD) using the key metrics provided from the radiation dose structure report of a CT scanner. Every CT study is required to output the kVp and mAs that were used, the dose length product and CT dose index volume which will all be shown on the CT console, but there is no direct method to go straight to the PSD. This project will test the hypothesis that the Size Specific Dose Estimates (SSDE) has a sufficiently strong linear relationship with PSD to allow direct calculation of the PSD directly from the SSDE.
III. Review of Related Literature:
The highest radiation dose accruing at a single site on a patient’s skin is referred to as the peak skin dose (PSD) which is related to the Computed Tomography dose index (CTDIvol) that is displayed on the console of CT scanners. However, the CT Dose Index was originally designed as an index not as a direct dosimetry method for patient dose assessment. More recently, modifications to original CTDI concept have attempted to convert it into to patient dosimetry method, but have with mixed results in terms of accuracy. Nonetheless, CTDI-based dosimetry is the current worldwide standard for estimation of patient dose in CT. Therefore, CTDIvol is often used to enable medical physicists to compare the dose output between different CT scanners.
Fearon, Thomas (2011) explained that current estimation of radiation dose from CT scans on patients has relied on the measurement of Computed Tomography Dose Index (CTDI) in standard cylindrical phantoms, and calculations based on mathematical representations of “standard man.” The purpose of this study was to investigate the feasibility of adapting a radiation treatment planning system (RTPS) to provide patient-specific CT dosimetry. A radiation treatment planning system was modified to calculate patient-specific CT dose distributions, which can be represented by dose at specific points within an organ of interest, as well as organ dose-volume (after image segmentation) for a GE Light Speed Ultra Plus CT scanner. Digital representations of the phantoms (virtual phantom) were acquired with the GE CT scanner in axial mode. Thermoluminescent dosimeter (TLDs) measurements in pediatric anthropomorphic phantoms were utilized to validate the dose at specific points within organs of interest relative to RTPS calculations and Monte Carlo simulations of the same virtual phantoms. Congruence of the calculated and measured point doses for the same physical anthropomorphic phantom geometry was used to verify the feasibility of the method. The advantage of the RTPS is the significant reduction in computation time, yielding dose estimates within 10%–20% of measured values.