Skip to main content
Erschienen in: European Radiology 6/2017

07.10.2016 | Breast

Breast dose reduction for chest CT by modifying the scanning parameters based on the pre-scan size-specific dose estimate (SSDE)

verfasst von: Masafumi Kidoh, Daisuke Utsunomiya, Seitaro Oda, Takeshi Nakaura, Yoshinori Funama, Hideaki Yuki, Kenichiro Hirata, Tomohiro Namimoto, Daisuke Sakabe, Masahiro Hatemura, Yasuyuki Yamashita

Erschienen in: European Radiology | Ausgabe 6/2017

Einloggen, um Zugang zu erhalten

Abstract

Objective

To investigate the usefulness of modifying scanning parameters based on the size-specific dose estimate (SSDE) for a breast-dose reduction for chest CT.

Materials and methods

We scanned 26 women with a fixed volume CT dose index (CTDIvol) (15 mGy) and another 26 with a fixed SSDE (15 mGy) protocol (protocol 1 and 2, respectively). In protocol 2, tube current was calculated based on the patient habitus obtained on scout images. We compared the mean breast dose and the inter-patient breast dose variability and performed linear regression analysis of the breast dose and the body mass index (BMI) of the two protocols.

Results

The mean breast dose was about 35 % lower under protocol 2 than protocol 1 (10.9 mGy vs. 16.8 mGy, p < 0.01). The inter-patient breast dose variability was significantly lower under protocol 2 than 1 (1.2 mGy vs. 2.5 mGy, p < 0.01). We observed a moderate negative correlation between the breast dose and the BMI under protocol 1 (r = 0.43, p < 0.01); there was no significant correlation (r = 0.06, p = 0.35) under protocol 2.

Conclusion

The SSDE-based protocol achieved a reduction in breast dose and in inter-patient breast dose variability.

Key Points

CT scan parameters can be modified based on the pre-scan SSDE.
The pre-scan SSDE is useful for a breast dose reduction.
The fixed SSDE protocol reduced individual variations in the breast dose.
Literatur
1.
Zurück zum Zitat Boice JD Jr, Monson RR (1977) Breast cancer in women after repeated fluoroscopic examinations of the chest. J Natl Cancer Inst 59:823–832CrossRefPubMed Boice JD Jr, Monson RR (1977) Breast cancer in women after repeated fluoroscopic examinations of the chest. J Natl Cancer Inst 59:823–832CrossRefPubMed
2.
Zurück zum Zitat Tokunaga M, Land CE, Yamamoto T et al (1987) Incidence of female breast cancer among atomic bomb survivors, Hiroshima and Nagasaki, 1950–1980. Radiat Res 112:243–272CrossRefPubMed Tokunaga M, Land CE, Yamamoto T et al (1987) Incidence of female breast cancer among atomic bomb survivors, Hiroshima and Nagasaki, 1950–1980. Radiat Res 112:243–272CrossRefPubMed
3.
Zurück zum Zitat Shore RE, Hempelmann LH, Kowaluk E et al (1977) Breast neoplasms in women treated with x-rays for acute postpartum mastitis. J Natl Cancer Inst 59:813–822CrossRefPubMed Shore RE, Hempelmann LH, Kowaluk E et al (1977) Breast neoplasms in women treated with x-rays for acute postpartum mastitis. J Natl Cancer Inst 59:813–822CrossRefPubMed
4.
Zurück zum Zitat Donnelly LF, Frush DP (2001) Fallout from recent articles on radiation dose and pediatric CT. Pediatr Radiol 31:388, discussion 389–391CrossRefPubMed Donnelly LF, Frush DP (2001) Fallout from recent articles on radiation dose and pediatric CT. Pediatr Radiol 31:388, discussion 389–391CrossRefPubMed
5.
Zurück zum Zitat Brenner DJ, Elliston CD, Hall EJ, Berdon WE (2001) Estimates of the cancer risks from pediatric CT radiation are not merely theoretical: comment on "point/counterpoint: in x-ray computed tomography, technique factors should be selected appropriate to patient size. against the proposition". Med Phys 28:2387–2388CrossRefPubMed Brenner DJ, Elliston CD, Hall EJ, Berdon WE (2001) Estimates of the cancer risks from pediatric CT radiation are not merely theoretical: comment on "point/counterpoint: in x-ray computed tomography, technique factors should be selected appropriate to patient size. against the proposition". Med Phys 28:2387–2388CrossRefPubMed
6.
Zurück zum Zitat Elojeimy S, Tipnis S, Huda W (2010) Relationship between radiographic techniques (kilovolt and milliampere-second) and CTDI(VOL). Radiat Prot Dosim 141:43–49CrossRef Elojeimy S, Tipnis S, Huda W (2010) Relationship between radiographic techniques (kilovolt and milliampere-second) and CTDI(VOL). Radiat Prot Dosim 141:43–49CrossRef
7.
Zurück zum Zitat Kidoh M, Utsunomiya D, Oda S et al (2015) Validity of the size-specific dose estimate in adults undergoing coronary CT angiography: comparison with the volume CT dose index. Int J Cardiovasc Imaging 31:205–211CrossRef Kidoh M, Utsunomiya D, Oda S et al (2015) Validity of the size-specific dose estimate in adults undergoing coronary CT angiography: comparison with the volume CT dose index. Int J Cardiovasc Imaging 31:205–211CrossRef
8.
Zurück zum Zitat Yamashiro T, Miyara T, Honda O et al (2014) Adaptive Iterative Dose Reduction Using Three Dimensional Processing (AIDR3D) improves chest CT image quality and reduces radiation exposure. PLoS One 9, e105735CrossRefPubMedPubMedCentral Yamashiro T, Miyara T, Honda O et al (2014) Adaptive Iterative Dose Reduction Using Three Dimensional Processing (AIDR3D) improves chest CT image quality and reduces radiation exposure. PLoS One 9, e105735CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Emigh B, Gordon CL, Connolly BL, Falkiner M, Thomas KE (2013) Effective dose estimation for pediatric upper gastrointestinal examinations using an anthropomorphic phantom set and metal oxide semiconductor field-effect transistor (MOSFET) technology. Pediatr Radiol 43:1108–1116CrossRefPubMed Emigh B, Gordon CL, Connolly BL, Falkiner M, Thomas KE (2013) Effective dose estimation for pediatric upper gastrointestinal examinations using an anthropomorphic phantom set and metal oxide semiconductor field-effect transistor (MOSFET) technology. Pediatr Radiol 43:1108–1116CrossRefPubMed
10.
Zurück zum Zitat Mattar EH, Hammad LF, Al-Mohammed HI (2011) Measurement and comparison of skin dose using OneDose MOSFET and Mobile MOSFET for patients with acute lymphoblastic leukemia. Med Sci Monit 17:MT51–55CrossRefPubMedPubMedCentral Mattar EH, Hammad LF, Al-Mohammed HI (2011) Measurement and comparison of skin dose using OneDose MOSFET and Mobile MOSFET for patients with acute lymphoblastic leukemia. Med Sci Monit 17:MT51–55CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Kinhikar RA, Murthy V, Goel V, Tambe CM, Dhote DS, Deshpande DD (2009) Skin dose measurements using MOSFET and TLD for head and neck patients treated with tomotherapy. Appl Radiat Isot 67:1683–1685CrossRefPubMed Kinhikar RA, Murthy V, Goel V, Tambe CM, Dhote DS, Deshpande DD (2009) Skin dose measurements using MOSFET and TLD for head and neck patients treated with tomotherapy. Appl Radiat Isot 67:1683–1685CrossRefPubMed
12.
Zurück zum Zitat Debray MP, Dauriat G, Khalil A et al (2015) Diagnostic accuracy of low-mA chest CT reconstructed with Model Based Iterative Reconstruction in the detection of early pleuro-pulmonary complications following a lung transplantation. Eur Radiol. doi:10.1007/s00330-015-4126-0 PubMed Debray MP, Dauriat G, Khalil A et al (2015) Diagnostic accuracy of low-mA chest CT reconstructed with Model Based Iterative Reconstruction in the detection of early pleuro-pulmonary complications following a lung transplantation. Eur Radiol. doi:10.​1007/​s00330-015-4126-0 PubMed
13.
Zurück zum Zitat Ichikawa Y, Kitagawa K, Nagasawa N, Murashima S, Sakuma H (2013) CT of the chest with model-based, fully iterative reconstruction: comparison with adaptive statistical iterative reconstruction. BMC Med Imaging 13:27CrossRefPubMedPubMedCentral Ichikawa Y, Kitagawa K, Nagasawa N, Murashima S, Sakuma H (2013) CT of the chest with model-based, fully iterative reconstruction: comparison with adaptive statistical iterative reconstruction. BMC Med Imaging 13:27CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Qi LP, Li Y, Tang L et al (2012) Evaluation of dose reduction and image quality in chest CT using adaptive statistical iterative reconstruction with the same group of patients. Br J Radiol 85:e906–911CrossRefPubMedPubMedCentral Qi LP, Li Y, Tang L et al (2012) Evaluation of dose reduction and image quality in chest CT using adaptive statistical iterative reconstruction with the same group of patients. Br J Radiol 85:e906–911CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Chen JH, Jin EH, He W, Zhao LQ (2014) Combining automatic tube current modulation with adaptive statistical iterative reconstruction for low-dose chest CT screening. PLoS One 9, e92414CrossRefPubMedPubMedCentral Chen JH, Jin EH, He W, Zhao LQ (2014) Combining automatic tube current modulation with adaptive statistical iterative reconstruction for low-dose chest CT screening. PLoS One 9, e92414CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Huda W, Vance A (2007) Patient radiation doses from adult and pediatric CT. AJR Am J Roentgenol 188:540–546CrossRefPubMed Huda W, Vance A (2007) Patient radiation doses from adult and pediatric CT. AJR Am J Roentgenol 188:540–546CrossRefPubMed
18.
19.
Zurück zum Zitat Niemann T, Zbinden I, Roser HW, Bremerich J, Remy-Jardin M, Bongartz G (2013) Computed tomography for pulmonary embolism: assessment of a 1-year cohort and estimated cancer risk associated with diagnostic irradiation. Acta Radiol 54:778–784CrossRefPubMed Niemann T, Zbinden I, Roser HW, Bremerich J, Remy-Jardin M, Bongartz G (2013) Computed tomography for pulmonary embolism: assessment of a 1-year cohort and estimated cancer risk associated with diagnostic irradiation. Acta Radiol 54:778–784CrossRefPubMed
20.
Zurück zum Zitat Preston DL, Ron E, Tokuoka S et al (2007) Solid cancer incidence in atomic bomb survivors: 1958–1998. Radiat Res 168:1–64CrossRefPubMed Preston DL, Ron E, Tokuoka S et al (2007) Solid cancer incidence in atomic bomb survivors: 1958–1998. Radiat Res 168:1–64CrossRefPubMed
21.
Zurück zum Zitat Preston DL, Mattsson A, Holmberg E, Shore R, Hildreth NG, Boice JD Jr (2002) Radiation effects on breast cancer risk: a pooled analysis of eight cohorts. Radiat Res 158:220–235CrossRefPubMed Preston DL, Mattsson A, Holmberg E, Shore R, Hildreth NG, Boice JD Jr (2002) Radiation effects on breast cancer risk: a pooled analysis of eight cohorts. Radiat Res 158:220–235CrossRefPubMed
22.
Zurück zum Zitat Boice JD Jr, Land CE, Shore RE, Norman JE, Tokunaga M (1979) Risk of breast cancer following low-dose radiation exposure. Radiology 131:589–597CrossRefPubMed Boice JD Jr, Land CE, Shore RE, Norman JE, Tokunaga M (1979) Risk of breast cancer following low-dose radiation exposure. Radiology 131:589–597CrossRefPubMed
23.
Zurück zum Zitat Hill DA, Preston-Martin S, Ross RK, Bernstein L (2002) Medical radiation, family history of cancer, and benign breast disease in relation to breast cancer risk in young women, USA. Cancer Causes Control 13:711–718CrossRefPubMed Hill DA, Preston-Martin S, Ross RK, Bernstein L (2002) Medical radiation, family history of cancer, and benign breast disease in relation to breast cancer risk in young women, USA. Cancer Causes Control 13:711–718CrossRefPubMed
24.
Zurück zum Zitat Kim YK, Sung YM, Choi JH, Kim EY, Kim HS (2013) Reduced radiation exposure of the female breast during low-dose chest CT using organ-based tube current modulation and a bismuth shield: comparison of image quality and radiation dose. AJR Am J Roentgenol 200:537–544CrossRefPubMed Kim YK, Sung YM, Choi JH, Kim EY, Kim HS (2013) Reduced radiation exposure of the female breast during low-dose chest CT using organ-based tube current modulation and a bismuth shield: comparison of image quality and radiation dose. AJR Am J Roentgenol 200:537–544CrossRefPubMed
25.
Zurück zum Zitat Angel E, Yaghmai N, Jude CM et al (2009) Monte Carlo simulations to assess the effects of tube current modulation on breast dose for multidetector CT. Phys Med Biol 54:497–512CrossRefPubMedPubMedCentral Angel E, Yaghmai N, Jude CM et al (2009) Monte Carlo simulations to assess the effects of tube current modulation on breast dose for multidetector CT. Phys Med Biol 54:497–512CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Euler A, Szucs-Farkas Z, Falkowski AL et al (2015) Organ-based tube current modulation in a clinical context: Dose reduction may be largely overestimated in breast tissue. Eur Radiol. doi:10.1007/s00330-015-4085-5 Euler A, Szucs-Farkas Z, Falkowski AL et al (2015) Organ-based tube current modulation in a clinical context: Dose reduction may be largely overestimated in breast tissue. Eur Radiol. doi:10.​1007/​s00330-015-4085-5
27.
Zurück zum Zitat Seidenfuss A, Mayr A, Schmid M, Uder M, Lell MM (2014) Dose reduction of the female breast in chest CT. AJR Am J Roentgenol 202:W447–452CrossRefPubMed Seidenfuss A, Mayr A, Schmid M, Uder M, Lell MM (2014) Dose reduction of the female breast in chest CT. AJR Am J Roentgenol 202:W447–452CrossRefPubMed
28.
Zurück zum Zitat Greess H, Lutze J, Nomayr A et al (2004) Dose reduction in subsecond multislice spiral CT examination of children by online tube current modulation. Eur Radiol 14:995–999CrossRefPubMed Greess H, Lutze J, Nomayr A et al (2004) Dose reduction in subsecond multislice spiral CT examination of children by online tube current modulation. Eur Radiol 14:995–999CrossRefPubMed
29.
Zurück zum Zitat Kalra MK, Maher MM, Kamath RS et al (2004) Sixteen-detector row CT of abdomen and pelvis: study for optimization of Z-axis modulation technique performed in 153 patients. Radiology 233:241–249CrossRefPubMed Kalra MK, Maher MM, Kamath RS et al (2004) Sixteen-detector row CT of abdomen and pelvis: study for optimization of Z-axis modulation technique performed in 153 patients. Radiology 233:241–249CrossRefPubMed
30.
Zurück zum Zitat Schindera ST, Nelson RC, Toth TL et al (2008) Effect of patient size on radiation dose for abdominal MDCT with automatic tube current modulation: phantom study. AJR Am J Roentgenol 190:W100–105CrossRefPubMed Schindera ST, Nelson RC, Toth TL et al (2008) Effect of patient size on radiation dose for abdominal MDCT with automatic tube current modulation: phantom study. AJR Am J Roentgenol 190:W100–105CrossRefPubMed
31.
Zurück zum Zitat Waszczuk LA, Guzinski M, Czarnecka A, Sasiadek MJ (2015) Size-specific dose estimates for evaluation of individual patient dose in CT protocol for renal colic. AJR Am J Roentgenol 205:100–105CrossRefPubMed Waszczuk LA, Guzinski M, Czarnecka A, Sasiadek MJ (2015) Size-specific dose estimates for evaluation of individual patient dose in CT protocol for renal colic. AJR Am J Roentgenol 205:100–105CrossRefPubMed
32.
Zurück zum Zitat Brady SL, Kaufman RA (2012) Investigation of American association of physicists in medicine report 204 size-specific dose estimates for pediatric CT implementation. Radiology 265:832–840CrossRefPubMed Brady SL, Kaufman RA (2012) Investigation of American association of physicists in medicine report 204 size-specific dose estimates for pediatric CT implementation. Radiology 265:832–840CrossRefPubMed
33.
Zurück zum Zitat Christner JA, Braun NN, Jacobsen MC, Carter RE, Kofler JM, McCollough CH (2012) Size-specific dose estimates for adult patients at CT of the torso. Radiology 265:841–847CrossRefPubMed Christner JA, Braun NN, Jacobsen MC, Carter RE, Kofler JM, McCollough CH (2012) Size-specific dose estimates for adult patients at CT of the torso. Radiology 265:841–847CrossRefPubMed
34.
Zurück zum Zitat McCollough CH, Bruesewitz MR, Kofler JM Jr (2006) CT dose reduction and dose management tools: overview of available options. Radiographics 26:503–512CrossRefPubMed McCollough CH, Bruesewitz MR, Kofler JM Jr (2006) CT dose reduction and dose management tools: overview of available options. Radiographics 26:503–512CrossRefPubMed
35.
Zurück zum Zitat Matsubara K, Sugai M, Toyoda A et al (2012) Assessment of an organ-based tube current modulation in thoracic computed tomography. J Appl Clin Med Phys 13:3731PubMed Matsubara K, Sugai M, Toyoda A et al (2012) Assessment of an organ-based tube current modulation in thoracic computed tomography. J Appl Clin Med Phys 13:3731PubMed
36.
Zurück zum Zitat Vollmar SV, Kalender WA (2008) Reduction of dose to the female breast in thoracic CT: a comparison of standard-protocol, bismuth-shielded, partial and tube-current-modulated CT examinations. Eur Radiol 18:1674–1682CrossRefPubMed Vollmar SV, Kalender WA (2008) Reduction of dose to the female breast in thoracic CT: a comparison of standard-protocol, bismuth-shielded, partial and tube-current-modulated CT examinations. Eur Radiol 18:1674–1682CrossRefPubMed
37.
Zurück zum Zitat Hopper KD (2002) Orbital, thyroid, and breast superficial radiation shielding for patients undergoing diagnostic CT. Semin Ultrasound CT MR 23:423–427CrossRefPubMed Hopper KD (2002) Orbital, thyroid, and breast superficial radiation shielding for patients undergoing diagnostic CT. Semin Ultrasound CT MR 23:423–427CrossRefPubMed
38.
Zurück zum Zitat Kalra MK, Dang P, Singh S, Saini S, Shepard JA (2009) In-plane shielding for CT: effect of off-centering, automatic exposure control and shield-to-surface distance. Korean J Radiol 10:156–163CrossRefPubMedPubMedCentral Kalra MK, Dang P, Singh S, Saini S, Shepard JA (2009) In-plane shielding for CT: effect of off-centering, automatic exposure control and shield-to-surface distance. Korean J Radiol 10:156–163CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Geleijns J, Wang J, McCollough C (2010) The use of breast shielding for dose reduction in pediatric CT: arguments against the proposition. Pediatr Radiol 40:1744–1747CrossRefPubMed Geleijns J, Wang J, McCollough C (2010) The use of breast shielding for dose reduction in pediatric CT: arguments against the proposition. Pediatr Radiol 40:1744–1747CrossRefPubMed
40.
Zurück zum Zitat Franck C, Vandevoorde C, Goethals I et al (2016) The role of Size-Specific Dose Estimate (SSDE) in patient-specific organ dose and cancer risk estimation in paediatric chest and abdominopelvic CT examinations. Eur Radiol 26:2646–2655CrossRefPubMed Franck C, Vandevoorde C, Goethals I et al (2016) The role of Size-Specific Dose Estimate (SSDE) in patient-specific organ dose and cancer risk estimation in paediatric chest and abdominopelvic CT examinations. Eur Radiol 26:2646–2655CrossRefPubMed
41.
Zurück zum Zitat Gabusi M, Riccardi L, Aliberti C, Vio S, Paiusco M (2016) Radiation dose in chest CT: Assessment of size-specific dose estimates based on water-equivalent correction. Phys Med 32:393–397CrossRefPubMed Gabusi M, Riccardi L, Aliberti C, Vio S, Paiusco M (2016) Radiation dose in chest CT: Assessment of size-specific dose estimates based on water-equivalent correction. Phys Med 32:393–397CrossRefPubMed
42.
Zurück zum Zitat Yoshizumi TT, Goodman PC, Frush DP et al (2007) Validation of metal oxide semiconductor field effect transistor technology for organ dose assessment during CT: comparison with thermoluminescent dosimetry. AJR Am J Roentgenol 188:1332–1336CrossRefPubMed Yoshizumi TT, Goodman PC, Frush DP et al (2007) Validation of metal oxide semiconductor field effect transistor technology for organ dose assessment during CT: comparison with thermoluminescent dosimetry. AJR Am J Roentgenol 188:1332–1336CrossRefPubMed
43.
Zurück zum Zitat Kinhikar RA, Sharma PK, Tambe CM et al (2006) Clinical application of a OneDose MOSFET for skin dose measurements during internal mammary chain irradiation with high dose rate brachytherapy in carcinoma of the breast. Phys Med Biol 51:N263–268CrossRefPubMed Kinhikar RA, Sharma PK, Tambe CM et al (2006) Clinical application of a OneDose MOSFET for skin dose measurements during internal mammary chain irradiation with high dose rate brachytherapy in carcinoma of the breast. Phys Med Biol 51:N263–268CrossRefPubMed
44.
Zurück zum Zitat Koivisto J, Schulze D, Wolff J, Rottke D (2014) Effective dose assessment in the maxillofacial region using thermoluminescent (TLD) and metal oxide semiconductor field-effect transistor (MOSFET) dosemeters: a comparative study. Dent Radiogr Photogr 43:20140202 Koivisto J, Schulze D, Wolff J, Rottke D (2014) Effective dose assessment in the maxillofacial region using thermoluminescent (TLD) and metal oxide semiconductor field-effect transistor (MOSFET) dosemeters: a comparative study. Dent Radiogr Photogr 43:20140202
45.
Zurück zum Zitat Foerth M, Seidenbusch MC, Sadeghi-Azandaryani M, Lechel U, Treitl KM, Treitl M (2015) Typical exposure parameters, organ doses and effective doses for endovascular aortic aneurysm repair: comparison of Monte Carlo simulations and direct measurements with an anthropomorphic phantom. Eur Radiol 25:2617–2626CrossRefPubMed Foerth M, Seidenbusch MC, Sadeghi-Azandaryani M, Lechel U, Treitl KM, Treitl M (2015) Typical exposure parameters, organ doses and effective doses for endovascular aortic aneurysm repair: comparison of Monte Carlo simulations and direct measurements with an anthropomorphic phantom. Eur Radiol 25:2617–2626CrossRefPubMed
Metadaten
Titel
Breast dose reduction for chest CT by modifying the scanning parameters based on the pre-scan size-specific dose estimate (SSDE)
verfasst von
Masafumi Kidoh
Daisuke Utsunomiya
Seitaro Oda
Takeshi Nakaura
Yoshinori Funama
Hideaki Yuki
Kenichiro Hirata
Tomohiro Namimoto
Daisuke Sakabe
Masahiro Hatemura
Yasuyuki Yamashita
Publikationsdatum
07.10.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 6/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4618-6

Weitere Artikel der Ausgabe 6/2017

European Radiology 6/2017 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.