Overview

What is the “Dose” ?

Dose profile
CTDI (CTDIFDA, CTDI100, CTDIw, CTDIw*)
DLP
The relationship between “Dose” and “Image quality”
What is the “Image quality” ?
“Low contrast Detectability” and “Dose”
Dose reduction techniques
Sure Exposure
Denoising filters
Iterative recon AIDR

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Dose profile

Focus of X-ray tube

Slit

Center of Gantry
Z-axis

Dose profile : D(z)

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CTDI
(Computed Tomography Dose Index)

Ideal definition

(Unit: mGy)

D(z) : Dose profile along a line z perpendicularar to tomographic plane

n : The number of tomographic sections produced in a single rotation
T : The nominal tomographic section thickness [cm]

But actually, there is two CTDI measurement methods.

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Definition of CTDIFDA and CTDI100

CTDIFDA (21 CFR Ch.I :1020.33.)

CTDI100 (IEC60601-2-44)

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Dosimetric phantom
Acrylic cylinder
16cm diameter phantom as Head mode
32cm diameter phantom as Body mode
Measurement position:
Center
Peripheral (4 positions of 1 cm depth from the surface)

10mm

１６０ｍｍ

３２０ｍｍ

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CTDIw (weighted CTDI100)

B1

In order to caliculate CTDIw,

B4 B2 the CTDI100(preripheral) is selected
A max value.
B3

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 Corrected CTDIw value (CTDIw*)

For conventional scan

CTDIw* = CTDIw

For helical scan

CTDIw* = CTDIw  ND  T / M

ND : The number of rows of detector elements

T : Nominal slice thickness
M : The couch movement distance per rotation

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For example

If CTDIw(Conventional) = “A” mGy

In case of SSCT (ND=1)
M=T (HP1.0) 　 then CTDIw* = “A” mGy.
M=2T (HP2.0) then CTDIw* = “A x 0.5” mGy.

In case of MSCT (ND=4)

M=3T (HP3.0) 　 then CTDIw* = A x 4 x T / 3T
= “ A x 1.33”
M=6T (HP6.0) 　 then CTDIw* = A x 4 x T / 6T
= “ A x 0.67”
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 Computed Tomography Dose Index
CTDI overview
7. n CTDIw Weighted tube output in mGy for 1 mAs
1/3*nCTDI100,c + 2/3*nCTDI100,p

8. CTDIw Weighted dose in mGy for used mAs

1/3*CTDI100,c + 2/3*CTDI100,p

9. CTDIw, eff Weighted dose in mGy for used mAs divided by pitch
CTDIw / Pitch

10. CTDIvol CTDIw, eff

11. CTDIvol,head CTDIvol measured using a phantom with 16 cm

diameter

12. CTDIvol,body CTDI measured using a phantom with 32 cm

vol
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What is the DLP ?

CTDIw* is an index of the exposure dose per

rotation at a thickness of 10 mm.
But, CTDIw* does not mean “total exposure dose
under the set scan conditions”. Is there any index?

DLP (Dose Length Product)

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The relationship between DLP and CTDIw*
(Helical)

Definition

DLP = CTDIw* x L
L : Helical scan range

For example
if L=300mm (30cm) , then DLP = CTDIw* x
30

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CT Dose should be evaluated by the ratio of
Image Quality and Dose.
Many people misunderstood it.

Dose
Image Quality

Sometimes, people just compares

the dose @ same X-ray protocol (mAs).
It is incorrect !!

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When we want to compare the dose and
the image quality between the different
manufacturer’s CT scanner,
Dose
Image Quality

CTDI is very objective. But it is something

difficult to evaluate the image quality !!

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What is the Image Quality ?
Image Noise
Signal-to-Noise Ratio (SNR)
Contrast-to-Noise Ration (CNR)
Low-Contrast Detectability

If we compare the different CT scanners using

different reconstruction methods, we can NOT
use the image noise to evaluate the image quality.

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 What is the Image Quality ?
Image Quality
Image Quality Image Quality

Image quality is a subjective concept

We can measure image quality in numeric values

Image Quality Image Quality


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What is the Image Quality ?

High contrast
Capability to visualize the smallest detail with 100HU
contrast difference
Lp/cm
Influences
L/R alignment
Vibration
FC
Focus size

Visual
High Contrast
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What is the Image Quality ?

Low contrast
Capability to visualize the smallest contast differences

“mm” x “%” 0.3%

1000HU contrast
Influences:
0.1%
F/B alignment 0.5%
(mA, kV, slice thickness)
vibration
FC 1.0%
calibration

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AIDR 3D (Adaptive Iterative Dose Reduction 3D)
Iterative Noise Reduction
Reduces image noise by up to 50%
Reduces dose by up to 75%

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 AIDR 3D Algorithm
Acquired
Projection Data

Scanner
AIDR 3D Image
Model
Anatomical Model Update
Based Optimization Object
Projection
Noise +
Reduction

Statistical
Model Blending %

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 AIDR 3D Algorithm
Acquired
Projection Data

Scanner
AIDR 3D Image
Model
Anatomical Model Update
Based Optimization Object
Projection
Noise +
Reduction

Statistical
Model Blending %

The scanner model analyzes the physical properties

of the CT system at the time of the acquisition.

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 AIDR 3D Algorithm
Acquired
Projection Data

Scanner
AIDR 3D Image
Model
Anatomical Model Update
Based Optimization Object
Projection
Noise +
Reduction

Statistical
Model Blending %

The statistical modeling characterizes both electronic

and quantum noise patterns in projection space.

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 AIDR 3D Algorithm
Acquired
Projection Data

Scanner
AIDR 3D Image
Model
Anatomical Model Update
Based Optimization Object
Projection
Noise +
Reduction

Statistical
Model Blending %

Adaptive processing in the raw domain based on the measured

scanner and statistical modeling that reduces noise and artifacts.

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 AIDR 3D Algorithm
Acquired
Projection Data

Scanner
AIDR 3D Image
Model
Anatomical Model Update
Based Optimization Object
Projection
Noise +
Reduction

Statistical
Model Blending %

A sophisticated iterative technique that optimizes reconstructions

for the particular body region being scanned, dramatically reducing
noise while preserving spatial resolution and image texture.

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 AIDR 3D Algorithm
Acquired
Projection Data

Scanner
AIDR 3D Image
Model
Anatomical Model Update
Based Optimization Object
Projection
Noise +
Reduction

Statistical
Model Blending %

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SURE
Exposure 3D

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SURE
Exposure 3D
Automatically adjusts mA based on
patient attenuation in X-Y-Z planes

Exam Plans automatically produce

consistent image quality
regardless of patient size or shape
Adaptive parameters
Automated and integrated in
protocols

Automatically optimizes tube

current to maximize image quality
and minimize radiation exposure
up to 40%

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SURE
Exposure 3D
Automatically adjusts mA based on
patient attenuation in X-Y-Z planes

Exam Plans automatically produce

consistent image quality
regardless of patient size or shape
Adaptive parameters
Automated and integrated in
protocols

Automatically optimizes tube

current to maximize image quality
and minimize radiation exposure
up to 40%

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Integrated, Robust Dose Management
AIDR 3D is seamlessly integrated with SUREExposure 3D

AIDR 3D OFF AIDR 3D ON

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AIDR 3D: Integrated with SURE
Exposure 3D

AIDR 3D OFF AIDR 3D ON

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AIDR 3D: Integrated with SURE
Exposure 3D

AIDR 3D OFF AIDR 3D ON

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Calculating Effective Dose

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Calculating Effective Dose
A common set of k factors is available from the following
paper:

AAPM REPORT NO. 96

The Measurement, Reporting, and Management of Radiation Dose in CT
Report of AAPM Task Group 23: CT Dosimetry
Diagnostic Imaging Council CT Committee

January 2008

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k-factors

Body Region 0 year old 1 year old 5 year old 10 year old Adult
Head & Neck 0.013 0.0085 0.0057 0.0042 0.0031
Head 0.011 0.0067 0.0040 0.0032 0.0021
Neck 0.017 0.012 0.011 0.0079 0.0059
Chest 0.039 0.026 0.018 0.013 0.014
Abdomen/pelvis 0.049 0.030 0.020 0.015 0.015
Trunk 0.044 0.028 0.019 0.014 0.015
Extremities 0.0008*

AAPM report No 96, 2008

*http://msct.eu/PDF_FILES/Appendix%20MSCT%20Dosimetry.pdf

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Calculating Effective Dose
Please use these k factors when reporting dose in all Toshiba
presentations.

Dose in presentations should be reported as follows:

Dose = XX mSv (k=0.014)

If a k factor is not available for the body region the DLP should be
reported.

DLP = XX mGy.cm

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