Validation of a method for estimating peak skin dose from CT-guided procedures

A. Kyle Jones; Meghan E. Kisiel; X. John Rong; Alda L. Tam

doi:10.1002/acm2.13261

Validation of a method for estimating peak skin dose from CT-guided procedures

A. Kyle Jones, Meghan E. Kisiel, X. John Rong, Alda L. Tam

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

A method for estimating peak skin dose (PSD) from CTDI_vol has been published but not validated. The objective of this study was to validate this method during CT-guided ablation procedures. Radiochromic film was calibrated and used to measure PSD. Sixty-eight patients were enrolled in this study, and measured PSD were collected for 46 procedures. CTDI_vol stratified by axial and helical scanning was used to calculate an estimate of PSD using the method [1.2 × CTDI_vol(helical) + 0.6 × CTDI_vol(axial)], and both calculated PSD and total CTDI_vol were compared to measured PSD using paired t-tests on the log-transformed data and Bland-Altman analysis. Calculated PSD were significantly different from measured PSD (P < 0.0001, bias, 18.3%, 95% limits of agreement, −63.0% to 26.4%). Measured PSD were not significantly different from total CTDI_vol (P = 0.27, bias, 3.97%, 95% limits of agreement, −51.6% to 43.7%). Considering that CTDI_vol is reported on the console of all CT scanners, is not stratified by axial and helical scanning modes, and is immediately available to the operator during CT-guided interventional procedures, it may be reasonable to use the scanner-reported CTDI_vol as an indicator of PSD during CT-guided procedures. However, further validation is required for other models of CT scanner.

Original language	English (US)
Pages (from-to)	224-228
Number of pages	5
Journal	Journal of applied clinical medical physics
Volume	22
Issue number	6
DOIs	https://doi.org/10.1002/acm2.13261
State	Published - Jun 2021

Keywords

CT dosimetry
CT-guided intervention
CTDI
ablation
peak skin dose

ASJC Scopus subject areas

Radiation
Instrumentation
Radiology Nuclear Medicine and imaging

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10.1002/acm2.13261

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title = "Validation of a method for estimating peak skin dose from CT-guided procedures",

abstract = "A method for estimating peak skin dose (PSD) from CTDIvol has been published but not validated. The objective of this study was to validate this method during CT-guided ablation procedures. Radiochromic film was calibrated and used to measure PSD. Sixty-eight patients were enrolled in this study, and measured PSD were collected for 46 procedures. CTDIvol stratified by axial and helical scanning was used to calculate an estimate of PSD using the method [1.2 × CTDIvol(helical) + 0.6 × CTDIvol(axial)], and both calculated PSD and total CTDIvol were compared to measured PSD using paired t-tests on the log-transformed data and Bland-Altman analysis. Calculated PSD were significantly different from measured PSD (P < 0.0001, bias, 18.3%, 95% limits of agreement, −63.0% to 26.4%). Measured PSD were not significantly different from total CTDIvol (P = 0.27, bias, 3.97%, 95% limits of agreement, −51.6% to 43.7%). Considering that CTDIvol is reported on the console of all CT scanners, is not stratified by axial and helical scanning modes, and is immediately available to the operator during CT-guided interventional procedures, it may be reasonable to use the scanner-reported CTDIvol as an indicator of PSD during CT-guided procedures. However, further validation is required for other models of CT scanner.",

keywords = "CT dosimetry, CT-guided intervention, CTDI, ablation, peak skin dose",

author = "Jones, {A. Kyle} and Kisiel, {Meghan E.} and Rong, {X. John} and Tam, {Alda L.}",

note = "Publisher Copyright: {\textcopyright} 2021 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine",

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AU - Kisiel, Meghan E.

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N2 - A method for estimating peak skin dose (PSD) from CTDIvol has been published but not validated. The objective of this study was to validate this method during CT-guided ablation procedures. Radiochromic film was calibrated and used to measure PSD. Sixty-eight patients were enrolled in this study, and measured PSD were collected for 46 procedures. CTDIvol stratified by axial and helical scanning was used to calculate an estimate of PSD using the method [1.2 × CTDIvol(helical) + 0.6 × CTDIvol(axial)], and both calculated PSD and total CTDIvol were compared to measured PSD using paired t-tests on the log-transformed data and Bland-Altman analysis. Calculated PSD were significantly different from measured PSD (P < 0.0001, bias, 18.3%, 95% limits of agreement, −63.0% to 26.4%). Measured PSD were not significantly different from total CTDIvol (P = 0.27, bias, 3.97%, 95% limits of agreement, −51.6% to 43.7%). Considering that CTDIvol is reported on the console of all CT scanners, is not stratified by axial and helical scanning modes, and is immediately available to the operator during CT-guided interventional procedures, it may be reasonable to use the scanner-reported CTDIvol as an indicator of PSD during CT-guided procedures. However, further validation is required for other models of CT scanner.

AB - A method for estimating peak skin dose (PSD) from CTDIvol has been published but not validated. The objective of this study was to validate this method during CT-guided ablation procedures. Radiochromic film was calibrated and used to measure PSD. Sixty-eight patients were enrolled in this study, and measured PSD were collected for 46 procedures. CTDIvol stratified by axial and helical scanning was used to calculate an estimate of PSD using the method [1.2 × CTDIvol(helical) + 0.6 × CTDIvol(axial)], and both calculated PSD and total CTDIvol were compared to measured PSD using paired t-tests on the log-transformed data and Bland-Altman analysis. Calculated PSD were significantly different from measured PSD (P < 0.0001, bias, 18.3%, 95% limits of agreement, −63.0% to 26.4%). Measured PSD were not significantly different from total CTDIvol (P = 0.27, bias, 3.97%, 95% limits of agreement, −51.6% to 43.7%). Considering that CTDIvol is reported on the console of all CT scanners, is not stratified by axial and helical scanning modes, and is immediately available to the operator during CT-guided interventional procedures, it may be reasonable to use the scanner-reported CTDIvol as an indicator of PSD during CT-guided procedures. However, further validation is required for other models of CT scanner.

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Validation of a method for estimating peak skin dose from CT-guided procedures

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