The size-specific dose estimate (SSDE) is a metric for an estimation of patient dose in computed tomography (CT). The SSDE strongly depends on the water-equivalent diameter (D W ). In abdominal CT examinations, a contrast agent is sometimes used to more clearly visualize tissue lesions. The Hounsfield unit (HU) of CT images with and without the use of a contrast agent at specific areas is slightly different and it may affect the D W value. This study aimed to compare the D W values calculated from axial CT images in patients who had undergone routine abdominal scans both with and without the use of a contrast agent. Axial images of 144 patients with a weight range of 3.5 kg to 90 kg who had undergone routine abdominal scans both with and without the use of a contrast agent using a Siemens Sensation 64 CT scanner were retrospectively collected. The D W values were automatically calculated using the Matlab-based IndoseCT (version 15a) software. The results show the percentage difference between D W,contrast and D W,non-contrast is below 2 %. As a result, the mean SSDE contrast is 1.5 % smaller than SSDE non-contrast . Due to the effect of a contrast agent on the D W and SSDE values is below 2 %, the axial images of CT abdomen without the use of a contrast agent can be used as the accurate estimation of D W and SSDE for images with the use of a contrast agent.

The dose received by a patient on CT examination is expressed in size-specific dose estimates (SSDE) which is a function of the patient diameter, x-ray attenuation, and scanner output (volume computed tomography dose index, CTDIvol). Patient diameter and x-ray attenuation are represented as water equivalent diameter (Dw). We conducted the research to analyze the relationships between body weight and Dw, CTDIvol, and size-specific dose estimates (SSDE) in contrast-enhanced thorax examinations. We used images from 100 patients (50 women and 50 men patients) whose weight range from 2.8 kg to 80 kg. The values of Dw, CTDIvol, and SSDE were automatically calculated from axial CT images using the IndoseCT software. Statistical analysis showed that the patient's body weight correlates linearly with the Dw. The linearity coefficient (R2) values for body weight and Dw is 0.43 (women) and 0.55 (men). However, weight was independent of the patient dose in terms of CTDIvol and SSDE. This was because the CT system used tube current modulation (TCM), which automatically adapted the tube current to patient size, resulting in a relatively constant dose regardless of the patient size (Dw).

Purpose: The aim of this work was to establish the relationships of patient size in terms of effective diameter (Deff) and water-equivalent diameter (Dw) with lateral (LAT) and anterior-posterior (AP) dimensions in order to predict the specific patient dose for thoracic, abdominal, and pelvic computed tomography (CT) examinations. Methods: A total of 47 thoracic images, 79 abdominal images, and 50 pelvic images were analyzed in this study. The patient’s images were retrospectively collected from Dr. Kariadi and Kensaras Hospitals, Semarang, Indonesia. The slices measured were taken from the middle of the scan range. The calculations of patient sizes (LAT, AP, Deff, and Dw) were automatically performed by IndoseCT 20b software. Deff and Dw were plotted as functions of LAT, AP, and AP+LAT. In addition, Dw was plotted as a function of Deff. Results: Strong correlations of Deff and Dw with LAT, AP, and AP+LAT were found. Stronger correlations were found in the Deff curves (R2 > 0.9) than in the Dw curves (R2 > 0.8). It was found that the average Deff was higher than the average Dw in the thoracic region, the average values were similar in the abdominal and pelvic regions. Conclusion: The current study extended the study of the relationships between Deff and Dw and the basic geometric diameter LAT, AP, and AP+LAT beyond those previously reported by AAPM. We evaluated the relationships for three regions, i.e. thoracic, abdominal, and pelvic regions. Based on our findings, it was possible to estimate Deff and Dw from only the LAT or AP dimension.