As multidetector computed tomography (CT) serves as an increasingly frequent diagnostic modality, radiation risks to patients became a greater concern, especially for children due to their inherently higher radiosensitivity to stochastic radiation damage. Current dose evaluation protocols include the computed tomography dose index (CTDI) or point detector measurements using anthropomorphic phantoms that do not sufficiently provide accurate information of the organ-averaged absorbed dose and corresponding effective dose to pediatric patients. In this study, organ and effective doses to pediatric patients under helical multislice computed tomography (MSCT) examinations were evaluated using an extensive series of anthropomorphic computational phantoms and Monte Carlo radiation transport simulations. Ten pediatric phantoms, five stylized (equation-based) ORNL phantoms (newborn, 1-year, 5-year, 10-year, and 15-year) and five tomographic (voxel-based) UF phantoms (9-month male, 4-year female, 8-year female, 11-year male, and 14-year male) were implemented into MCNPX for simulation, where a source subroutine was written to explicitly simulate the helical motion of the CT x-ray source and the fan beam angle and collimator width. Ionization chamber measurements were performed and used to normalize the Monte Carlo simulation results. On average, for the same tube current setting, a tube potential of 100 kVp resulted in effective doses that were 105% higher than seen at 80 kVp, and 210% higher at 120 kVp regardless of phantom type. Overall, the ORNL phantom series was shown to yield values of effective dose that were reasonably consistent with those of the gender-specific UF phantom series for CT examinations of the head, pelvis, and torso. However, the ORNL phantoms consistently overestimated values of the effective dose as seen in the UF phantom for MSCT scans of the chest, and underestimated values of the effective dose for abdominal CT scans. These discrepancies increased with increasing kVp. Finally, absorbed doses to select radiation sensitive organs such as the gonads, red bone marrow, colon, and thyroid were evaluated and compared between phantom types. Specific anatomical problems identified in the stylized phantoms included excessive pelvic shielding of the ovaries in the female phantoms, enhanced red bone marrow dose to the arms and rib cage for chest exams, an unrealistic and constant torso thickness resulting in excessive x-ray attenuation in the regions of the abdominal organs, and incorrect positioning of the thyroid within the stylized phantom neck resulting in insufficient shielding by clavicles and scapulae for lateral beam angles. To ensure more accurate estimates of organ absorbed dose in multislice CT, it is recommended that voxel-based phantoms, potentially tailored to individual body morphometry, be utilized in any future prospective epidemiological studies of medically exposed children.

This paper reports on the methodology and materials used to construct anthropomorphic phantoms for use in dosimetry studies, improving on methods and materials previously described by Jones et al. [Med Phys. 2006;33(9):3274–82]. To date, the methodology described has been successfully used to create a series of three different adult phantoms at the University of Florida (UF). All phantoms were constructed in 5 mm transverse slices using materials designed to mimic human tissue at diagnostic photon energies: soft tissue‐equivalent substitute (STES), lung tissue‐equivalent substitute (LTES), and bone tissue‐equivalent substitute (BTES). While the formulation for BTES remains unchanged from the previous epoxy resin compound developed by Jones et al. [Med Phys. 2003;30(8):2072—81], both the STES and LTES were redesigned utilizing a urethane‐based compound which forms a pliable tissue‐equivalent material. These urethane‐based materials were chosen in part for improved phantom durability and easier accommodation of real‐time dosimeters. The production process has also been streamlined with the use of an automated machining system to create molds for the phantom slices from bitmap images based on the original segmented computed tomography (CT) datasets. Information regarding the new tissue‐equivalent materials, as well as images of the construction process and completed phantom, are included.PACS number: 87.53.Bn

The main purpose of this work was to quantify patient organ doses from the two kilovoltage cone beam computed tomography (CBCT) systems currently available on medical linear accelerators, namely the X‐ray Volumetric Imager (XVI, Elekta Oncology Systems) and the On‐Board Imager (OBI, Varian Medical Systems). Organ dose measurements were performed using a fiber‐optic coupled (FOC) dosimetry system along with an adult male anthropomorphic phantom for three different clinically relevant scan sites: head, chest, and pelvis. The FOC dosimeter was previously characterized at diagnostic energies by Hyer et al. [Med Phys 2009;36(5):1711–16] and a total uncertainty of approximately 4% was found for in‐phantom dose measurements. All scans were performed using current manufacturer‐installed clinical protocols and appropriate bow‐tie filters. A comparison of image quality between these manufacturer‐installed protocols was also performed using a Catphan 440 image quality phantom. Results indicated that for the XVI, the dose to the lens of the eye (1.07 mGy) was highest in a head scan, thyroid dose (19.24 mGy) was highest in a chest scan, and gonad dose (29 mGy) was highest in a pelvis scan. For the OBI, brain dose (3.01 mGy) was highest in a head scan, breast dose (5.34 mGy) was highest in a chest scan, and gonad dose (34.61 mGy) was highest in a pelvis scan. Image quality measurements demonstrated that the OBI provided superior image quality for all protocols, with both better spatial resolution and low‐contrast detectability. The measured organ doses were also used to calculate a reference male effective dose to allow further comparison of the two machines and imaging protocols. The head, chest, and pelvis scans yielded effective doses of 0.04, 7.15, and 3.73 mSv for the XVI, and 0.12, 1.82, and 4.34 mSv for the OBI, respectively.PACS number: 87.57.uq

Tissue equivalent materials have a variety of uses, including routine quality assurance and quality control in both diagnostic and therapeutic physics. They are frequently used in a research capacity to measure doses delivered to patients undergoing various therapeutic procedures. However, very few tissue equivalent materials have been developed for research use at the low photon energies encountered in diagnostic radiology. In this paper, we present a series of tissue-equivalent (TE) materials designed to radiographically mimic human tissue at diagnostic photon energies. These tissue equivalent materials include STES-NB (newborn soft tissue substitute), BTES-NB (newborn bone tissue substitute), LTES (newborn as well as a child/adult lung tissue substitute), STES (child/adult soft tissue substitute), and BTES (child/adult bone tissue substitute). In all cases, targeted reference elemental compositions are taken from those specified in the ORNL stylized computational model series. For each material, reference values of mass density, mass attenuation coefficients (10-150 keV), and mass energy-absorption coefficients (10-150 keV) were matched as closely as permitted by material selection and manufacturing constraints. Values of mu/rho and mu(en)/rho for the newborn TE materials are noted to have maximum deviations from their ORNL reference values of from 0 to -3% and from +2% to -3%, respectively, over the diagnostic energy range 10-150 keV. For the child/adult TE materials, these same maximal deviations of mu/rho and mu(en)/rho are from +1.5% to -3% and from +3% to -3%, respectively. Simple calculations of x-ray fluence attenuation under narrow-beam geometry using a 66 kVp spectrum typical of newborn CR radiographs indicate that the tissue-equivalent materials presented here yield estimates of absorbed dose at depth to within 3.6% for STES-NB, 3.2% for BTES-NB, and 1.2% for LTES of the doses assigned to reference newborn soft, bone, and lung tissue, respectively.

A commercial patient dose verification system utilizing non-invasive metal oxide semiconductor field effect transistor (MOSFET) dosimeters originally designed for radiotherapy applications has been evaluated for use at diagnostic energy levels. The system features multiple dosimeters that may be used to monitor entrance or exit skin dose and intracavity doses in phantoms in real time. We have characterized both the standard MOSFET dosimeter designed for radiotherapy dose verification and a newly developed "high sensitivity" MOSFET dosimeter designed for lower dose measurements. The sensitivity, linearity, angular response, post-exposure response, and physical characteristics were evaluated. The average sensitivity (free in air, including backscatter) of the radiotherapy MOSFET dosimeters ranged from 3.55 x 10(4) mV per C kg(-1) (9.2 mV R(-1)) to 4.87 x 10(4) mV per C kg(-1) (12.6 mV R(-1)) depending on the energy of the x-ray field. The sensitivity of the "high sensitivity" MOSFET dosimeters ranged from 1.15 x 10(5) mV per C kg(-1) (29.7 mV R(-1)) to 1.38 x 10(5) mV per C kg(-1) (35.7 mV R(-1)) depending on the energy of the x-ray field. The high sensitivity dosimeters demonstrated excellent linearity at high energies (90 and 120 kVp) and acceptable linearity at lower energies (60 kVp). The angular response was significant for free-in-air exposures, as illustrated by the sensitivity differences between the two sides of the dosimeter, but was excellent for measurements within a tissue equivalent cylinder. The post-exposure drift response is a complicated but reproducible function of time. Real-time monitoring requires little if any corrections for the post-exposure drift response. The MOSFET dosimeter system brings some unique capabilities to diagnostic radiology dosimetry including small size, real-time capabilities, nondestructive measurement, good linearity, and a predictable angular response.