Although the use of CT in medical diagnosis delivers radiation doses to patients that are higher than those from other radiological procedures, lack of optimized protocols could be an additional source of increased dose in developing countries. The aims of this study are, first, to determine the magnitude of radiation doses received by selected radiosensitive organs of patients undergoing CT examinations and compare them with other studies, and second, to assess how CT scanning protocols in practice affect patient organ doses. In order to achieve these objectives, patient organ doses from five common CT examinations were obtained from eight hospitals in Tanzania. The patient organ doses were estimated using measurements of CT dose indexes (CTDI), exposure‐related parameters, and the ImPACT spreadsheet based on NRPB conversion factors. A large variation of mean organ doses among hospitals was observed for similar CT examinations. These variations largely originated from different CT scanning protocols used in different hospitals and scanner type. The mean organ doses in this study for the eye lens (for head), thyroid (for chest), breast (for chest), stomach (for abdomen), and ovary (for pelvis) were 63.9 mGy, 12.3 mGy, 26.1 mGy, 35.6 mGy, and 24.0 mGy, respectively. These values were mostly comparable to and slightly higher than the values of organ doses reported from the literature for the United Kingdom, Japan, Germany, Norway, and the Netherlands. It was concluded that patient organ doses could be substantially minimized through careful selection of scanning parameters based on clinical indications of study, patient size, and body region being examined. Additional dose reduction to superficial organs would require the use of shielding materials.PACS numbers: 87.59 Fm; 87.66Jj; 87.52‐g

No abstract

Head computed tomography examinations are often accompanied with unnecessary irradiation of superficial organs that are rarely the main target for the investigation. The aim of this work is to demonstrate that lead shields could be effectively used to protect superficial organs without compromising image quality where superficial organ itself is not a target and that the irradiation of the superficial organ is unavoidable. The objective was achieved by first assessing the image quality using phantom measurements made with and without lead shielding in order to determine optimal shielding thickness for patient applications. The entrance surface doses (ESDs) to superficial organs of sixty patients were measured using LiF-thermoluminescent dosemeters without, with one layer, or with two layers of lead shields. Phantom studies demonstrated that the use of modified lead shields of up to 0.25 mm thickness could be used without significant effect on the image quality for central and posterior regions. In these studies, lead shields of 0.25 mm thickness reduce the ESDs to the lens of the eyes and thyroid by 44 and 51%, respectively. The image quality reduction by eye shields was significant to the anterior (i.e. orbital) region but marginal to the central and posterior regions (cerebrum). In view of the above, the use of modified lead shields could reduce the dose to the superficial organs considerably without significantly compromising image quality.

Without the knowledge of reference dose levels (RDLs) from computed tomography (CT) examinations, the optimal dose to patients undergoing CT examinations cannot be realised. The aim of this study was therefore to assess the radiation dose levels from CT examinations according to reference dose quantities proposed by the European Commission (EC) guidelines. The dosimetric quantities proposed in the EC for CT are weighted CT dose index (CTDI(w)) for a single slice and dose-length product (DLP) for a complete examination. The RDLs from five common CT examinations were obtained from eight hospitals. The RDLs in terms of CTDI(w) and DLP were estimated from measurements of CTDI in standard phantoms using typical exposure parameters. Mean values of CTDI(w) for head and lumbar spine had a range of 25-77 and 18-47 mGy, respectively, while those for chest, abdomen and pelvis had a range of about 11-25 mGy, respectively. Mean values of DLP for head, chest and abdomen had a range of 610-1684, 496-992 and 717-1428 mGy cm, respectively, while those for lumbar spine and pelvis had a range of 200-382 and 526-1302 mGy cm, respectively. Wide variations of mean CTDI(w) and DLP values among hospitals observed for similar CT examinations were mainly attributed to the variations of CT scanning protocols and scanner types. The mean CTDI(w) values per examination for almost all hospitals were below proposed RDLs, while the mean DLP values per examination were almost all above the proposed RDLs for all except one hospital. These were mainly influenced by the large scan length used in Tanzanian hospitals. In order to achieve the required level of dose for establishment of the national RDLs, it was concluded that further investigation of optimization of scanning protocols is needed.

Since patient doses from computed tomography (CT) are relatively high, risk-benefit analysis requires dose to patients and image quality be optimised. The aim of this study was to develop a patient-dependent optimisation technique that uses patient diameter to select a combination of CT scanning parameters that minimise dose delivered to patients undergoing abdominal CT examinations. The study was performed using cylindrical phantoms of diameters ranging from 16 to 40 cm in order to establish the relationship between image degradation, CT scanning techniques, patient dose and patient size from two CT scanners. These relationships were established by scanning the phantoms using standard scanning technique followed by selected combinations of scanning parameters. The image noises through phantom images were determined using region of interest software available in both scanners. The energy depositions to the X-ray detector through phantoms were determined from measurements of CT dose index in air corrected for attenuation of the phantom materials. The results demonstrate that exposure settings (milliampere seconds) could be reduced by up to 82 % for smaller phantom relative to standard milliampere seconds, while detector signal could be reduced by up to 93 % for smaller phantom relative to energy depositions required when scanned using standard scanning protocols. It was further revealed that the use of the object-specific scanning parameters on studies performed with phantom of different diameters could reduce the incident radiation to small size object by up to 86 % to obtain the same image quality required for standard adult object. In view of the earlier mentioned fact, substantial dose saving from small-sized adults and children patients undergoing abdomen CT examinations could be achieved through optimal adjustment of CT scanning technique based on the patient transverse diameter.