The Computed Tomography Dose Index (CTDI) is an indicator for dose management in computed tomography (CT), but has limited use for patient dosimetry. To evaluate the patient dose, the size-speci c dose estimate (SSDE), reported by the American Association of Physics in Medicine task groups 204, 220, and 293, must be calculated by the CTDI vol (z) displayed on the CT console and the conversion factor f(D(z)) from the effective diameter (D Eff ) or water equivalent diameter (D w ). However, no reports have veri ed the appropriateness of using the 320-mm diameter phantom for dose assessment in CT examinations involving the lower limbs. Therefore, we validated a new method for evaluating the SSDE(z) of the lower limbs, using two 160-mm diameter phantoms instead of the 320-mm diameter phantom. The CTDI vol (z) obtained from Monte Carlo (MC) simulation study was reliable because they were almost the same as obtained in a dosimetry study. The conversion factor f (D (z l.l .)) for the lower limbs was evaluated based on the CTDI vol (z) obtained by MC simulation performed using two polymethyl methacrylate cylinder phantoms of 160-mm diameter. The MC simulation was performed by the International Commission on Radiological Protection publication 135 reference adult phantom and was used to evaluate the absorbed dose of the pelvis, lower limbs, knees, and ankles. The dose showing the greatest difference was the lower limbs, which was 8.3 mGy (16%) lower than the absorbed dose. Thus, the SSDE (z l.l .) could be estimated from the CTDI 320 vol (z) displayed on the CT scanner console.