National survey of patient doses from whole-body FDG PET-CT examinations in France in 2011

Étard, C.; Célier, D.; Roch, P.; Aubert, Bernard

doi:10.1093/rpd/ncs066

Cited by 56 publications

(57 citation statements)

References 2 publications

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“…The mean and 75th percentile CTDI vol was equal to 6.6 and 7.7 mGy, respectively (28). The mean value agreed well with the data reported in Table 2, and the lower 75th percentile may suggest a narrower CTDI vol distribution.…”

Section: Discussionsupporting

confidence: 86%

Diagnostic Reference Levels of CT Radiation Dose in Whole-Body PET/CT

et al. 2015

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The role of CT in PET/CT imaging includes acquisition techniques for diagnostic, anatomic localization, and attenuation correction purposes. Diagnostic reference levels of the volumetric CT dose index (CTDI vol ) are available for dedicated CT procedures on selected body regions, but similar reference levels for whole-body CT used in PET/CT examinations are limited. This work reports CTDI vol values from sites that conduct whole-body oncologic PET/CT examinations and participated in the scanner validation program of the Society of Nuclear Medicine and Molecular Imaging Clinical Trials Network. Methods: From 2010 to 2014, a total of 154 sites submitted CT acquisition parameters used in their clinical 18 F-FDG PET/CT oncology protocols. From these parameters, the CTDI vol was estimated using the ImPACT CTDI dosimetry tables. Histograms of CTDI vol values were created for each year, and descriptive statistics, including mean, median, and 75th percentile, were reported. Repeated-measures ANOVA was performed to determine whether significant differences occurred between reporting years. Results: A wide range of technical parameters was reported, most notably in tube current. Between 2010 and 2014, the median CTDI vol ranged from 4.9 to 6.2 mGy and the 75th percentile from 9.7 to 10.2 mGy. There was no significant change in CTDI vol between reporting years (repeated-measures ANOVA, P 5 0.985). Conclusion: The 75th percentile CTDI vol reported in this work was 9.8 mGy averaged over all reporting years. These data provide a resource for establishing CTDI vol reference values specific to performing CT in PET/CT whole-body examinations. The wide ranges of CT acquisition parameters reported by sites suggest that CTDI vol reference levels may be beneficial for optimization of CT protocols.

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Section: Discussionsupporting

confidence: 86%

Diagnostic Reference Levels of CT Radiation Dose in Whole-Body PET/CT

et al. 2015

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“…ED derived from the CT component of whole-body PET/CT varies widely, from 5 to 25 mSv, among PET facilities (2)(3)(4)(5)(6)(7)(8). Mean whole-body ED in all 80 patients was 4.61 mSv, indicating relatively low dose, in this study.…”

Section: Discussionmentioning

confidence: 52%

“…The problem of CT acquisition additional to PET is an increase in radiation exposure. The effective dose (ED) derived from the CT component varies widely from 5 to 25 mSv (2)(3)(4)(5)(6)(7)(8) and often exceeds the ED from 18 F-FDG injection. Although a large amount of radiation exposure is required to acquire highquality CT images for diagnostic purposes, lesion localization and attenuation correction can be achieved on CT images of lower quality.…”

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confidence: 99%

Methods of CT Dose Estimation in Whole-Body ¹⁸F-FDG PET/CT

et al. 2015

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We evaluated the effective dose (ED) of the CT component of wholebody PET/CT using software dedicated to CT dose estimation and from dose-length product (DLP) values to establish practical methods of ED estimation. Methods: Eighty adult patients who underwent 18 F-FDG whole-body PET/CT were divided into groups A and B, each consisting of 20 men and 20 women. In group A, ED of the CT component was calculated using CT-Expo for 6 anatomic regions separately, and whole-body ED was obtained by summing the regional EDs (CT-Expo method). DLP was calculated for each of the 6 regions and multiplied by a corresponding conversion factor described in International Commission on Radiological Protection publication 102 to obtain the ED for each region (regional DLP method). Whole-body ED was also calculated as the product of a whole-body DLP value provided by the scanner automatically and a conversion factor (simple DLP method). Moreover, the ED/DLP values were calculated using whole-body ED estimated by the CT-Expo method and the scannerderived DLP, to optimize the conversion factor. In group B, the optimized conversion factor was applied for the estimation of ED by the simple DLP method. Results: In group A, the regional DLP method allowed an accurate estimation of mean whole-body ED as a result of counterbalance of mild overestimation in men and mild underestimation in women, regarding the CT-Expo method as a standard. The simple DLP method using a conversion factor for the trunk (0.015 mSv/mGy/cm) caused overestimation. On the basis of the ED/DLP values in group A, a modified conversion factor of 0.013 mSv/mGy/cm and sex-specific conversion factors of 0.012 and 0.014 mSv/mGy/cm for men and women, respectively, were determined. In group B, the use of the modified conversion factor improved accuracy, and the use of sex-specific conversion factors eliminated sex-dependent residual errors. Conclusion: ED of the CT component of whole-body PET/CT can be assessed by multiplying the scannerderived DLP by a conversion factor optimized for whole-body PET/CT. PET with 18 F-FDG has been accepted as a valuable tool in oncology practice. CT images are commonly acquired together with PET images in a single imaging session with an integrated PET/CT scanner (1) and are used for diagnosis on CT images themselves, localization of lesions delineated by PET, and attenuation correction of PET images. The problem of CT acquisition additional to PET is an increase in radiation exposure. The effective dose (ED) derived from the CT component varies widely from 5 to 25 mSv (2-8) and often exceeds the ED from 18 F-FDG injection. Although a large amount of radiation exposure is required to acquire highquality CT images for diagnostic purposes, lesion localization and attenuation correction can be achieved on CT images of lower quality. Dose reduction with preserving clinical utilities should be pursued in each facility considering the purpose of CT and using dose reduction technologies (9,10).Estimation of ED is a prerequisite for optimization and mo...

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“…Specifically, although half-body fluorine-18 fluorodeoxyglucose ( 18 F-FDG) oncology imaging comprises the majority of PET-CT imaging procedures worldwide, limited guidance exists on acceptable levels of CT dose in adults. Etard et al [7] undertook a survey of 18 F-FDG oncology PET-CT practice and doses in France in 2011 and presented typical PET and CT doses including proposed national DRLs for half-body scans. In all cases the CT data were used for AC and localization, but acquisition parameters and patient doses varied considerably between centres.…”

Section: Introductionmentioning

confidence: 99%