Organ dose and total effective dose of whole-body CT in multiple myeloma patients

Abstract

Objective To evaluate organ dose and total effective dose of whole-body low-dose CT (WBLDCT) performed on different CTscanner models in patients with multiple myeloma (MM) and to compare it to the effective dose of radiographic skeletal survey and representative diagnostic CTs. Material and methods We retrospectively analyzed data from 228 patients (47.4% females, mean age 67.9 ± 10.4 years, mean weight 81.8 ± 22.4 kg) who underwent WBLDCT for the work-up or surveillance of MM. Patients were scanned using one of six multi-detector CT-scanners. Organ doses and total effective doses per scan were calculated using a commercially available dosemanagement platform (Radimetrics, Bayer Healthcare, Leverkusen, Germany). The median effective dose was compared to radiographic skeletal survey and representative diagnostic CTs. Results The mean effective dose of our WBLDCT-protocol was 4.82 mSv. A significantly higher effective dose was observed in females compared to males (4.95 vs. 4.70 mSv, P = 0.002). Mean organ dose ranged from 3.72 mSv (esophagus) to 13.09 mSv (skeleton). Mean effective dose varied amongst different CT-scanners (range 4.34-8.37 mSv). The median effective dose of WBLDCT was more than twice the dose of a skeletal survey (4.82 vs. 2.04 mSv), 23% higher than a diagnostic contrast-enhanced chest CT (3.9 mSv), 46% lower than a diagnostic contrast-enhanced abdomen/pelvis CT (9.0 mSv), and 45% lower than a lumbar spine CT (8.7 mSv). Conclusions WBLDCT in MM has a higher effective dose than a radiographic skeletal survey, but a lower effective dose than diagnostic CTs of lumbar spine, abdomen and pelvis. This underlines the broad applicability of WBLDCT in the management of MM patients.

Whole Body Low Dose Computed Tomography Using Third-Generation Dual-Source Multidetector With Spectral Shaping: Protocol Optimization and Literature Review

“… 4 Most recent studies, instead, employes a 120 kV protocol and a tube current between 30 and 100 mAs, to achieve an effective dose ranging between 2.7 mSv 9 and 29,5 mSv. 4 , 6 - 10 , 12 - 18 , 21 - 23 , 25 - 32 Other studies have been focused on a different approach based on low tube voltage (80 kV) and high current (200–230 mAs), generating an effective dose of about 4.5 mSv. 14 …”

“…Then, raw data images were reconstructed in 1.5 mm slice thickness using a Br64 kernel to generate axial images, while 1 mm slice thickness to generate coronal images of the whole body and sagittal images of the spine through multiplanar reformation (MPR). The dose report, with CT dose index (CTDI) and Dose-Length Product (DLP) for the WBLDCT protocol, as defined above, were read from the examination summary reports produced by the CT scanner for each patient, while the dose effects were calculated by multiplying DLP for a whole-body absorption rate constant (0.00842), 10 for each patient. Moreover, a literature analysis was performed in order to compare the dose report obtained with the literature standard until 2020 ( Table 1 ).…”

Whole Body Low Dose Computed Tomography (WBLDCT) Can Be Comparable to Whole-Body Magnetic Resonance Imaging (WBMRI) in the Assessment of Multiple Myeloma

“…The dose report, expressed as CT dose index (CTDI) and dose–length product (DLP) were recorded from the examination summary reports produced by the CT scanner for each patient, while the effective dose (ED) was calculated using methods previously reported [ 14 ].…”

“…Cross-sectional imaging is preferred over conventional radiography (CR) for the evaluation of bone disease because of higher sensitivity [ 1 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ] but the choice of imaging modality is made according to availability, cost, and institutional preference [ 15 ].…”

Dynamic PET imaging with ultra-low-activity of 18F-FDG: unleashing the potential of total-body PET

“…In the work by Liu et al, a low-dose whole-body CT scan was performed before 18 F-FDG PET scan for each subject [12]. This CT scan was used for attenuation coefficient (AC) instead of disease diagnosis, with its effective radiation dose (~2.4 mSv) being significantly lower than a typical diagnostic body CT exam and the CT component of a typical modern PET/CT exam (~5-10 mSv) [13][14][15]. With the constant advancements of CT tube and detector technologies [16], patient-specific scan technologies, and artificial intelligence (AI)-based CT dose reduction technologies (e.g., TrueFidelity Deep Learning Image Reconstruction from GE Healthcare [17,18], Advanced Intelligent Clear-IQ Engine from Canon Medical Systems USA Inc. [19][20][21], among others), there is considerable promise for the CT component of whole-body PET/CT exam to routinely achieve sub-mSv effective doses in the future, which means the entire whole-body PET/CT exam with ultra-low-activity of 18 F-FDG can be accomplished under 2 mSv.…”