ICRP Publication 102: Managing Patient Dose in Multi-Detector Computed Tomography (MDCT), Annals of the ICRP Volume 37/1

ICRP Publication 102: Managing Patient Dose in Multi-Detector Computed Tomography (MDCT)

Annals of the ICRP Volume 37/1

By International Commission on Radiological Protection


1.MDCT TECHNOLOGY

1.1.Background
1.2.Introduction to MDCT technology
1.3.Differences between SDCT and MDCT
1.4.Upcoming developments
1.5.What is the motivation for this report?

2.RADIATION DOSE IN MDCT

2.1.Introduction
2.2.Are doses in MDCT different and why?
2.3.What are the considerations for users switching over from SDCT to MDCT?
2.3.1.Factors that can increase dose in MDCT
2.3.2.Factors that can decrease dose in MDCT
2.4.Dose surveys and diagnostic reference levels
2.5.Perspective on radiation risks
2.5.1.Deterministic risk
2.5.2.Stochastic risk
2.6.Responsibilities for patient dose management

3.WHAT CONSIDERATIONS AND ACTIONS AFFECT PATIENT DOSE?

3.1.Compromise between dose and image quality
3.1.1.General descriptors of image quality
3.1.2.Different imaging tasks require different levels of quality
3.2.Equipment and protocol issues affecting patient dose
3.2.1.Overbeaming
3.2.2.Overranging
3.2.3.Image thickness
3.3.Operator choices that affect patient dose
3.3.1.Scanner model and manufacturer
3.3.2.Tube current (mA) and tube current?exposure time product (mAs)
3.3.3.Image quality selection paradigms
3.3.4.Temporal mA modulation
3.4.Tube voltage (kVp)
3.5.Pitch, beam collimation and slice width
3.6.Scan coverage and indication
3.7.System Software: Image reconstruction, noise reduction, and metal artefact reduction algorithms
3.8.Modification of scan acquisition and reconstruction parameters

4.DOSE MANAGEMENT IN CLINICAL PRACTICE

4.1.Justification of examination
4.2.Training issues
4.3.Techniques and doses for particular CT examinations
4.3.1.Chest CT
4.3.2.CT for coronary calcium quantification and non-invasive coronary angiography
4.3.3.CT colonography
4.3.4.CT for trauma
4.3.5.CT of the urinary tract
4.3.6.CT-guided interventions
4.3.7.CT in children
4.3.8.CT of the pregnant patient
4.3.9 Future directions

APPENDIX A. HOW TO DESCRIBE DOSE IN CT