Adopting DAP as a dose metric in CT
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1 Adopting DAP as a dose metric in CT Nick Weir Department of Medical Physics Royal Infirmary of Edinburgh NHS Lothian
2 Dose Area Product (DAP) in CT Hypothesis: There are advantages to using DAP: (i) In quality assurance measurements (ii) In patient dose calculations Problems with CTDI DAP measurements on a wide beam CT scanner Potential for patient dosimetry?
3 What is Dose Area Product (DAP)? Int(D.dA) (equn), units: mgy cm 2 For uniform beam ~ Dose x Area Proportional to total energy absorbed Invariant with distance from source e-radiography.net
4 Problems with CTDI Std integration length 100 mm CT beams now extend up to >= 160 mm CTDI w100 in 14 cm phantoms underestimates CTDI w300 : 37-47% beam widths mm (Mori et al., BJR, 2006) >40% at 160 mm (Geleijns et al, PMB, 2009)
5 Previously proposed solutions: Scan through small chamber e.g. Farmer: Can t do on fixed table cone beam systems. Central dose within beam can be measured using a small chamber a useful QA measurement, but no information on beam periphery (e.g. has collimation changed?). Would need to measure beam thickness each time on each setting as well. Extended phantoms: (i) Geleijns et al., 300 mm pencil chamber, 350 mm phantom -> CTDI300 (ii) RTI..Pull small detector through phantoms during exposure using motorised jig (not commercially available system) Cumbersome, expensive
6 DAP measurements
7 DAP measurements
8 DAP vs 100mm chamber: Effect of collimation Vary collimation (Large filter) DAP per 100 mas D100air per 100 mas DAP (ugym^2) collimation (mm) Dose (mgy)
9 DAP vs CTDI 300 : Effect of collimation (L filter) DAP/collim CTDI300 Collimation (ugym^2/mm) norm. (mgy) norm
10 DAP vs 100mm chamber: Effect of kvp, filter Meas (norm to 120 kv, L filt) Large filter DAP D100air CTDI300_air DAP D100air CTDI300air Medium Filter DAP D100air CTDI300air Small Filter kv kv kv
11 Pros & cons of DAP as a QA measurement + Whole beam - Fixed tube Easy set-up Fast
12 DAP: Patient dosimetry Are we collecting all of the beam? 55 cm isocentre 60 cm gantry x b 27 cm 24.6 o x b = 25 cm!
13 Are we collecting all of the beam? 40 Beam profile in x air kerma (mgy) chamber gafchromic film x@housing (mm)
14 DAP in CT patient dosimetry CTDIw time consuming measurements CTDI phantom assumptions Additional measurements
15 Patient dosimetry Dosimetry comparison for Cardiac CTA (Toshiba Aquilion ONE) 120 kv 400 ma 0.35s x 1 rotation L filter 160 mm collimation centred on heart E dlp ImPACT CTDosimetry.xls (ICRP60) NRPB R262: DAP-> Dose conversion factors
16 Patient dosimetry: Scanner matching ImPACT scanner matching carried out for Toshiba Aquilion ONE ImPACT factor calculated from (CTDI_centre/CTDI_air), (CTDI_periphery/CTDI_air) Large filter, 120 kv -> Philps LX, 120 kv (MCDATASET 19)
17 Patient dosimetry DLP Edlp (0.014) ImPACT DAP 162 mgy.cm 3.0 msv /-0.1 msv 1435 ugym 2
18 Patient dosimetry DLP Edlp (0.014) ImPACT DAP Heart AP Heart LLat Heart PA Heart RLat 162 mgy.cm 3.0 msv /-0.1 msv 1435 ugym msv 1.07 msv 0.98 msv 1.12 msv
19 Patient dosimetry DLP Edlp (0.014) ImPACT DAP Heart AP Heart LLat Heart PA Heart RLat Total Edap 162 mgy.cm 3.0 msv /-0.1 msv 1435 ugym msv 1.07 msv 0.98 msv 1.12 msv 4.0 msv (Chest views 3.2 msv) 2.9 x 10-3 msv/ugy/m 2
20 Pros & cons of DAP for CT patient dosimetry + Proportional to energy imparted, risk - Beam shaping filter issues Use same software as other radiography Unify units, improve understanding! Scout doses
21 Conclusions and further work DAP measurements useful in wide beam QA Good comparator of risk Preliminary dose calculations promising Effect of beam shaping on organ doses / effective doses to be studied Calculate E dap for range of examinations, scanners
22 Acknowledgements Nicola Bate, Senior Physicist, Dept of Medical Physics, NHS Lothian Leila Nichol, Pt 1 Trainee, Dept of Medical Physics, NHS Lothian
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