- Quality Control in Cone-Beam Computed Tomography (CBCT) EFOMP-ESTRO-IAEA Protocol, 2017
- Quality Assurance Programme for Computed Tomography: Diagnostic and Therapy Applications, IAEA Human Health Series No.19, 2012 (IAEA)
- Cody D.D., Mahesh M., AAPM-RSNA Physics Tutorials for Residents: Technologic Advances in Multidetector CT with a Focus on Cardiac Imaging, Radiographics 27 (2007) 1829
- European Guidelines on Quality Criteria for Computed Tomography, 1998 (EC)
- Diagnostic Radiology Physics: A Handbook for Teachers and Students, 2014 (IAEA)
- Status Of Computed Tomography Dosimetry For Wide Cone Beam Scanners, IAEA Human Health Reports No.5, 2011 (IAEA)
- Managing patient dose in multi-detector computed tomography, 2007 (ICRP)
- Sprawls P., AAPM Tutorial: CT Image Detail and Noise, 12 (1992) 1041
- Nagel H.D. Radiation Exposure in Computed Tomography: Fundamentals, Influencing Parameters, Dose Assessment, Optimisation, Scanner Data, Terminology, COCIR, Frankfurt, Germany (2000).
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Computed tomography
Introduction
Computed tomography (CT) was first introduced into medical imaging in the mid-1970s. Today CT results in 24% of the total radiation dose from all sources to the population in the United States, and 49% of the medical radiation dose to the population [UNSCEAR, 2008]. CT provides significant diagnostic information and eliminates the need for exploratory surgery which was common before the advent of CT. Consequently, it is essential to ensure that CT provides the necessary diagnostic information, i.e., image quality is acceptable for the task, while optimizing the radiation dose to the patient.
Important Principles
CT scanners can result in high doses to the patient. Cases of erythema and epilation have been reported as a result of perfusion studies with CT.
It is essential to understand the factors impacting on patient dose in CT. These include the selection of kilovoltage and tube current as well as the spacing of the acquired images. In addition, it is not just the CT equipment and technical factors that are important. For example, in perfusion studies the number of images acquired in a selected region of the body will have a significant impact on patient dose. Consequently, the selection of techniques and protocols by the imaging physician or radiographer can change patient doses dramatically.
One of the latest developments in the field of cross-sectional imaging is the introduction of cone-beam computed tomography (CBCT). Quality control of CBCT systems [EFOMP-ESTRO-IAEA PROTOCOL] is an essential part of quality assurance to periodically check that quality requirements are met, reduce uncertainties and errors and reduce the likelihood of accidents and incidents. Radiation exposure levels must be measured to ensure that patient doses associated with CBCT examinations are kept as low as reasonably achievable consistent with the required diagnostic information.
Introduction to References
The basics of CT are presented in the IAEA Handbook on the Physics of Diagnostic Radiology, Cody and Mahesh, and Sprawls. The intricacies of CT dose measurement are described in Nagel and dose management is discussed in the ICRP publication.