Effective dose: A useful concept in diagnostic radiology

Columbia University, New York, NY, USA.
Radiation Protection Dosimetry (Impact Factor: 0.91). 02/2008; 128(4):503-8. DOI: 10.1093/rpd/ncn056
Source: PubMed

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    • "The set of 'tissue weighting factors' has been revised periodically to reflect the latest epidemiological information, most recently in ICRP Publication 103(ICRP 2007a) which replaces the recommendations in IRCP Publication 60 (ICRP 1991). Although, the ICRP developed the concept of effective dose for the purpose of setting occupational dose limits for radiation protection, and stated that the effective dose concept should not be used to indicate risk for specific individuals, the quantity is still widely used by the radiology community to compare risk for patients who undergo x-ray imaging (McCollough and Schueler 2000, McNitt-Gray 2002, Brenner and Huda 2008). The effective dose is defined only for the ICRP reference adult models (ICRP 2009), but the methodology has been applied to other computational phantoms (Xu 2014). "
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    ABSTRACT: This paper describes the development and testing of VirtualDose-a software for reporting organ doses for adult and pediatric patients who undergo x-ray computed tomography (CT) examinations. The software is based on a comprehensive database of organ doses derived from Monte Carlo (MC) simulations involving a library of 25 anatomically realistic phantoms that represent patients of different ages, body sizes, body masses, and pregnant stages. Models of GE Lightspeed Pro 16 and Siemens SOMATOM Sensation 16 scanners were carefully validated for use in MC dose calculations. The software framework is designed with the 'software as a service (SaaS)' delivery concept under which multiple clients can access the web-based interface simultaneously from any computer without having to install software locally. The RESTful web service API also allows a third-party picture archiving and communication system software package to seamlessly integrate with VirtualDose's functions. Software testing showed that VirtualDose was compatible with numerous operating systems including Windows, Linux, Apple OS X, and mobile and portable devices. The organ doses from VirtualDose were compared against those reported by CT-Expo and ImPACT-two dosimetry tools that were based on the stylized pediatric and adult patient models that were known to be anatomically simple. The organ doses reported by VirtualDose differed from those reported by CT-Expo and ImPACT by as much as 300% in some of the patient models. These results confirm the conclusion from past studies that differences in anatomical realism offered by stylized and voxel phantoms have caused significant discrepancies in CT dose estimations.
    Full-text · Article · Jul 2015 · Physics in Medicine and Biology
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    • "The effective dose was defined by the International Commission of Radiological Protection (ICRP) as an estimate of the corresponding uniform whole-body dose when non-uniform irradiation was developed, such as medical imaging [11,12]. The effective dose is commonly used as an assessment tool for radiation exposure because it can provide a relative value of radiation exposure between different types or ranges of radiological examinations regardless of target organ or body part [13]. "
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    ABSTRACT: In contrast to patients with underlying cancer or chronic disease, injury patients are relatively young, and can be expected to live their natural lifespan if injuries are appropriately treated. Multiple and repeated diagnostic scans might be performed in these patients during admission. Nevertheless, radiation exposure in injury patients has been overlooked and underestimated because of the emergent nature of such situations. Therefore, we tried to assess the cumulative effective dose (cED) of injury patients in the emergency department. We included patients who visited the emergency department (ED) of a single tertiary hospital due to injury between February 2010 and February 2011. The cED for each patient was calculated and compared across age, sex and injury mechanism. A total of 11,676 visits (mean age: 28.0 years, M:F = 6,677:4,999) were identified. Although CT consisted of only 7.8% of total radiologic examinations (n=78,025), it accounted for 87.1% of the total cED. The mean cED per visit was 2.6 mSv. A significant difference in the cED among injury mechanisms was seen (p<0.001) and patients with traffic accidents and fall down injuries showed relatively high cED values. Hence, to reduce the cED of injury patients, an age-, sex- and injury mechanism-specific dose reduction strategy should be considered.
    Full-text · Article · Dec 2013 · PLoS ONE
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    • "If one is interested in quantifying the cancer risk for an individual patient to be submitted to a radiological procedure, one should find the latest age-, sex-and organ-or tissue-specific risk coefficients for cancer incidence and cancer mortality and multiply these coefficients with the average organ or tissue equivalent doses. Following a proposal made by D Brenner (Brenner and Huda 2008), the sum over risk-weighted organs and tissues equivalent doses can be considered as 'whole-body effective risk', given by the equation "
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    ABSTRACT: CALDose_X is a software tool that provides the possibility of calculating incident air kerma (INAK) and entrance surface air kerma (ESAK), two important quantities used in x-ray diagnosis, based on the output of the x-ray equipment. Additionally, the software uses conversion coefficients (CCs) to assess the absorbed dose to organs and tissues of the human body, the effective dose as well as the patient's cancer risk for radiographic examinations. The CCs, ratios between organ or tissue absorbed doses and measurable quantities, have been calculated with the FAX06 and the MAX06 phantoms for 34 projections of 10 commonly performed x-ray examinations, for 40 combinations of tube potential and filtration ranging from 50 to 120 kVcp and from 2.0 to 5.0 mm aluminum, respectively, for various field positions, for 29 selected organs and tissues and simultaneously for the measurable quantities, INAK, ESAK and kerma area product (KAP). Based on the x-ray irradiation parameters defined by the user, CALDose_X shows images of the phantom together with the position of the x-ray beam. By using true to nature voxel phantoms, CALDose_X improves earlier software tools, which were mostly based on mathematical MIRD5-type phantoms, by using a less representative human anatomy.
    Full-text · Article · Nov 2008 · Physics in Medicine and Biology
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