Advanced Computational Methods for Radiation Dose Optimization in CT

Shreekripa Rao; Krishna Sharan; Srinidhi Gururajarao Chandraguthi; Rechal Nisha Dsouza; Leena R David; Sneha Ravichandran; Mubarak Taiwo Mustapha; Dilip Shettigar; Berna Uzun; Rajagopal Kadavigere; Suresh Sukumar; Dilber Uzun Ozsahin

doi:10.3390/diagnostics14090921

Advanced Computational Methods for Radiation Dose Optimization in CT

Diagnostics (Basel). 2024 Apr 29;14(9):921. doi: 10.3390/diagnostics14090921.

Authors

Shreekripa Rao¹, Krishna Sharan², Srinidhi Gururajarao Chandraguthi², Rechal Nisha Dsouza¹, Leena R David^{3

4}, Sneha Ravichandran³, Mubarak Taiwo Mustapha^{5

6}, Dilip Shettigar³, Berna Uzun^{5

7}, Rajagopal Kadavigere⁸, Suresh Sukumar³, Dilber Uzun Ozsahin^{4

5

9}

Affiliations

¹ Department of Radiotherapy and Oncology, Manipal College of Health Professions, Manipal 576104, India.
² Department of Radiotherapy and Oncology, Kasturba Medical College and Hospital, Manipal 576104, India.
³ Department of Medical Imaging Technology, Manipal College of Health Professions, Manipal 576104, India.
⁴ Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates.
⁵ Operational Research Centre in Healthcare, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey.
⁶ Department of Biomedical Engineering, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey.
⁷ Department of Mathematics, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey.
⁸ Department of Radiodiagnosis and Imaging, Kasturba Medical College and Hospital, Manipal 576104, India.
⁹ Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates.

Abstract

Background: In planning radiotherapy treatments, computed tomography (CT) has become a crucial tool. CT scans involve exposure to ionizing radiation, which can increase the risk of cancer and other adverse health effects in patients. Ionizing radiation doses for medical exposure must be kept "As Low As Reasonably Achievable". Very few articles on guidelines for radiotherapy-computed tomography scans are available. This paper reviews the current literature on radiation dose optimization based on the effective dose and diagnostic reference level (DRL) for head, neck, and pelvic CT procedures used in radiation therapy planning. This paper explores the strategies used to optimize radiation doses, and high-quality images for diagnosis and treatment planning.

Methods: A cross-sectional study was conducted on 300 patients with head, neck, and pelvic region cancer in our institution. The DRL, effective dose, volumetric CT dose index (CTDI_vol), and dose-length product (DLP) for the present and optimized protocol were calculated. DRLs were proposed for the DLP using the 75th percentile of the distribution. The DLP is a measure of the radiation dose received by a patient during a CT scan and is calculated by multiplying the CT dose index (CTDI) by the scan length. To calculate a DRL from a DLP, a large dataset of DLP values obtained from a specific imaging procedure must be collected and can be used to determine the median or 75th-percentile DLP value for each imaging procedure.

Results: Significant variations were found in the DLP, CTDI_vol, and effective dose when we compared both the standard protocol and the optimized protocol. Also, the optimized protocol was compared with other diagnostic and radiotherapy CT scan studies conducted by other centers. As a result, we found that our institution's DRL was significantly low. The optimized dose protocol showed a reduction in the CTDI_vol (70% and 63%), DLP (60% and 61%), and effective dose (67% and 62%) for both head, neck, and pelvic scans.

Conclusions: Optimized protocol DRLs were proposed for comparison purposes.

Keywords: computed tomography; diagnostic reference level; dose-length product; effective dose; radiotherapy.

Grants and funding

This research was funded by the Indian Council of Medical Research (grant number 2020-5567).