Dose length product to effective dose coefficients in children

Philip W Chu; Cameron Kofler; Malini Mahendra; Yifei Wang; Cameron A Chu; Carly Stewart; Bradley N Delman; Brian Haas; Choonsik Lee; Wesley E Bolch; Rebecca Smith-Bindman

doi:10.1007/s00247-023-05638-1

Dose length product to effective dose coefficients in children

Pediatr Radiol. 2023 Jul;53(8):1659-1668. doi: 10.1007/s00247-023-05638-1. Epub 2023 Mar 16.

Authors

Philip W Chu¹, Cameron Kofler², Malini Mahendra^{3

4}, Yifei Wang¹, Cameron A Chu¹, Carly Stewart¹, Bradley N Delman⁵, Brian Haas⁶, Choonsik Lee⁷, Wesley E Bolch⁸, Rebecca Smith-Bindman^{9

10

11}

Affiliations

¹ Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, Box 0560, San Francisco, CA, 94143, USA.
² Department of Radiology, The University of Chicago, Chicago, IL, USA.
³ Department of Pediatrics, Division of Pediatric Critical Care, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, USA.
⁴ Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA.
⁵ Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁶ Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
⁷ Radiation Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
⁸ Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
⁹ Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, Box 0560, San Francisco, CA, 94143, USA. Rebecca.Smith-Bindman@ucsf.edu.
¹⁰ Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA. Rebecca.Smith-Bindman@ucsf.edu.
¹¹ Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA. Rebecca.Smith-Bindman@ucsf.edu.

Abstract

Background: The most accurate method for estimating effective dose (the most widely understood metric for tracking patient radiation exposure) from computed tomography (CT) requires time-intensive Monte Carlo simulation. A simpler method multiplies a scalar coefficient by the widely available scanner-reported dose length product (DLP) to estimate effective dose.

Objective: Develop pediatric effective dose coefficients and assess their agreement with Monte Carlo simulation.

Materials and methods: Multicenter, population-based sample of 128,397 pediatric diagnostic CT scans prospectively assembled in 2015-2020 from the University of California San Francisco International CT Dose Registry and the University of Florida library of highly realistic hybrid computational phantoms. We generated effective dose coefficients for seven body regions, stratified by patient age, diameter, and scanner manufacturer. We applied the new coefficients to DLPs to calculate effective doses and assessed their correlations with Monte Carlo radiation transport-generated effective doses.

Results: The reported effective dose coefficients, generally higher than previous studies, varied by body region and decreased in magnitude with increasing age. Coefficients were approximately 4 to 13-fold higher (across body regions) for patients <1 year old compared with patients 15-21 years old. For example, head CT (54% of scans) dose coefficients decreased from 0.039 to 0.003 mSv/mGy-cm in patients <1 year old vs. 15-21 years old. There were minimal differences by manufacturer. Using age-based conversion coefficients to estimate effective dose produced moderate to strong correlations with Monte Carlo results (Pearson correlations 0.52-0.80 across body regions).

Conclusions: New pediatric effective dose coefficients update existing literature and can be used to easily estimate effective dose using scanner-reported DLP.

Keywords: Computed tomography; Effective dose coefficients; Registry.

Publication types

Multicenter Study

MeSH terms

Adolescent
Adult
Child
Computer Simulation
Humans
Infant
Monte Carlo Method
Phantoms, Imaging
Radiation Dosage
Radiometry* / methods
Tomography, X-Ray Computed* / methods
Young Adult

Abstract

Publication types

MeSH terms

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