Technical Note: Measurement of bow tie profiles in CT scanners using radiochromic film.

PURPOSE: To provide a noninvasive technique to measure the intensity profile of the fan beam in a computed tomography (CT) scanner that is cost effective and easily implemented without the need to access proprietary scanner information or service modes. METHODS: The fabrication of an inexpensive aperture is described, which is used to expose radiochromic film in a rotating CT gantry. A series of exposures is made, each of which is digitized on a personal computer document scanner, and the resulting data set is analyzed to produce a self-consistent calibration of relative radiation exposure. The bow tie profiles were analyzed to determine the precision of the process and were compared to two other measurement techniques, direct measurements from CT gantry detectors and a dynamic dosimeter. RESULTS: The radiochromic film method presented here can measure radiation exposures with a precision of ∼ 6% root-mean-square relative error. The intensity profiles have a maximum 25% root-mean-square relative error compared with existing techniques. CONCLUSIONS: The proposed radiochromic film method for measuring bow tie profiles is an inexpensive (∼$100 USD + film costs), noninvasive method to measure the fan beam intensity profile in CT scanners.

Measurement of bow tie profiles in CT scanners using a real-time dosimeter.

PURPOSE: Several areas of computed tomography (CT) research require knowledge about the intensity profile of the x-ray fan beam that is introduced by a bow tie filter. This information is considered proprietary by CT manufacturers, so noninvasive measurement methods are required. One method using real-time dosimeters has been proposed in the literature. A commercially available dosimeter was used to apply that method, and analysis techniques were developed to extract fan beam profiles from measurements. METHODS: A real-time ion chamber was placed near the periphery of an empty CT gantry and the dose rate versus time waveform was recorded as the x-ray source rotated about the isocenter. In contrast to previously proposed analysis methods that assumed a pointlike detector, the finite-size ion chamber received varying amounts of coverage by the collimated x-ray beam during rotation, precluding a simple relationship between the source intensity as a function of fan beam angle and measured intensity. A two-parameter model for measurement intensity was developed that included both effective collimation width and source-to-detector distance, which then was iteratively solved to minimize the error between duplicate measurements at corresponding fan beam angles, allowing determination of the fan beam profile from measured dose-rate waveforms. Measurements were performed on five different scanner systems while varying parameters such as collimation, kVp, and bow tie filters. On one system, direct measurements of the bow tie profile were collected for comparison with the real-time dosimeter technique. RESULTS: The data analysis method for a finite-size detector was found to produce a fan beam profile estimate with a relative error between duplicate measurement intensities of <5%. It was robust over a wide range of collimation widths (e.g., 1-40 mm), producing fan beam profiles that agreed with a relative error of 1%-5%. Comparison with a direct measurement technique on one system produced agreement with a relative error of 2%-6%. Fan beam profiles were found to differ for different filter types on a given system and between different vendors. CONCLUSIONS: A commercially available real-time dosimeter probe was found to be a convenient and accurate instrument for measuring fan beam profiles. An analysis method was developed that could handle a wide range of collimation widths by explicitly considering the finite width of the ion chamber. Relative errors in the profiles were found to be less than 5%. Measurements of five different clinical scanners demonstrate the variation in bow tie designs, indicating that generic bow tie models will not be adequate for CT system research.

Comparison of simulated cone beam computed tomography to conventional helical computed tomography for imaging of rhinosinusitis.

OBJECTIVES/HYPOTHESIS: Cone beam computed tomography (CBCT) has emerged as a low radiation dose alternative to traditional computed tomography (CT) to evaluate the paranasal sinuses. The purpose of our study was to determine how often clinically important findings would be missed if CBCT was used routinely for sinus imaging. STUDY DESIGN: Retrospective review. METHODS: We evaluated all maxillofacial CT scans performed for sinusitis over a 1-year period. The original multidetector CT (MDCT) images were reviewed retrospectively. A theoretical CBCT was then created from the original study utilizing only the bone algorithm images and separately reviewed. We calculated the proportion of abnormal findings that were identified on the MDCT but would have been missed by the theoretical CBCT, and reviewed the medical record to determine which potentially missed findings would have changed management. Radiation dose from the MDCT scanners was calculated and compared to published dose estimates for the paranasal sinuses on CBCT. RESULTS: Maxillofacial CTs from 361 consecutive patients were included, of which 12 (3.3%) demonstrated findings that would have been missed on the theoretical CBCT. Of those, four (1.1%) would have resulted in a change in management. Effective radiation dose for our scanners ranged from 0.67 mSv to 2.15 mSv, compared to a published estimated dose of 0.2 mSV for CBCT. CONCLUSIONS: In the majority of patients undergoing simulated CBCT for evaluation of sinusitis, incidental findings of soft-tissue disease were rare. With appropriate selection of patients, CBCT can offer substantial radiation dose reduction and may provide a viable alternative to standard MDCT sinus imaging protocols.

Evaluation of a limited three-slice head CT protocol for monitoring patients with ventriculoperitoneal shunts.

OBJECTIVE: Patients with a ventriculoperitoneal shunt for the management of hydrocephalus often undergo multiple head CT examinations for assessment of shunt malfunction. The purpose of this study was to evaluate whether a limited three-slice CT protocol would consistently provide adequate information for the diagnosis of shunt malfunction with a decrease in effective dose. MATERIALS AND METHODS: The study group included 231 unenhanced head CT examinations performed on 128 patients with shunts for hydrocephalus. The original contiguous CT images were reviewed retrospectively. A theoretic limited three-slice study was then created from the original complete CT study and separately reviewed. This limited three-slice study was created by using the lateral topographic image to select three axial locations as follows: midpoint between foramen magnum and vertex, top of the mastoid air cells, and orbital roof. The limited study was graded for parameters of image adequacy with the original full protocol study as the reference standard. RESULTS: Twenty-four of the 231 (10.4%) full studies had findings consistent with shunt failure; all 231 studies would have been correctly categorized with the limited three-slice protocol. The sensitivity of three-slice CT for identifying the ventricular system was 91.6% and for identifying the catheter tip, 93.5%. Limited-slice CT examination would have resulted in greater than 90% mean dose reduction in both adult and pediatric populations. CONCLUSION: Unenhanced head CT with a limited-slice protocol provides adequate diagnostic information for the diagnosis of shunt malfunction with a greater than 90% reduction in effective dose.