Coronary computed tomography angiographic detection of in-stent restenosis via deep learning reconstruction: a feasibility study.

OBJECTIVES: Evaluation of in-stent restenosis (ISR), especially for small stents, remains challenging during computed tomography (CT) angiography. We used deep learning reconstruction to quantify stent strut thickness and lumen vessel diameter at the stent and compared it with values obtained using conventional reconstruction strategies. METHODS: We examined 166 stents in 85 consecutive patients who underwent CT and invasive coronary angiography (ICA) within 3 months of each other from 2019-2021 after percutaneous coronary intervention with coronary stent placement. The presence of ISR was defined as percent diameter stenosis ≥ 50% on ICA. We compared a super-resolution deep learning reconstruction, Precise IQ Engine (PIQE), and a model-based iterative reconstruction, Forward projected model-based Iterative Reconstruction SoluTion (FIRST). All images were reconstructed using PIQE and FIRST and assessed by two blinded cardiovascular radiographers. RESULTS: PIQE had a larger full width at half maximum of the lumen and smaller strut than FIRST. The image quality score in PIQE was higher than that in FIRST (4.2 ± 1.1 versus 2.7 ± 1.2, p < 0.05). In addition, the specificity and accuracy of ISR detection were better in PIQE than in FIRST (p < 0.05 for both), with particularly pronounced differences for stent diameters < 3.0 mm. CONCLUSION: PIQE provides superior image quality and diagnostic accuracy for ISR, even with stents measuring < 3.0 mm in diameter. CLINICAL RELEVANCE STATEMENT: With improvements in the diagnostic accuracy of in-stent stenosis, CT angiography could become a gatekeeper for ICA in post-stenting cases, obviating ICA in many patients after recent stenting with infrequent ISR and allowing non-invasive ISR detection in the late phase. KEY POINTS: • Despite CT technology advancements, evaluating in-stent stenosis severity, especially in small-diameter stents, remains challenging. • Compared with conventional methods, the Precise IQ Engine uses deep learning to improve spatial resolution. • Improved diagnostic accuracy of CT angiography helps avoid invasive coronary angiography after coronary artery stenting.

Comparison of lung CT number and airway dimension evaluation capabilities of ultra-high-resolution CT, using different scan modes and reconstruction methods including deep learning reconstruction, with those of multi-detector CT in a QIBA phantom study.

OBJECTIVE: Ultra-high-resolution CT (UHR-CT), which can be applied normal resolution (NR), high-resolution (HR), and super-high-resolution (SHR) modes, has become available as in conjunction with multi-detector CT (MDCT). Moreover, deep learning reconstruction (DLR) method, as well as filtered back projection (FBP), hybrid-type iterative reconstruction (IR), and model-based IR methods, has been clinically used. The purpose of this study was to directly compare lung CT number and airway dimension evaluation capabilities of UHR-CT using different scan modes with those of MDCT with different reconstruction methods as investigated in a lung density and airway phantom design recommended by QIBA. MATERIALS AND METHODS: Lung CT number, inner diameter (ID), inner area (IA), and wall thickness (WT) were measured, and mean differences between measured CT number, ID, IA, WT, and standard reference were compared by means of Tukey's HSD test between all UHR-CT data and MDCT reconstructed with FBP as 1.0-mm section thickness. RESULTS: For each reconstruction method, mean differences in lung CT numbers and all airway parameters on 0.5-mm and 1-mm section thickness CTs obtained with SHR and HR modes showed significant differences with those obtained with the NR mode on UHR-CT and MDCT (p < 0.05). Moreover, the mean differences on all UHR-CTs obtained with SHR, HR, or NR modes were significantly different from those of 1.0-mm section thickness MDCTs reconstructed with FBP (p < 0.05). CONCLUSION: Scan modes and reconstruction methods used for UHR-CT were found to significantly affect lung CT number and airway dimension evaluations as did reconstruction methods used for MDCT. KEY POINTS: • Scan and reconstruction methods used for UHR-CT showed significantly higher CT numbers and smaller airway dimension evaluations as did those for MDCT in a QIBA phantom study (p < 0.05). • Mean differences in lung CT number for 0.25-mm, 0.5-mm, and 1.0-mm section thickness CT images obtained with SHR and HR modes were significantly larger than those for CT images at 1.0-mm section thickness obtained with MDCT and reconstructed with FBP (p < 0.05). • Mean differences in inner diameter (ID), inner area (IA), and wall thickness (WT) measured with SHR and HR modes on 0.5- and 1.0-mm section thickness CT images were significantly smaller than those obtained with NR mode on UHR-CT and MDCT (p < 0.05).

[Survey of Recognition, Utilization, and Evaluation for Diagnostic Reference Levels in the Field of X-ray Computed Tomography].

A survey on recognition, utilization, and evaluation for diagnostic reference levels (DRLs) after establishing Japan DRLs 2015 in the field of X-ray computed tomography (CT) was conducted for members of Japanese Society of Radiological Technology using web-based questionnaire system. The survey consisted of provincial branches to which respondents belong, their occupation, years of professional experience, years of experience in X-ray CT section, recognition of DRLs, and utilization and evaluation of DRLs in the field of X-ray CT section. Each survey item had one to eight questions. A total of 369 members completed the questionnaire. Among them, 295 out of 369 (79.9%) members knew that DRLs were released in Japan. After establishing the DRLs, 226 of 330 (68.5%) and 123 of 319 (38.6%) members investigated the doses used for adult and pediatric CT at their facilities, respectively. Although 345 of 369 (93.5%) members answered that DRLs are necessary for the field of X-ray CT, only 142 of 369 (38.5%) members thought that the established DRLs are enough to use in the field of X-ray CT. The survey has clarified the current status of recognition, utilization, and evaluation for DRLs in the field of X-ray CT after establishing the DRLs in Japan.

The most effective influence of 17-(3-ethoxypropyl) substituent on the binding affinity and the agonistic activity in KNT-127 derivatives, δ opioid receptor agonists.

We investigated the structure-activity relationship of KNT-127 (opioid δ agonist) derivatives with various 17-substituents which are different in length and size. The 17-substituent in KNT-127 derivatives exerted a great influence on the affinity and agonistic activity for the δ receptor. While the compounds with electron-donating 17-substituents showed higher affinities for the δ receptor than those with electron-withdrawing groups, KNT-127 derivatives with 17-fluoroalkyl groups (the high electron-withdrawing groups) showed high selectivities for the δ receptor among evaluated compounds. In addition, the basicity of nitrogen as well as the structure of the 17-N substituent such as the length and configuration at an asymmetric carbon atom contributed to agonist properties for the δ receptor. Thus, the analog with a 17-(3-ethoxypropyl) group showed the best selectively and potent agonistic activity for the δ receptor among KNT-127 derivatives. These findings should be useful for designing novel δ selective agonists.

Utilization of Saccharomyces cerevisiae recombinant strain incapable of both ethanol and glycerol biosynthesis for anaerobic bioproduction.

The yeast Saccharomyces cerevisiae produces ethanol and glycerol as major unwanted byproducts, unless ethanol and glycerol are the target compounds. Minimizing the levels of these byproducts is important for bioproduction processes using yeast cells. In this study, we constructed a yeast strain in which both ethanol and glycerol production pathways were disrupted and examined its culture characteristics. In wild-type yeast strain, metabolic pathways that produce ethanol and glycerol play an important role in reoxidizing nicotinamide adenine dinucleotide (NADH) generated during glycolysis, particularly under anaerobic conditions. Strains in which both pathways were disrupted therefore failed to grow and consume glucose under anaerobic conditions. Introduction of desired metabolic reaction(s) coupled with NADH oxidation enabled the engineered strain to consume substrate and produce target compound(s). Here we introduced NADH-oxidization-coupled L-lactate production mechanisms into a yeast strain incapable of ethanol and glycerol biosynthesis, based on in silico simulation using a genome-scale metabolic model of S. cerevisiae. From the results of in silico simulation based on flux balance analysis, a feasible anaerobic non-growing metabolic state, in which L-lactate yield approached the theoretical maximum, was identified and this phenomenon was verified experimentally. The yeast strain incapable of both ethanol and glycerol biosynthesis is a potentially valuable host for bioproduction coupled with NADH oxidation under anaerobic conditions.

Synthesis of quinolinomorphinan derivatives as highly selective δ opioid receptor ligands.

We have reported previously the novel δ opioid agonist KNT-127 which showed high affinity and selectivity for the δ receptor. Moreover, the analgesic effect of subcutaneously administered KNT-127 was more potent than that of a prototypical δ agonist (-)-TAN-67 in the acetic acid writhing test. This study of the structure-activity relationship of KNT-127 derivatives focused on the introduction of substituents onto the 5'-, 6'-, 7'- or 8'-position of the quinoline ring and revealed that many derivatives with 5'- or 8'-substituents showed high affinities and selectivities for the δ receptor. Especially, SYK-153 with an 8'-OH group showed the highest affinity and the most balanced and highest selectivity for the δ receptor among the synthesized compounds.

Synthesis of quinolinomorphinan-4-ol derivatives as δ opioid receptor agonists.

The previously reported morphinan derivative SN-28 showed high selectivity and agonist activity for the δ opioid receptor. In the course of examining the structure-activity relationship of SN-28 derivatives, the derivatives with the 4-hydroxy group (SN-24, 26, 27) showed higher selectivities for the δ receptor over the µ receptor than the corresponding SN-28 derivatives with the 3-hydroxy group (SN-11, 23, 28). Derivatives with the 4-hydroxy group showed potent agonist activities for the δ receptor in the [(35)S]GTPγS binding assay. Although the 17-cyclopropylmethyl derivative (SN-11) with a 3-hydroxy group showed the lowest selectivity for the δ receptor among the morphinan derivatives, the agonist activity toward the δ receptor was the most potent for candidates with the 3-hydroxy group.

Comprehensive phenotypic analysis of single-gene deletion and overexpression strains of Saccharomyces cerevisiae.

We quantified the growth behaviour of all available single-gene deletion and overexpression strains of budding yeast. Genome-wide analyses enabled the extraction of the genes and identification of the functional categories for which genetic perturbation caused the change of growth behaviour. Statistical analyses revealed defective growth for 646 deletion and 1302 overexpression strains. We classified these deleted and overexpressed genes into known functional categories, and identified several functional categories having fragility and robustness for cellular growth. We also screened the deletion and overexpression strains that exhibited a significantly higher growth rate than the strain without genetic perturbation, and found that three deletion and two overexpression strains were high-growth strains. The genes and functional categories identified in the analysis might provide useful information on designing industrially useful yeast strains.

Evaluation of swallowing using 320-detector-row multislice CT. Part I: single- and multiphase volume scanning for three-dimensional morphological and kinematic analysis.

A 320-detector-row multislice computed tomography (320-MSCT) scanner can acquire a volume data set covering a maximum range of 16 cm and can generate axial images 0.5-mm thick at 0.5-mm intervals. Three-dimensional (3D) images reconstructed from the thin axial slices include multiplanar reconstruction and 3D-CT. Single-phase 3D images are reconstructed from 0.175-s data, and multiphase 3D images are created in 29 phases at intervals of 0.1 s. Continuous replay of these 3D images produces four-dimensional moving images. In order to determine the feasibility of the morphologic and kinematic analyses of swallowing using 320-MSCT, single-phase volume scanning was performed on three patients and multiphase volume scanning was performed on one healthy volunteer. The single-phase 3D images clearly and accurately showed the structures involved in swallowing, and the multiphase 3D images were able to show the oral stage to the early esophageal stage of swallowing, allowing a kinematic analysis of swallowing. We developed a reclining chair that allows scanning to be performed with the subject in a semisitting position, which makes swallowing evaluation by 320-MSCT applicable not only to research on healthy swallowing but also to the clinical examination of dysphagia patients.

Synthesis of pyrrolomorphinan derivatives as kappa opioid agonists.

We synthesized pyrrolomorphinan derivatives 6, 7, and 9 to examine whether the pyrrole ring would be an accessory site in the kappa opioid receptor selective antagonist, nor-binaltorphimine. Derivative 6 had an alpha,beta-unsaturated ketone substituent that strongly bound to the kappa receptor. The compound with the highest kappa receptor selectivity, 6e, produced a dose-dependent antinociceptive effect in the mouse acetic acid writhing test. However, derivatives 7 and 9, which did not have alpha,beta-unsaturated ketone substituents, showed less kappa receptor selectivity than compound 6. Based on structure-activity relationships, we proposed that these compounds adopted active structures for kappa selective agonist activity. The pyrrole ring would not function as an accessory site, but the ability of the side chain on the pyrrole ring to localize above the C-ring appeared to confer kappa selective agonist activity. These results will promote the design of novel kappa agonists.

[Automatic selection of optimal cardiac-phase in coronary CT angiography--its clinical usefulness for patients with atrial fibrillation].

The optimal cardiac phases for coronary CT angiography (CTA) are end-systole and mid-diastole, in which cardiac movement is slow. In conventional methods, these cardiac phases are determined by visual selection. We have compared the images in the optimal cardiac phases that were selected by the conventional method and cardiac-phase search software (Phase Navi), and examined the clinical usefulness of Phase Navi in patients with atrial fibrillation. The subjects were 38 patients (regular rhythm: 20, atrial fibrillation: 18). The continuity scores of patients with regular rhythm (Phase Navi, conventional methods) were 2.4+/-0.3-2.5+/-0.3 in end-systole and 2.4+/-0.5-2.4+/-0.4 in mid-diastole. The scores of patients with atrial fibrillation (Phase Navi, conventional methods) were 2.3+/-0.4-2.3+/-0.4 in end-systole, and 2.2+/-0.5-2.1+/-0.6 in mid-diastole. Because the continuity scores of the optimal images from Phase Navi were similar to those from the conventional method, Phase Navi had clinical usefulness in patients with atrial fibrillation.

Fluctuation of quantitative values on acquisition time and the reconstruction conditions in 99mTc-SPECT.

OBJECTIVE: This study aims to carry out a quantitative analysis with high reproducibility using single-photon emission computed tomography/computed tomography (SPECT/CT); we investigated the optimum parameters for the acquisition and the reconstruction. MATERIALS AND METHODS: SPECT images were acquired with varying time per view using SPECT phantom (JS-10) and the body phantom of National Electrical Manufacturers Association and International Electrotechnical Commission (Body-phantom), respectively. For the image reconstruction condition, we changed the product of subset and iteration (SI product) and the Gaussian filter using a three-dimensional ordered subset expectation maximization. A combination of no scattering correction and no attenuation correction (SC-/AC-) and a combination of scattering correction and attenuation correction by CT images (SC+/AC+) were performed. The dose linearity, the recovery coefficient, the scatter ratio, and the coefficient of variation were evaluated using JS-10. Using Body-phantom, contrast-to-noise ratios of the hot spheres (13, 17 mm) were calculated. Moreover, the change in the maximum standardized uptake value (SUVmax) and the average SUV (SUVmean) were evaluated for each sphere. RESULT: From the evaluation results using the JS-10, dose linearity, recovery coefficient, scatter ratio, and coefficient of variation were all good when time per view was 50-150 s, the Gaussian filter was 8-12 mm, and the SI product was 150. From the evaluation results using Body-phantom, comparing the Gaussian filter with 8 mm and 12 mm, the contrast-to-noise ratio was better for 12 mm and the error rate to the change of the scan-time was up to 3.7%. However, SUVmax and SUVmean using 8 mm were closer to the design value of the phantom. CONCLUSION: It is necessary that Quantitative SPECT be acquired at 50 s or more per view per detection, reconstructed using a three-dimensional ordered subset expectation maximization with SC+/AC+, the SI product is 150 times, and the Gaussian Filter is 8-12 mm. This suggested that the quantitative analysis would be carried out with good reproducibility.

New weighting factor of weighted CTDI equation for PMMA phantom diameter from 8 to 40 cm: A Monte Carlo study.

PURPOSE: The weighted computed tomography dose index (CTDIw ) uses measured CTDI values at the center and periphery of a cylindrical phantom. The CTDIw value is calculated using conventional, Bakalyar's, and Choi's weighting factors. However, these weighting factors were produced from only 16- and 32-cm-diameter cylindrical phantoms. This study aims to devise new weighting factors to provide more accurate average dose in the central cross-sectional plane of cylindrical phantoms over a wide range of object diameters, by using Monte Carlo simulations. METHODS: Simulations were performed by modeling a Toshiba Aquilion ONE CT scanner, in order to compute the cross-sectional dose profiles of polymethyl methacrylate (PMMA) cylindrical phantoms of each diameter (8-40 cm at 4-cm steps), for various tube voltages and longitudinal beam widths. Two phantom models were simulated, corresponding to the CTDI100 method and the method recommended by American Association of Physicists in Medicine (AAPM) task group 111. The dose-computation PMMA cylinders of 1 mm diameter were located between the phantom surfaces and the centers at intervals of 1 mm, from which cross-sectional dose profiles were calculated. By using linear least-squares fits to the obtained cross-sectional dose profiles data, we determined new weighting factors to estimate more accurate average doses in the PMMA cylindrical phantoms by using the CTDIw equation: CTDIw = Wcenter ・ CTDIcenter + Wperiphery ・ CTDIperiphery . In order to demonstrate the validity of the devised new weighting factors, the percentage difference between average dose and CTDIw value was evaluated for the weighting factors (conventional, Bakalyar's, Choi's, and devised new weighting factors) in each calculated cross-sectional dose profile. RESULTS: With the use of linear least-squares techniques, new weighting factors (Wcenter = 3/8 and Wperiphery = 5/8 where Wcenter and Wperiphery are weighting factors for CTDIcenter and CTDIperiphery ) were determined. The maximum percentage differences between average dose and CTDIw value were 16, -12, -8, and -6% for the conventional, Bakalyar's, Choi's, and devised new weighting factors, respectively. CONCLUSIONS: We devised new weighting factors (Wcenter = 3/8 and Wperiphery = 5/8) to provide more accurate average dose estimation in PMMA cylindrical phantoms over a wide range of diameter. The CTDIw equation with devised new weighting factors could estimate average dose in PMMA cylindrical phantoms with a maximum difference of -6%. The results of this study can estimate the average dose in PMMA cylindrical phantoms more accurately than the conventional weighting factors (Wcenter = 1/3 and Wperiphery = 2/3).

Influence of 320-detector-row volume scanning and AAPM report 111 CT dosimetry metrics on size-specific dose estimate: a Monte Carlo study.

The American Association of Physicists in Medicine (AAPM) task group 204 has recommended the use of size-dependent conversion factors to calculate size-specific dose estimate (SSDE) values from volume computed tomography dose index (CTDIvol) values. However, these conversion factors do not consider the effects of 320-detector-row volume computed tomography (CT) examinations or the new CT dosimetry metrics proposed by AAPM task group 111. This study aims to investigate the influence of these examinations and metrics on the conversion factors reported by AAPM task group 204, using Monte Carlo simulations. Simulations were performed modelling a Toshiba Aquilion ONE CT scanner, in order to compute dose values in water for cylindrical phantoms with 8-40-cm diameters at 2-cm intervals for each scanning parameter (tube voltage, bow-tie filter, longitudinal beam width). Then, the conversion factors were obtained by applying exponential regression analysis between the dose values for a given phantom diameter and the phantom diameter combined with various scanning parameters. The conversion factors for each scanning method (helical, axial, or volume scanning) and CT dosimetry method (i.e., the CTDI100 method or the AAPM task group 111 method) were in agreement with those reported by AAPM task group 204, within a percentage error of 14.2 % for phantom diameters ≥11.2 cm. The results obtained in this study indicate that the conversion factors previously presented by AAPM task group 204 can be used to provide appropriate SSDE values for 320-detector-row volume CT examinations and the CT dosimetry metrics proposed by the AAPM task group 111.

Pin-photodiode array for the measurement of fan-beam energy and air kerma distributions of X-ray CT scanners.

PURPOSE: Patient dose estimation in X-ray computed tomography (CT) is generally performed by Monte Carlo simulation of photon interactions within anthropomorphic or cylindrical phantoms. An accurate Monte Carlo simulation requires an understanding of the effects of the bow-tie filter equipped in a CT scanner, i.e. the change of X-ray energy and air kerma along the fan-beam arc of the CT scanner. To measure the effective energy and air kerma distributions, we devised a pin-photodiode array utilizing eight channels of X-ray sensors arranged at regular intervals along the fan-beam arc of the CT scanner. METHODS: Each X-ray sensor consisted of two plate type of pin silicon photodiodes in tandem - front and rear photodiodes - and of a lead collimator, which only allowed X-rays to impinge vertically to the silicon surface of the photodiodes. The effective energy of the X-rays was calculated from the ratio of the output voltages of the photodiodes and the dose was calculated from the output voltage of the front photodiode using the energy and dose calibration curves respectively. RESULTS: The pin-photodiode array allowed the calculation of X-ray effective energies and relative doses, at eight points simultaneously along the fan-beam arc of a CT scanner during a single rotation of the scanner. CONCLUSIONS: The fan-beam energy and air kerma distributions of CT scanners can be effectively measured using this pin-photodiode array.

[Evaluation of time resolution in cardiac synchronized image reconstruction using multi-slice CT].

One of the newest CT application technologies is cardiac synchronized image reconstruction. In this technology, evaluation of time-resolution is very important. We developed a method of measuring time-resolution in cardiac synchronized reconstruction, and evaluated various scanning protocols. In our experiment, ECG-gated scanning was done by multi-slice CT (Aquilion16 Super Heart Edition, Toshiba Medical Systems Co., Ltd., Japan). The nominal slice thickness was 0.5 mm, and rotation time was 0.5 sec. Input heart rate was set at 40, 45, 50, 55, 60, 70, 75, 80, and 90 bpm, and helical pitch at 3.2, 4.0, and 4.8 (beam-pitch: 0.200, 0.250 and 0.300). We measured FWTM of the obtained sensitivity distribution and compared at each scanning protocol. Time resolution improved as helical pitch decreased and heart rate increased. However, phase-time resolution deteriorated as heart rate increased. The results of our experiment indicated that a segment center was determined by X-ray tube rotation time and heart rate, and the number of segments was determined by heart rate, helical pitch, and reconstruction position. Time resolution changed with X-ray tube rotation time, heart rate, helical pitch, and reconstruction position. In this report, we provide a reference for an optimal scanning protocol in cardiac synchronized image reconstruction.

[The improvement in the cerebral blood flow analysis software in case of CT-perfusion inspection and the examination of the scan protocol].

In our hospital, CT-perfusion was introduced in April, 2002. It is used to diagnose, to determine what treatment to use and to prognosticate cerebral blood flow after operation in super acute period brain infarct. At the beginning of the introduction, processing time and dosage for partial areas needed improvement. Therefore, we investigated the possibility of shorter processing time and lower dosage of radiation with the help of improvement in the analysis software as well as a different scan method. Two methods of reducing radiation dosage were examined. (1) The speed of X-ray rotation was slowed down; while photon per image was maintained, total mAs was lowered. (2) Continuation scan was replaced by intermission one. Analyzing time with older and newer version of analysis software was compared. The dosage was able to decrease by 25% as a result of the rotation speed slowed down; it became further less by 50% with the intermission scan. Processing such as the vein extraction was automated by using new analysis software and successfully shorten the analysing time without damaging the reliability of analyses. We forecast that more clinical research on further lowering dosage and stabilization of analyzing will enable us to provide better information.

[Visualization of coronary artery stents by MSCT at 0.5-mm slice thickness].

Coronary artery visualization by multi-slice CT and the evaluation of coronary stenosis were examined. Multi-slice CT could not be used for evaluation after the coronary artery stent custody method. We examined various coronary artery stent custody phantoms and stent visualization of clinical examples by using multi-slice CT with a slice thickness of 0.5 mm. ECG-gated scanning was done by inputting ECG using 4DAS (Data Acquisition System) multi-slice CT with a slice thickness of 0.5 mm. We carried out image reconstruction, measured the CT number, and examined the inside stent. The CT number of the inside stent rose in accordance with stent diameter. The inside stent was visualized clearly at 0.5 mm in comparison with 1.0 mm in slice thickness. Visualization of the lumen was influenced in the Stent Custody Phantom by the quality of the stent material, Strut form, and the size of the diameter. The inside stent could be evaluated with the S670 4 mmphi stent. Form evaluation of the inside stent was possible, although the cavity in the stent was influenced by the difference in distance between peaks.

[Dose estimation with CTDI100, air in computed tomography].

Although the principal dosimetric quantity in computed tomography (CT) can be assessed using a pencil ionization chamber with an active length of 100 mm, standard CT dosimetry phantoms of polymethylmethacrylate (PMMA) , and plates of aluminum, most facilities do not possess the requisites. We present a practical method of estimating CTDI(100, c), CTDI(100, p) and the half-value layer (HVL) from CTDI(100, air), which is measured parallel with the axis of rotation of the scanner to free-in-air. The three data chosen for this method of estimation were as follows: 1) the relation of HVL to CTDI(100, air) per radiographic exposure (mAs); 2) the relation of HVL to CTDI(100, c) per CTDI(100, air); 3) the relation of HVL to CTDI(100, p) per CTDI(100, air). The data were based on the measured values of six CT scanners, so as to avoid dependence on the technical characteristics of a specific manufacturer. The estimated value has a possible maximum uncertainty of 20%, although this method of estimation is practical for dose assessment.

Influence of difference in cross-sectional dose profile in a CTDI phantom on X-ray CT dose estimation: a Monte Carlo study.

The longitudinal dose profile in a computed tomography dose index (CTDI) phantom had been studied by many researchers. The cross-sectional dose profile in the CTDI phantom, however, has not been studied. It is also important to understand the cross-sectional dose profile in the CTDI phantom for dose estimation in X-ray CT. In this study, the cross-sectional dose profile in the CTDI phantom was calculated by use of a Monte Carlo (MC) simulation method. A helical or a 320-detector-row cone-beam X-ray CT scanner was simulated. The cross-sectional dose profile in the CTDI phantom from surface to surface through the center point was calculated by MC simulation. The shape of the calculation region was a cylinder of 1-mm-diameter. The length of the cylinder was 23, 100, or 300 mm to represent various CT ionization chamber lengths. Detailed analyses of the energy depositions demonstrated that the cross-sectional dose profile was different in measurement methods and phantom sizes. In this study, we also focused on the validation of the weighting factor used in weighted CTDI (CTDI w ). As it stands now, the weighting factor used in CTDI w is (1/3, 2/3) for the (central, peripheral) axes. Our results showed that an equal weighting factor, which is (1/2, 1/2) for the (central, peripheral) axes, is more suitable to estimate the average cross-sectional dose when X-ray CT dose estimation is performed.