Peak skin and eye lens radiation dose from brain perfusion CT: CTDIvol and Monte Carlo based estimations. Issue 126 (May 2020) - Lopez-Rendon, X.
Highlights: MC simulations allow more flexibility to evaluate organ doses in realistic models. CTDIvol should be used with caution for peak skin dose. CTDIvol can be used as a conservative metric for average organ dose estimations. Abstract: Purpose: To quantify the eye lens, peak skin and brain doses associated with head CT perfusion exam by means of thermoluminescent dosimeters (TLDs) measurements in a cadaver and compare them to Monte Carlo (MC) dose estimations as well as to the CTDIvol . Method: 18 TLDs were inserted in the brain, skin, and eye lenses of a female cadaver head, who underwent a CT brain perfusion scan using a Siemens Definition Flash. The table-toggling protocol used 80 kVp, 200 mAs, 32 × 1.2 mm collimation and 30 sequences. From the CT images, a voxel model was created. Doses were calculated with a MC framework (EGSnrc) and compared to TLD measurements. TLD measurements were also compared to the displayed CTDIvol . Results: The average measured doses were: 185 mGy for the eyes lenses, 107 mGy for the skin, 172 mGy for the brain and 273 mGy for the peak skin. The reported CTDIvol of 259 mGy overestimated the averaged organ doses but not the peak skin dose. MC estimated organ doses were 147 mGy for the eyes (average), 104 mGy for the skin and 178 mGy for the brain (-20 %, -3% and 4% difference respect to the TLDs measurements, respectively). Conclusions: CTDIvol remains a conservative metric for average brain, skin and eyes lenses doses. For accurate eye lens and skin dose estimates MC simulations can be used. CTDIvol should be used with caution as it was of the same order of magnitude as the peak skin dose for this protocol and this particular CT scanner.