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Published in: BMC Medical Imaging 1/2016

Open Access 01-12-2016 | Research article

Radiation dosimetry of 18F-FDG PET/CT: incorporating exam-specific parameters in dose estimates

Authors: Brian Quinn, Zak Dauer, Neeta Pandit-Taskar, Heiko Schoder, Lawrence T. Dauer

Published in: BMC Medical Imaging | Issue 1/2016

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Abstract

Background

Whole body fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is the standard of care in oncologic diagnosis and staging, and patient radiation dose must be well understood to balance exam benefits with the risk from radiation exposure. Although reference PET/CT patient doses are available, the potential for widely varying total dose prompts evaluation of clinic-specific patient dose. The aims of this study were to use exam-specific information to characterize the radiation dosimetry of PET/CT exams that used two different CT techniques for adult oncology patients and evaluate the practicality of employing an exam-specific approach to dose estimation.

Methods

Whole body PET/CT scans from two sets of consecutive adult patients were retrospectively reviewed. One set received a PET scan with a standard registration CT and the other a PET scan with a diagnostic quality CT. PET dose was calculated by modifying the standard reference phantoms in OLINDA/EXM 1.1 with patient-specific organ mass. CT dose was calculated using patient-specific data in ImPACT. International Commission on Radiological Protection publication 103 tissue weighting coefficients were used for effective dose.

Results

One hundred eighty three adult scans were evaluated (95 men, 88 women). The mean patient-specific effective dose from a mean injected 18F-FDG activity of 450 ± 32 MBq was 9.0 ± 1.6 mSv. For all standard PET/CT patients, mean effective mAs was 39 ± 11 mAs, mean CT effective dose was 5.0 ± 1.0 mSv and mean total effective dose was 14 ± 1.3 mSv. For all diagnostic PET/CT patients, mean effective mAs was 120 ± 51 mAs, mean CT effective dose was 15.4 ± 5.0 mSv and mean total effective dose was 24.4 ± 4.3 mSv. The five organs receiving the highest organ equivalent doses in all exams were bladder, heart, brain, liver and lungs.

Conclusions

Patient-specific parameters optimize the patient dosimetry utilized in the medical justification of whole body PET/CT referrals and optimization of PET and CT acquisition parameters. Incorporating patient-specific data into dose estimates is a worthwhile effort for characterizing patient dose, and the specific dosimetric information assists in the justification of risk and optimization of PET/CT.
Literature
1.
go back to reference Czernin J, Schelbert H. PET/CT Imaging: Facts, opinions, hopes, and questions. J Nucl Med. 2004;45(Suppl):1S–3S. Czernin J, Schelbert H. PET/CT Imaging: Facts, opinions, hopes, and questions. J Nucl Med. 2004;45(Suppl):1S–3S.
2.
go back to reference Czernin J, Allen-Auerbach M, Schelbert HR. Improvements in cancer staging with PET/CT: Literature-based evidence as of September 2006. J Nucl Med. 2007;48(1):78S–88S.PubMed Czernin J, Allen-Auerbach M, Schelbert HR. Improvements in cancer staging with PET/CT: Literature-based evidence as of September 2006. J Nucl Med. 2007;48(1):78S–88S.PubMed
3.
go back to reference Bockisch A, Beyer T, Antoch G, et al. Positron emission tomography/computed tompgraphy--imaging protocols, artifacts, and pitfalls. Mol Imag Bio. 2004;6:188–89.CrossRef Bockisch A, Beyer T, Antoch G, et al. Positron emission tomography/computed tompgraphy--imaging protocols, artifacts, and pitfalls. Mol Imag Bio. 2004;6:188–89.CrossRef
4.
go back to reference ICRP. Radiological Protection and Safety in Medicine. A Report of the International Commission on Radiological Protection. Ann ICRP. 1996;26:1–47. ICRP. Radiological Protection and Safety in Medicine. A Report of the International Commission on Radiological Protection. Ann ICRP. 1996;26:1–47.
5.
go back to reference Brink JA, Amis E. Image wisely: a campaign to increase awareness about adult radiation protection. Radiology. 2010;257(3):601–2.CrossRefPubMed Brink JA, Amis E. Image wisely: a campaign to increase awareness about adult radiation protection. Radiology. 2010;257(3):601–2.CrossRefPubMed
6.
go back to reference ICRP. The 2007 Recommendations of the International Commission on Radiological Protection, ICRP Publication 103. Ann ICRP. 2007;37:1–332.CrossRef ICRP. The 2007 Recommendations of the International Commission on Radiological Protection, ICRP Publication 103. Ann ICRP. 2007;37:1–332.CrossRef
7.
go back to reference Stabin MG. Uncertainties in Internal Dose Calculations for Radiopharmaceuticals. J Nucl Med. 2008;119:853–60.CrossRef Stabin MG. Uncertainties in Internal Dose Calculations for Radiopharmaceuticals. J Nucl Med. 2008;119:853–60.CrossRef
8.
go back to reference Shrimpton PC, Wall B, Yoshizumi TT, Hurwitz LM, Goodman PC. Effective Dose and Dose-Length Product in CT. Radiology. 2009;250(2):604–5.CrossRefPubMed Shrimpton PC, Wall B, Yoshizumi TT, Hurwitz LM, Goodman PC. Effective Dose and Dose-Length Product in CT. Radiology. 2009;250(2):604–5.CrossRefPubMed
9.
go back to reference Hendee WR, I.O.f.M.P. Policy Statement of the International Organization for Medical Physics. Radiology. 2013;267(2):326–7.CrossRefPubMed Hendee WR, I.O.f.M.P. Policy Statement of the International Organization for Medical Physics. Radiology. 2013;267(2):326–7.CrossRefPubMed
12.
go back to reference Dauer LT, Branets I, Stabulas-Savage J, et al. Optimising Radiographic Bitewing Examination to Adult and Juvenile Patients Through the Use of Anthropomorphic Phantoms. Radiat Prot Dosimetry. 2013;158:51–8.CrossRefPubMed Dauer LT, Branets I, Stabulas-Savage J, et al. Optimising Radiographic Bitewing Examination to Adult and Juvenile Patients Through the Use of Anthropomorphic Phantoms. Radiat Prot Dosimetry. 2013;158:51–8.CrossRefPubMed
13.
go back to reference NCRP. Uncertainties in Internal Radiation Dose Assessment. NCRP Report 164. NCRP Publications, Bethesda, MD; 2009. NCRP. Uncertainties in Internal Radiation Dose Assessment. NCRP Report 164. NCRP Publications, Bethesda, MD; 2009.
16.
go back to reference Kamel E, Hany T, Burger C, et al. CT vs 68Ge Attenuation Correction in a Combined PET/CT System: Evaluation of the Effect of Lowering CT Tube Current. Eur J Nucl Med Mol Imaging. 2002;29(3):346–50.CrossRefPubMed Kamel E, Hany T, Burger C, et al. CT vs 68Ge Attenuation Correction in a Combined PET/CT System: Evaluation of the Effect of Lowering CT Tube Current. Eur J Nucl Med Mol Imaging. 2002;29(3):346–50.CrossRefPubMed
17.
go back to reference Kalender WA, Schmidt B, Zankl M, Schmidt M. A PC Program for Estimating Organ Dose and Effective Dose Values in Computed Tomography. Eur Radiol. 1999;9(3):555–62.CrossRefPubMed Kalender WA, Schmidt B, Zankl M, Schmidt M. A PC Program for Estimating Organ Dose and Effective Dose Values in Computed Tomography. Eur Radiol. 1999;9(3):555–62.CrossRefPubMed
18.
go back to reference Kalender W, Deak P, Smal Y. Multisection CT protocols: sex- and age-specific conversion factors used to determine effective dose from dose length product. Radiology. 2010;257(1):158–66.CrossRefPubMed Kalender W, Deak P, Smal Y. Multisection CT protocols: sex- and age-specific conversion factors used to determine effective dose from dose length product. Radiology. 2010;257(1):158–66.CrossRefPubMed
19.
go back to reference ICRP. Report of the Task Group on Reference Man. ICRP Publication 23. Oxford: Pergamon Press; 1975. ICRP. Report of the Task Group on Reference Man. ICRP Publication 23. Oxford: Pergamon Press; 1975.
20.
go back to reference Measurements, I.C.o.R.U.a. Measurement of Dose Equivalents from External Photon and Electron Radiations. ICRU Report 47. Bethesda, MD: ICRU; 1992. Measurements, I.C.o.R.U.a. Measurement of Dose Equivalents from External Photon and Electron Radiations. ICRU Report 47. Bethesda, MD: ICRU; 1992.
21.
go back to reference ICRP. Radiation Dose to Patients from Radiopharmaceuticals: Addendum 2 to ICRP Publication 53, Also Includes Addendum 1 to ICRP Publication 72. ICRP Publication 80. Oxford, UK: Pergamon Press; 1998. ICRP. Radiation Dose to Patients from Radiopharmaceuticals: Addendum 2 to ICRP Publication 53, Also Includes Addendum 1 to ICRP Publication 72. ICRP Publication 80. Oxford, UK: Pergamon Press; 1998.
22.
go back to reference Brenner DJ, Elliston C. Estimated Radiation Risks Potentially Associated with Full-Body CT Screening. Radiology. 2012;232:735–8.CrossRef Brenner DJ, Elliston C. Estimated Radiation Risks Potentially Associated with Full-Body CT Screening. Radiology. 2012;232:735–8.CrossRef
23.
go back to reference Brix G, Lechel U, Glatting G, Ziegler S, Munzig W, Muller S, Beyer T. Radiation Exposured of PAtients Undergoing Whole-Body Dual-Modality 18F-FDG PET/CT Examinations. J Nucl Med. 2005;46(4):608–13.PubMed Brix G, Lechel U, Glatting G, Ziegler S, Munzig W, Muller S, Beyer T. Radiation Exposured of PAtients Undergoing Whole-Body Dual-Modality 18F-FDG PET/CT Examinations. J Nucl Med. 2005;46(4):608–13.PubMed
24.
go back to reference Groves AM, Owen K, Courtney HM, et al. 16-detector Multiclice CT: Dosimetry Estimation by TLD Measurement Compared with Monte Carlo Simulation. Br J Radiol. 2004;77:662–5.CrossRefPubMed Groves AM, Owen K, Courtney HM, et al. 16-detector Multiclice CT: Dosimetry Estimation by TLD Measurement Compared with Monte Carlo Simulation. Br J Radiol. 2004;77:662–5.CrossRefPubMed
25.
go back to reference Huang B, Law M, Khong PL. Whole-Body PET/CT Scanning: Estimation of Radiation Dose and Cancer Risk. Radiology. 2009;251(1):166–74.CrossRefPubMed Huang B, Law M, Khong PL. Whole-Body PET/CT Scanning: Estimation of Radiation Dose and Cancer Risk. Radiology. 2009;251(1):166–74.CrossRefPubMed
26.
go back to reference Khamwan K, Krisanachinda A, Pasawang P. The Determination of Patient Dose From F-18-FDG PET/CT Examination. Radiat Prot Dosimetry. 2010;141:50–5.CrossRefPubMed Khamwan K, Krisanachinda A, Pasawang P. The Determination of Patient Dose From F-18-FDG PET/CT Examination. Radiat Prot Dosimetry. 2010;141:50–5.CrossRefPubMed
27.
go back to reference Mahmud MH et al. Estimation of patient radiation dose from whole body18F- FDG PET/CT examination in cancer imaging: a preliminary study. Journal of Physics: Conference Series. 2014;546:012008. Mahmud MH et al. Estimation of patient radiation dose from whole body18F- FDG PET/CT examination in cancer imaging: a preliminary study. Journal of Physics: Conference Series. 2014;546:012008.
28.
go back to reference Leide-Svegborn S. Radiation Exposure of Patients and Personnel from a PET/CT Procedure with 18F-FDG. Radiat Prot Dosimetry. 2010;139:208–13.CrossRefPubMed Leide-Svegborn S. Radiation Exposure of Patients and Personnel from a PET/CT Procedure with 18F-FDG. Radiat Prot Dosimetry. 2010;139:208–13.CrossRefPubMed
29.
go back to reference Theocharopoulos N, Damilakis J, Perisinakis K, et al. Effective Doses to Adult and Pediatric Patients from Multislice Computed Tomography: A Method Based on Energy Imparted. Med Phys. 2006;33(10):3846–56.CrossRefPubMed Theocharopoulos N, Damilakis J, Perisinakis K, et al. Effective Doses to Adult and Pediatric Patients from Multislice Computed Tomography: A Method Based on Energy Imparted. Med Phys. 2006;33(10):3846–56.CrossRefPubMed
30.
go back to reference Tsalafoutas IA, Koukourakis G. Patient Dose Considerations in Computed Tomography Examinations. World J Radiol. 2004;2(7):262–8.CrossRef Tsalafoutas IA, Koukourakis G. Patient Dose Considerations in Computed Tomography Examinations. World J Radiol. 2004;2(7):262–8.CrossRef
31.
go back to reference Wu TH, Huang Y, Lee JJ, et al. Radiation Exposure During Transmission Measurements: Comparison Between CT- and Germanium-based Techniques with a Current PET Scanner. Eur J Nucl Med Mol Imaging. 2004;77:662–5. Wu TH, Huang Y, Lee JJ, et al. Radiation Exposure During Transmission Measurements: Comparison Between CT- and Germanium-based Techniques with a Current PET Scanner. Eur J Nucl Med Mol Imaging. 2004;77:662–5.
32.
go back to reference Stabin MG, Sparks R, Crowe E. OLINDA/EXM: The Second-Generation Personal computer Software for Internal Dose Assessment in Nuclear Medicine. J Nucl Med. 2005;46(6):1023–7.PubMed Stabin MG, Sparks R, Crowe E. OLINDA/EXM: The Second-Generation Personal computer Software for Internal Dose Assessment in Nuclear Medicine. J Nucl Med. 2005;46(6):1023–7.PubMed
33.
go back to reference Bolch WE, Eckerman K, Sgouros G, Thomas SR. MIRD Pamphlet No 21: A Generalized Schema for Radiopharmaceutical Dosimetry-Standardization of Nomenclature. J Nucl Med. 2009;50(3):477–84.CrossRefPubMed Bolch WE, Eckerman K, Sgouros G, Thomas SR. MIRD Pamphlet No 21: A Generalized Schema for Radiopharmaceutical Dosimetry-Standardization of Nomenclature. J Nucl Med. 2009;50(3):477–84.CrossRefPubMed
34.
go back to reference ICRP. Radiation Dose to Patients from Radiopharmaceuticals. Addendum 3 to ICRP Publication 53. ICRP Publication 106. Ann ICRP. 2008;38(1-2):1–197.CrossRefPubMed ICRP. Radiation Dose to Patients from Radiopharmaceuticals. Addendum 3 to ICRP Publication 53. ICRP Publication 106. Ann ICRP. 2008;38(1-2):1–197.CrossRefPubMed
35.
go back to reference Hays MT, Watson E, Thomas SR, Stabin M. MIRD Dose Estimate Report No 19: Radiation Absorbed Dose Estimates from 18F-FDG. J Nucl Med. 2002;43(2):210–4.PubMed Hays MT, Watson E, Thomas SR, Stabin M. MIRD Dose Estimate Report No 19: Radiation Absorbed Dose Estimates from 18F-FDG. J Nucl Med. 2002;43(2):210–4.PubMed
36.
go back to reference Deloar HM, Fujiwara T, Shidahara M, Nakamura T, Watabe H, Narita Y, Itoh M, Miyake M, Watanuki S. Estimation of Absorbed Dose for 2-[F-18]fluoro-2-deoxy-D-glucose Using Whole-Body Positron Emission Tomography and Magnetic Resonance Imaging. Eur J Nucl Med. 1998;25(6):585–74. Deloar HM, Fujiwara T, Shidahara M, Nakamura T, Watabe H, Narita Y, Itoh M, Miyake M, Watanuki S. Estimation of Absorbed Dose for 2-[F-18]fluoro-2-deoxy-D-glucose Using Whole-Body Positron Emission Tomography and Magnetic Resonance Imaging. Eur J Nucl Med. 1998;25(6):585–74.
37.
go back to reference Clark LD, Stabin M, Fernald MJ, Brill AB. Changes in Radiation Dose with Variations in Human Anatomy: Moderately and Severely Obese Adults. J Nucl Med. 2010;51:929–32.CrossRefPubMedPubMedCentral Clark LD, Stabin M, Fernald MJ, Brill AB. Changes in Radiation Dose with Variations in Human Anatomy: Moderately and Severely Obese Adults. J Nucl Med. 2010;51:929–32.CrossRefPubMedPubMedCentral
38.
go back to reference ICRP. Basic Anatomical and Physiological Data for Use in Radiological Protection: Reference Values. A Report of Age- and Gender-Related Differences in the Anatomical and Physiological Characteristics of Reference Individuals. Ann ICRP. 2002;32:5–265.CrossRef ICRP. Basic Anatomical and Physiological Data for Use in Radiological Protection: Reference Values. A Report of Age- and Gender-Related Differences in the Anatomical and Physiological Characteristics of Reference Individuals. Ann ICRP. 2002;32:5–265.CrossRef
39.
go back to reference Marine PM, Stabin MG, Fernald MJ, Brill AB. Changes in Radiation Dose with Variations in Human Anatomy: Larger and Smaller Normal-Stature Adults. J Nucl Med. 2010;51(5):806–11.CrossRefPubMedPubMedCentral Marine PM, Stabin MG, Fernald MJ, Brill AB. Changes in Radiation Dose with Variations in Human Anatomy: Larger and Smaller Normal-Stature Adults. J Nucl Med. 2010;51(5):806–11.CrossRefPubMedPubMedCentral
40.
go back to reference ICRP. ICRP Publication 105. Radiation Protection in Medicine. Ann ICRP. 2007;37:1–63.CrossRef ICRP. ICRP Publication 105. Radiation Protection in Medicine. Ann ICRP. 2007;37:1–63.CrossRef
41.
go back to reference Grimes J, Celler A. Comparison of Internal Dose Estimates Obtained Using Organ-Level, Voxel 5 Value, and Monte Carlo Techniques. Med Phys. 2014;41(9):92501.CrossRef Grimes J, Celler A. Comparison of Internal Dose Estimates Obtained Using Organ-Level, Voxel 5 Value, and Monte Carlo Techniques. Med Phys. 2014;41(9):92501.CrossRef
42.
go back to reference Ding A, Gu J, Liu H, Caracappa P, Xu XG. The Design of a New PC Software for Estimating Patient Doses from CT Scans. Health Phys. 2009;97(1):S56. Ding A, Gu J, Liu H, Caracappa P, Xu XG. The Design of a New PC Software for Estimating Patient Doses from CT Scans. Health Phys. 2009;97(1):S56.
43.
go back to reference AAPM. Size-specific dose estimates (SSDE) in pediatric and adult body CT examinations: Report of AAPM Task Group 204. College Park, MD: American Association of Physicists in Medicine; 2011. AAPM. Size-specific dose estimates (SSDE) in pediatric and adult body CT examinations: Report of AAPM Task Group 204. College Park, MD: American Association of Physicists in Medicine; 2011.
44.
go back to reference Saade C, H.M., Ammous A et al, Weight-based Protocols during Whole Body FDG PET/CT Significantly Reduces Radiation Dose without Compromising Image Quality, in RSNA 2015 Scientific Assembly and Annual Meeting. Chicago, IL. Saade C, H.M., Ammous A et al, Weight-based Protocols during Whole Body FDG PET/CT Significantly Reduces Radiation Dose without Compromising Image Quality, in RSNA 2015 Scientific Assembly and Annual Meeting. Chicago, IL.
Metadata
Title
Radiation dosimetry of 18F-FDG PET/CT: incorporating exam-specific parameters in dose estimates
Authors
Brian Quinn
Zak Dauer
Neeta Pandit-Taskar
Heiko Schoder
Lawrence T. Dauer
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Medical Imaging / Issue 1/2016
Electronic ISSN: 1471-2342
DOI
https://doi.org/10.1186/s12880-016-0143-y

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