PMID- 24211194
OWN - NLM
STAT- MEDLINE
DCOM- 20141124
LR  - 20220311
IS  - 1876-861X (Electronic)
IS  - 1876-861X (Linking)
VI  - 8
IP  - 2
DP  - 2014 Mar-Apr
TI  - Entrance skin dosimetry and size-specific dose estimate from pediatric chest CTA.
PG  - 97-107
LID - S1934-5925(13)00414-0 [pii]
LID - 10.1016/j.jcct.2013.08.002 [doi]
AB  - BACKGROUND: Size-specific dose estimate (SSDE), which corrects CT dose index 
      (CTDI) for body diameter and is a better measure of organ dose than is CTDI, has 
      not yet been validated in vivo. OBJECTIVE: The purpose was to determine the 
      correlation between SSDE and measured breast entrance skin dose (ESD) for 
      pediatric chest CT angiography across a variety of techniques, scanner models, 
      and patient sizes. METHODS: During 42 examinations done on 4 different scanners 
      over 7 years, we measured mid-sternal ESD as an approximation of breast dose with 
      skin dosimeters. We recorded age, weight, effective tube current, kilovoltage 
      potential, console CTDI, and dose-length product, from which we calculated 
      effective dose. We measured effective chest diameter to convert CTDI to SSDE, and 
      we correlated SSDE with measured ESD, using linear regression. We evaluated image 
      quality to answer the clinical question. RESULTS: Patient mean (+/-SD) age was 8.4 
      +/- 6.1 years (median, 7.9 years; range, 0.02-19.5 years); mean weight was 35 +/- 27 
      kg (median, 26 kg; range, 3.5-115 kg); effective chest diameter was 20 +/- 7 cm 
      (median, 19 cm; range, 10-35 cm). Mean effective dose was 2.9 +/- 2.8 mSv (median, 
      2.2 mSv; range, 0.1-14.4 mSv). We observed a linear correlation (R(2) = 0.98, P < 
      .005) between SSDE (mean, 11 +/- 11mGy; median, 7 mGy; range, 0.5-40 mGy) and 
      breast ESD (mean, 12 +/- 11 mGy; median, 7 mGy; range, 0.3-44 mGy). Our doses, 
      which compared favorably with those previously reported, decreased significantly 
      (P < .05) during the course of our study, because of the introduction of 
      automatic exposure control, low kilovoltage, and high pitch techniques. All 
      studies were of diagnostic quality. CONCLUSION: SSDE is a valid dose measure in 
      children undergoing chest CT angiography over a wide range of scanner platforms, 
      techniques, and patient sizes, and it may be used to model breast dose and to 
      document the results of dose reduction strategies.
CI  - Copyright (c) 2014 Society of Cardiovascular Computed Tomography. Published by 
      Elsevier Inc. All rights reserved.
FAU - Westra, Sjirk J
AU  - Westra SJ
AD  - Division of Pediatric Radiology, Department of Radiology, Massachusetts General 
      Hospital, 55 Fruit Street, White 246 A, Boston, MA 02114, USA. Electronic 
      address: swestra@partners.org.
FAU - Li, Xinhua
AU  - Li X
AD  - Division of Pediatric Radiology, Department of Radiology, Massachusetts General 
      Hospital, 55 Fruit Street, White 246 A, Boston, MA 02114, USA.
FAU - Gulati, Kavita
AU  - Gulati K
AD  - Division of Pediatric Radiology, Department of Radiology, Massachusetts General 
      Hospital, 55 Fruit Street, White 246 A, Boston, MA 02114, USA.
FAU - Singh, Sarabjeet
AU  - Singh S
AD  - Division of Pediatric Radiology, Department of Radiology, Massachusetts General 
      Hospital, 55 Fruit Street, White 246 A, Boston, MA 02114, USA.
FAU - Liu, Bob
AU  - Liu B
AD  - Division of Pediatric Radiology, Department of Radiology, Massachusetts General 
      Hospital, 55 Fruit Street, White 246 A, Boston, MA 02114, USA.
FAU - Kalra, Mannudeep K
AU  - Kalra MK
AD  - Division of Pediatric Radiology, Department of Radiology, Massachusetts General 
      Hospital, 55 Fruit Street, White 246 A, Boston, MA 02114, USA.
FAU - Abbara, Suhny
AU  - Abbara S
AD  - Division of Pediatric Radiology, Department of Radiology, Massachusetts General 
      Hospital, 55 Fruit Street, White 246 A, Boston, MA 02114, USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20130823
PL  - United States
TA  - J Cardiovasc Comput Tomogr
JT  - Journal of cardiovascular computed tomography
JID - 101308347
SB  - IM
MH  - Adolescent
MH  - Age Factors
MH  - Body Weight
MH  - Child
MH  - Child, Preschool
MH  - Coronary Angiography/adverse effects/instrumentation/*methods
MH  - Equipment Design
MH  - Female
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Linear Models
MH  - Male
MH  - *Multidetector Computed Tomography/adverse effects/instrumentation
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - *Radiation Dosage
MH  - Radiation Injuries/etiology/prevention & control
MH  - Radiography, Thoracic/adverse effects/instrumentation/*methods
MH  - Risk Factors
MH  - Skin/*radiation effects
MH  - Tomography Scanners, X-Ray Computed
MH  - Young Adult
OTO - NOTNLM
OT  - Breast dose
OT  - CT image quality
OT  - Chest CT angiography
OT  - Effective dose
OT  - Pediatric
OT  - Radiation dose
EDAT- 2013/11/12 06:00
MHDA- 2014/12/15 06:00
CRDT- 2013/11/12 06:00
PHST- 2012/11/23 00:00 [received]
PHST- 2013/03/27 00:00 [revised]
PHST- 2013/08/16 00:00 [accepted]
PHST- 2013/11/12 06:00 [entrez]
PHST- 2013/11/12 06:00 [pubmed]
PHST- 2014/12/15 06:00 [medline]
AID - S1934-5925(13)00414-0 [pii]
AID - 10.1016/j.jcct.2013.08.002 [doi]
PST - ppublish
SO  - J Cardiovasc Comput Tomogr. 2014 Mar-Apr;8(2):97-107. doi: 
      10.1016/j.jcct.2013.08.002. Epub 2013 Aug 23.