小林 正尚

This study aimed to assess fetal radiation exposure in pregnant women undergoing computed tomography (CT) and rotational angiography (RA) examinations for the diagnosis of pelvic trauma. In addition, this study aimed to compare the dose distributions between the two examinations. Surface and average fetal doses were estimated during CT and RA examinations using a pregnant phantom model and real-time dosemeters. The pregnant model phantom was constructed using an anthropomorphic phantom, and a custom-made abdominal phantom was used to simulate pregnancy. The total average fetal dose received by pregnant women from both CT scans (plain, arterial and equilibrium phases) and a single RA examination was ~60 mGy. Because unnecessary repetition of radiographic examinations, such as CT or conventional 2D angiography can increase the radiation risk, the irradiation range should be limited, if necessary, to reduce overall radiation exposure.

This study evaluated the validity of pharyngeal 2D area measurements acquired from the lateral view for predicting the actual 3D volume in healthy adults during swallowing. Seventy-five healthy adults (39 females, 36 males; mean age 51.3 years) were examined using 320-row area detector computed tomography (320-ADCT). All participants swallowed a 10 mL honey-thick barium bolus upon command while seated in a 45° semi-reclining position. Multi-planar reconstruction images and dynamic 3D-CT images were obtained using Aquilion ONE software. Pharyngeal 2D area and 3D volume measurements were taken before swallowing and at the frame depicting maximum pharyngeal constriction. Pharyngeal volume before swallowing (PVhold) was accurately predicted by 2D area (R2 = 0.816). Adding height and sex to the model increased R2 to 0.836. Regarding pharyngeal volume during maximum constriction (PVmax), 2D area also exhibited acceptable predictive power (R2 = 0.777). However, analysis of statistical residuals and outliers revealed a greater tendency for prediction errors when there is less complete constriction of the pharynx as well as asymmetry in bolus flow or movement. Findings highlight the importance of routinely incorporating anterior-posterior views during VFSS exams. Future work is needed to determine clinical utility of pharyngeal volume measurements derived from 320-ADCT.

PURPOSE: Organ dose evaluation is important for optimizing cone beam computed tomography (CBCT) scan protocols. However, an evaluation method for various CBCT scanners is yet to be established. In this study, we developed scanner-independent conversion coefficients to estimate organ doses using appropriate peak dose (f(0)) indices. METHODS: This study included various scanners (angiography scanners and linear accelerators) and protocols for the head and body (thorax, abdomen, and pelvis) scan regions. f(0) was measured at five conventional positions (center position (f(0)c) and four peripheral positions (f(0)p) at 90° intervals) in the CT dose index (CTDI) phantom. To identify appropriate measurement positions for organ dose estimation, various f(0) indices were considered. Organ doses were measured by using optically stimulated luminescence dosimeters positioned in an anthropomorphic phantom. Thereafter, the conversion coefficients were calculated from each obtained f(0) value and organ or tissue dose using a linear fit for all scanners, and the coefficient of variation (CV) of the conversion coefficients was calculated for each organ or tissue. The f(0) index with the minimum CV value was proposed as the appropriate index. RESULTS: The appropriate f(0) index was determined as f(0)c for the body region and a maximum of four f(0)p values for the head region. Using the proposed conversion coefficients based on the appropriate f(0) index, the organ/tissue doses were well estimated with a mean error of 14.2% across all scanners and scan regions. CONCLUSIONS: The proposed scanner-independent coefficients are useful for organ dose evaluation using CBCT scanners.