Tomonobu Haba

Abstract Purpose The energy threshold is an important parameter for precise material identification employing photon‐counting techniques. However, in such applications, the appropriate energy threshold has not been clarified. Therefore, we aimed to determine the appropriate energy threshold range for precise material identification, focusing on effective atomic number (Z) values as an index. Methods The atomic number was estimated using a previously proposed algorithm and Monte Carlo simulations. This algorithm included three steps: calculating the attenuation factor from the incident photon counts on a photon‐counting detector, correcting the beam‐hardening effects, and estimating the atomic number from the attenuation factor index using the calibration curve. Monte Carlo simulations were performed to add Poisson noise to an ideal x‐ray spectrum. The total number of incident x‐rays was set in the range of 10³–10⁶. The x‐ray spectra were generated at tube voltages of 50–120 kV. Polymethyl methacrylate (Z = 6.5) and aluminum (Z = 13) were used for the analysis. The energy threshold was varied at intervals of 1 keV to estimate the atomic number. We evaluated the appropriate energy threshold range for accurately estimating the atomic number using the obtained atomic number data and statistical uncertainty under various conditions. Results The appropriate energy threshold range was found to be 31–38 keV for a tube voltage range of 50–120 kV. At this energy threshold, the atomic number can be estimated within an accuracy of ± 0.7 at 10⁵ counts for the atomic number range of 6.5 (PMMA) to 13 (Al). Conclusions We found the appropriate energy threshold range. The findings of this study are expected to be useful for appropriately setting the energy threshold during precise material identification using photon‐counting detectors for clinical applications.

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.

Abstract During fetal computed tomography (CT) imaging, because of differences in the pregnancy period and scanning conditions, different doses of radiation are absorbed by the fetus. We propose a correction coefficient for determining the fetal size-specific dose estimate (SSDE) from the CT dose index (CTDI) displayed on the console at tube voltages of 80–135 kVp. The CTDIs corresponding to pregnant women and fetuses were evaluated using a Monte Carlo (MC) simulation, and the ratio of these CTDIs was defined as the Fetus-factor. When the effective diameter of a fetus was approximately 10 cm, the Fetus-factor was 1.0. The estimated pregnant SSDE was multiplied by the Fetus-factor to estimate the fetal SSDE, which was compared with the fetal dose obtained by the MC simulation of the image of the fetal CT examination. The fetal dose could be estimated with an error of 31.5% in fetal examinations conducted using helical CT.

This study aimed to compare the dose and noise level of four tube voltages in abdominal computerized tomography (CT) examinations in different abdominal circumference sizes of pregnant women. Fetal radiation doses were measured with two anthropomorphic pregnant phantoms and real-time dosimeters of photoluminescence sensors using four tube voltages for abdominal CT. The noise level was measured at the abdomen of two anthropomorphic pregnant phantoms. In the large pregnant phantom, the mean fetal doses performed using 120 and 135 kV were statistically significantly lower than the lower tube voltages (P < 0.05). In the small pregnant phantom, the mean fetal dose performed by 100, 120, and 135 kV was significantly lower than the lowest tube voltage tested (P < 0.05). The ratios of the peripheral mean dose to the centric mean dose showed that the ratios of 80 kV were the highest and those for 135 kV were the lowest in both pregnant phantoms. The ratios of the peripheral mean dose to the centric mean dose decreased as the tube voltage increased. Compared with low tube voltages, high tube voltages such as 120 and 135 kV could reduce radiation doses to the fetus without compromising the image uniformity in abdominal CT examinations during pregnancy. On low tube voltage protocols, the dose near the maternal skin surface may be increased in large pregnant women because of reduced penetration of the x rays.

<title>Abstract</title> Organ-effective modulation (OEM) is a computed tomography scanning technique that reduces the exposure dose to organs at risk. Ultrasonography is commonly used for prenatal imaging, but its reliability is reported to be limited. Radiography and computed tomography (CT) are reliable but pose risk of radiation exposure to the pregnant woman and her fetus. Although there are many reports on the exposure dose associated with fetal CT scans, no reports exist on OEM use in fetal CT scans. We measured the basic characteristics of organ-effective modulation (X-ray output modulation angle, maximum X-ray output modulation rate, total X-ray output modulation rate, and noise modulation) and used them in a Monte Carlo simulation to evaluate the effect of this technique on fetal CT scans in terms of image quality and exposure dose to the pregnant woman and fetus. Using ImPACT MC software, Monte Carlo simulations of OEM_ON and OEM_OFF were run on 8 cases involving fetal CT scans. We confirmed that the organ-effective modulation X-ray output modulation angle was 160°; the X-ray output modulation rate increased with increasing tube current; and no modulation occurred at tube currents of 80 mA or below. Our findings suggest that OEM has only a minimal effect in reducing organ exposure in pregnant women; therefore, it should be used on the anterior side (OEM_ON,front) to reduce the exposure dose to the fetus.

Presently, the scanning start angle of the X-ray tube of X-ray computed tomography (CT) scanners cannot be controlled. As a result, there is room for reducing patient dose because the peaks of the dose distributions may overlap during multiphasic CT imaging. This study investigated methods of dose reduction by performing a Monte Carlo simulation of the X-ray tube scanning start angle and locally absorbed dose in multiphasic CT imaging. In the Monte Carlo simulation, the largest decrease in the absorbed dose was seen, when the scanning start angle between the phases was±180°. Even though with present X-ray CT scanners, the scanning start angle cannot be controlled, it is possible to decrease the absorbed dose by taking the orbital synchronized scanning and scanning range into consideration. In future we hope that, we will be able to easily reduce the dose by controlling the scanning start angle.

Size-specific dose estimate (SSDE) was proposed by the American Association of Physicists in Medicine (AAPM) Task Group 204 to consider the effect of patient size in the x-ray CT dose estimation. Size correction factors to calculate SSDE were derived based on the conventional weighted CT dose index (CTDIw) equation. This study aims to investigate the influence of Bakalyar's and the authors' own CTDIw equations on the size correction factors described by the AAPM Task Group 204, using Monte Carlo simulations. The simulations were performed by modeling four types of x-ray CT scanner designs, to compute the dose values in water for cylindrical phantoms with 8-40 cm diameters. CTDI100 method and the AAPM Task Group 111's proposed method were employed as the CT dosimetry models. Size correction factors were obtained for the computed dose values of various phantom diameters for the conventional, Bakalyar's, and the authors' weighting factors. Maximum difference between the size correction factors for the Bakalyar's weighting factor and those of the AAPM Task Group 204 was 27% for a phantom diameter of 11.2 cm. On the other hand, the size correction factors calculated for the authors' weighting factor were in good agreement with those from the AAPM Task Group 204 report with a maximum difference of 17%. The results indicate that the SSDE values obtained with the authors' weighting factor can be evaluated by using the size correction factors reported by the AAPM Task Group 204, which is currently accepted as a standard.

X-ray image evaluation is commonly performed by determining the detective quantum efficiency (DQE). DQE is calculated with a presampled modulation transfer function (MTF), incident photon fluence, and digital noise power spectrum (NPS). Accurate evaluation of MTF, incident photon fluence, and NPS is important for precise DQE determination. In this study, we focused on the accuracy of the incident photon fluence in mammography. The incident photon fluence is calculated using the squared signal-to-noise ratio (SNRin2) value as specified in the International Electrotechnical Commission (IEC) 62220-1-2 report. However, the reported SNRin2 values were determined using a computer program, and the reported values may differ from those calculated from an X-ray spectrum that is measured with actual mammography equipment. Therefore, we evaluated the error range of reported SNRin2 values in mammography to assess the accuracy of the incident photon fluence. First, X-ray spectra from various mammography systems were measured with a CdTe spectrometer. Six mammographic X-ray units were used in this study. Second, the SNRin2 values were calculated from the measured X-ray spectra. The calculated values were compared to the reported values. The results show that the percentage differences between the calculated and reported SNRin2 values were within - 4.1% of each other. The results obtained in this study indicate that the SNRin2 values provided in the IEC report are a robust and convenient tool for calculating the incident photon fluence for DQE evaluation in mammography.