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An in-house step-wedge phantom for the calibration of pixel values in CT localizer radiographs for water-equivalent diameter measurement

Rif’ah Sitti M., Anam Choirul, Sutanto Heri, Asiah Rin H., Holid Heryani, Dougherty Geoff

Polish Journal of Medical Physics and Engineering

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2023

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Vol. 29, Iss. 1

50--57

EN

Introduction: To develop an in-house acrylic-based step-wedge phantom with several thickness configurations for calibrating computed tomography (CT) localizer radiographs in order to measure the water-equivalent diameter (Dw) and the size-specific dose estimate (SSDE). Method: We developed an in-house step-wedge phantom using 3 mm thick acrylic, filled with water. The phantom had five steps with thicknesses of 6, 12, 18, 24, and 30 cm. The phantom was scanned using a 64-slice Siemens Definition AS CT scanner with tube currents of 50, 100, 150, 200, and 250 mA. The relationship between pixel value (PV) and water-equivalent thickness (tw) was obtained for the different step thicknesses. This was used to calibrate the CT localizer radiographs in order to measure Dw and SSDE. The results of Dw and SSDE from the radiographs were compared with those calculated from axial CT images. Results: The relationship between PV and tw from CT localizer radiographs of the phantom step-wedge produced a linear relationship with R2 > 0.990. The linear relationships of the Dw and SSDE values obtained from CT localizer radiographs and axial CT images had R2 values > 0.94 with a statistical test of p-value > 0.05. The Dw difference between those from CT localizer radiographs and axial CT images was 3.7% and the SSDE difference between both was 4.3%. Conclusion: We have successfully developed a step-wedge phantom to calibrate the relationship between PV and tw. Our phantom can be easily used to calibrate CT localizer radiographs in order to measure Dw and SSDE.

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The effective and water-equivalent diameters as geometrical size functions for estimating CT dose in the thoracic, abdominal, and pelvic regions

Dewi Winda Kusuma, Anam Choirul, Hidayanto Eko, Nitasari Arrum, Dougherty Geoff

Polish Journal of Medical Physics and Engineering

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2021

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Vol. 27, Iss. 3

213--222

EN

Purpose: The aim of this work was to establish the relationships of patient size in terms of effective diameter (Deff) and water-equivalent diameter (Dw) with lateral (LAT) and anterior-posterior (AP) dimensions in order to predict the specific patient dose for thoracic, abdominal, and pelvic computed tomography (CT) examinations. Methods: A total of 47 thoracic images, 79 abdominal images, and 50 pelvic images were analyzed in this study. The patient’s images were retrospectively collected from Dr. Kariadi and Kensaras Hospitals, Semarang, Indonesia. The slices measured were taken from the middle of the scan range. The calculations of patient sizes (LAT, AP, Deff, and Dwf) were automatically performed by IndoseCT 20b software. Deff and Dw were plotted as functions of LAT, AP, and AP+LAT. In addition, Dw was plotted as a function of Deff. Results: Strong correlations of Deff and Dw with LAT, AP, and AP+LAT were found. Stronger correlations were found in the Deff curves (R2 > 0.9) than in the Dw curves (R2 > 0.8). It was found that the average Deff was higher than the average Dw in the thoracic region, the average values were similar in the abdominal and pelvic regions. Conclusion: The current study extended the study of the relationships between Deff and Dw and the basic geometric diameter LAT, AP, and AP+LAT beyond those previously reported by AAPM. We evaluated the relationships for three regions, i.e. thoracic, abdominal, and pelvic regions. Based on our findings, it was possible to estimate Deff and Dw from only the LAT or AP dimension.

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Correlation between age and head diameters in the paediatric patients during CT examination of the head

Fahmi Arif, Anam Choirul, Suryono, Ali Mohd Hanafi, Jauhari Arif

Polish Journal of Medical Physics and Engineering

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2019

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Vol. 25, Iss. 4

229--235

EN

An estimate of patient dose, patient size should be used to normalise the output dose of CT machine in the terms of volume CT dose index, CTDIvol. There are two metrics to characterise the patient size, i.e. the effective diameter (Deff) and the water-equivalent diameter (Dw). These two metrics could be estimated by patient age. However, to date, relationships between the age and head patient size (Deff and Dw) have not been established for the pediatric patients. The aim of this study was to establish the relationships between the age and head patient size (Deff and the Dw) as the basis for calculating the size-specific dose estimate (SSDE) for paediatric head CT examination. The data were retrospectively collected from serial images of the CT head in the DICOM file from one hundred and thirteen paediatric patients aged 0-17 years (63 male and 50 female patients) underwent head CT examinations. The patient’s sizes (Deff and Dw) were calculated from the patient’s images using the IndoseCT version 15a software. The Deff and Dw values were correlated with age of patients using regression analysis. It was found that patient size (Deff and Dw) correlated well with the age of the patient with R2 more than 0.8. The size of the Dw is bigger than the Deff. The Deff values for male patients are 12.38 to 16.21 cm, and Dw values are 11.96 to 18.16 cm, respectively. For female patients, the values of Deff are from 11.54 to 16.87 cm, and the values of Dw are from 11.60 to 17.86 cm, respectively.