{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:45:13Z","timestamp":1788788713642,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T00:00:00Z","timestamp":1728691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>CT examinations commonly start with the acquisition of one or two localizer radiographs (2D localizers). Recently, a manufacturer introduced the option to perform a heavily filtrated low\u2010dose helical scan as a localizer acquisition. To compare the dose of one or two 2D localizer acquisitions to the dose of a 3D localizer acquisition, one cannot simply compare the CTDIs of the different acquisition techniques, because of the use of different geometries and spectra.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To compare the organ and effective dose for various CT localizer acquisition techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A Geant4\u2010based Monte Carlo simulation, replicating a clinical wide\u2010area CT scanner was developed and validated. Various localizer acquisition strategies were simulated: Anterior\u2010posterior (AP) alone, PA alone, combined AP+lateral (LAT), and PA+LAT 2D localizers, and an Ag\u2010filtered 3D localizer acquisition. Validation was performed by measuring and simulating CTDI<jats:sub>100<\/jats:sub> in both the periphery and the center of a CTDI phantom. The software was subsequently used to estimate organ and effective doses for localizers for chest, abdomen\u00a0+\u00a0pelvis, and the combined chest, abdomen, and pelvis exams. As representations of patients, eight ICRP computational phantoms (adult, 15\u2010, 10\u2010, and 5\u2010year, both male and female) and five female and five male XCAT phantoms with various BMIs were used. The dose of the various strategies was compared to the current clinically\u2010implemented AP+LAT localizers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CTDI<jats:sub>100<\/jats:sub>\u2010measurements and simulations within the CTDI\u2010phantom differs by a maximum of 8.1% and by an average of 0.9%. For chest, the average effective doses for AP, PA, AP+LAT, and the 3D localizer are 0.10, 0.07, 0.32, and 0.22 mSv, respectively. The organ dose to the breast varies the most across the various localizer strategies and is, on average, 0.17, 0.03, 0.44, and 0.33 mGy, in the same order. For abdomen, the average effective doses are 0.11, 0.07, 0.36, and 0.25 mSv for the AP, PA, AP+LAT and the 3D localizer, respectively. The organ dose to the stomach varies the most across the various localizers and is on average 0.14, 0.08, 0.58, and 0.30 mGy, in the same order. The PA\u2010only localizer results in the lowest organ dose to the most radiosensitive organs and the lowest effective dose. For the chest exam, compared to AP+LAT, the PA+LAT results in a 7\u00a0\u00b1\u00a02% effective dose reduction (mean\u00a0\u00b1\u00a0standard deviation), while the 3D localizer results in a 21\u00a0\u00b1\u00a03% effective dose reduction. Using AP or PA only would result in 69\u00a0\u00b1\u00a02% and 76\u00a0\u00b1\u00a02% reduction, respectively. For the abdomen exam, also compared to AP+LAT, PA+LAT results in 6\u00a0\u00b1\u00a02% effective dose reduction, while the 3D localizer results in a 20\u00a0\u00b1\u00a05% reduction. Using AP or PA only would result in 69\u00a0\u00b1\u00a05% and 76\u00a0\u00b1\u00a04% reduction, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using a PA localizer results in a lower or equivalent organ dose in the most radiosensitive organs, and a lower effective dose compared to an AP localizer for both chest and abdomen+pelvis exams. Compared to a two\u2010localizer strategy, the 3D localizer results in a lower effective dose in both the chest and abdomen+pelvis region.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.17447","type":"journal-article","created":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T17:39:46Z","timestamp":1728754786000},"page":"576-584","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Comparing organ and effective dose of various CT localizer acquisition strategies: A Monte Carlo study"],"prefix":"10.1002","volume":"52","author":[{"given":"Luuk J.","family":"Oostveen","sequence":"first","affiliation":[{"name":"Department of Medical Imaging Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sjoerd","family":"Tunissen","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Sechopoulos","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Radboud University Medical Center  Nijmegen The Netherlands"},{"name":"Technical Medicine Center University of Twente  Enschede The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4813296"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.13781"},{"key":"e_1_2_8_4_1","unstructured":"American Association of Physicists in Medicine.Lung Cancer Screening CT Protocols Version 6.0. 9 November 2023. 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