{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T14:34:01Z","timestamp":1770561241974,"version":"3.49.0"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2012,11,5]],"date-time":"2012-11-05T00:00:00Z","timestamp":1352073600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:sec><jats:title>Purpose:<\/jats:title><jats:p>The potential health risks associated with low levels of ionizing radiation have created a movement in the radiology community to optimize computed tomography (CT) imaging protocols to use the lowest radiation dose possible without compromising the diagnostic usefulness of the images. Despite efforts to use appropriate and consistent radiation doses, studies suggest that a great deal of variability in radiation dose exists both within and between institutions for CT imaging. In this context, the authors have developed an automated size\u2010specific radiation dose monitoring program for CT and used this program to assess variability in size\u2010adjusted effective dose from CT imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>The authors radiation dose monitoring program operates on an independent health insurance portability and accountability act compliant dosimetry server. Digital imaging and communication in medicine routing software is used to isolate dose report screen captures and scout images for all incoming CT studies. Effective dose conversion factors (<jats:italic>k<\/jats:italic>\u2010factors) are determined based on the protocol and optical character recognition is used to extract the CT dose index and dose\u2010length product. The patient\u02c8s thickness is obtained by applying an adaptive thresholding algorithm to the scout images and is used to calculate the size\u2010adjusted effective dose (ED<jats:sub>adj<\/jats:sub>). The radiation dose monitoring program was used to collect data on 6351 CT studies from three scanner models (GE Lightspeed Pro 16, GE Lightspeed VCT, and GE Definition CT750 HD) and two institutions over a one\u2010month period and to analyze the variability in ED<jats:sub>adj<\/jats:sub> between scanner models and across institutions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>No significant difference was found between computer measurements of patient thickness and observer measurements (<jats:italic>p<\/jats:italic> = 0.17), and the average difference between the two methods was less than 4%. Applying the size correction resulted in ED<jats:sub>adj<\/jats:sub> that differed by up to 44% from effective dose estimates that were not adjusted by patient size. Additionally, considerable differences were noted in ED<jats:sub>adj<\/jats:sub> distributions between scanners, with scanners employing iterative reconstruction exhibiting significantly lower ED<jats:sub>adj<\/jats:sub> (range: 9%\u201364%). Finally, a significant difference (up to 59%) in ED<jats:sub>adj<\/jats:sub> distributions was observed between institutions, indicating the potential for dose reduction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>The authors developed a robust automated size\u2010specific radiation dose monitoring program for CT. Using this program, significant differences in ED<jats:sub>adj<\/jats:sub> were observed between scanner models and across institutions. This new dose monitoring program offers a unique tool for improving quality assurance and standardization both within and across institutions.<\/jats:p><\/jats:sec>","DOI":"10.1118\/1.4761871","type":"journal-article","created":{"date-parts":[[2012,11,6]],"date-time":"2012-11-06T00:35:35Z","timestamp":1352162135000},"page":"7131-7139","source":"Crossref","is-referenced-by-count":61,"title":["Automated size\u2010specific CT dose monitoring program: Assessing variability in CT dose"],"prefix":"10.1002","volume":"39","author":[{"given":"Olav","family":"Christianson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald","family":"Frush","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ehsan","family":"Samei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,11,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra072149"},{"key":"e_1_2_6_3_1","unstructured":"National Council on Radiation Protection and Measurements Scientific Committee 6\u20102 on Radiation Exposure of the U.S. Population \u201cIonizing radiation exposure of the population of the United States \u201d NCRP Report No. 160 (National Council on Radiation Protection and Measurements Bethesda MD. 2009)."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.09.3268"},{"key":"e_1_2_6_5_1","first-page":"373","article-title":"Diagnostic reference levels in radiology","volume":"77","author":"Seeram E.","year":"2006","journal-title":"Radiol. Technol."},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.09.2330"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.09.3957"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/rpd\/ncn056"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.icrp.2007.11.001"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.317115048"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2010.12.022"},{"key":"e_1_2_6_12_1","doi-asserted-by":"crossref","unstructured":"C.McCollough \u201cThe Measurement Reporting and Management of Radiation Dose in CT \u201d AAPM Report No. 96 (American Association of Physicists in Medicine College Park MD 2008).","DOI":"10.37206\/97"},{"key":"e_1_2_6_13_1","doi-asserted-by":"crossref","unstructured":"S.Boone D.Cody C.McCollough M.McNitt\u2010Gray andT.Toth \u201cSize\u2010specific dose estimates (SSDE) in pediatric and adult body CT examinations \u201d AAPM Report No.204(American Association of Physicists in Medicine College Park MD 2011).","DOI":"10.37206\/143"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3058482"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.276075120"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2040747"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1576952"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3515864"}],"container-title":["Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1118%2F1.4761871","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1118%2F1.4761871","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1118\/1.4761871","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T17:14:48Z","timestamp":1694884488000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1118\/1.4761871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,11]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2012,11]]}},"alternative-id":["10.1118\/1.4761871"],"URL":"https:\/\/doi.org\/10.1118\/1.4761871","archive":["Portico"],"relation":{},"ISSN":["0094-2405","2473-4209"],"issn-type":[{"value":"0094-2405","type":"print"},{"value":"2473-4209","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,11]]}}}