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      Technical note: No increase in effective dose from half compared to full rotation pelvis cone beam CT

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          Abstract

          Purpose

          To image the abdomen of a patient with a gantry mounted imaging system of a linear accelerator, different cone beam computed tomography ( CBCT) protocols are available. The whole‐body dose of a full rotation abdomen CBCT and a half rotation CBCT was compared. In our clinic, both CBCT protocols are used in daily routine work.

          Methods

          With an adult anthropomorphic Alderson phantom, the whole‐body dose per CBCT scan was measured with thermoluminescence dosimeters. The half rotation CBCT was applied such that the gantry mounted X‐ray source rotated around the right side of the phantom. The 183 measurement locations covered all ICRP recommended critical organs (except the gonads). The effective dose was calculated with the mean organ dose and the corresponding tissue weighting factors. A point‐by‐point dose comparison of both protocols was conducted.

          Results

          The effective dose was 5.4  mSv ±5% and 5.0  mSv ±5% (estimated type B 1 σ) for the full and the half rotation CBCT respectively. There was no significant difference ( α = 0.05) in the effective dose within the precision of the measurement (1 σ = 5%). The half rotation CBCT displayed an inhomogeneous dose distribution in a transversal phantom slice in contrast with the full rotation CBCT. In the imaging region, the mean dose was (20.5 ± 3.4)  mGy and (19.2 ± 7.4)  mGy (measured type A 1 σ) for the full and the half rotation CBCT respectively.

          Conclusion

          The half compared to the full rotation CBCT displays a smaller field‐of‐view in a transversal slice and no significant difference in the effective dose. Hence, the full rotation CBCT is favorable compared to the half rotation CBCT. However, by using the half rotation protocol, critical volumes in the patient can be spared compared to the full rotation protocol.

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          Most cited references11

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          The management of imaging dose during image-guided radiotherapy: report of the AAPM Task Group 75.

          Radiographic image guidance has emerged as the new paradigm for patient positioning, target localization, and external beam alignment in radiotherapy. Although widely varied in modality and method, all radiographic guidance techniques have one thing in common--they can give a significant radiation dose to the patient. As with all medical uses of ionizing radiation, the general view is that this exposure should be carefully managed. The philosophy for dose management adopted by the diagnostic imaging community is summarized by the acronym ALARA, i.e., as low as reasonably achievable. But unlike the general situation with diagnostic imaging and image-guided surgery, image-guided radiotherapy (IGRT) adds the imaging dose to an already high level of therapeutic radiation. There is furthermore an interplay between increased imaging and improved therapeutic dose conformity that suggests the possibility of optimizing rather than simply minimizing the imaging dose. For this reason, the management of imaging dose during radiotherapy is a different problem than its management during routine diagnostic or image-guided surgical procedures. The imaging dose received as part of a radiotherapy treatment has long been regarded as negligible and thus has been quantified in a fairly loose manner. On the other hand, radiation oncologists examine the therapy dose distribution in minute detail. The introduction of more intensive imaging procedures for IGRT now obligates the clinician to evaluate therapeutic and imaging doses in a more balanced manner. This task group is charged with addressing the issue of radiation dose delivered via image guidance techniques during radiotherapy. The group has developed this charge into three objectives: (1) Compile an overview of image-guidance techniques and their associated radiation dose levels, to provide the clinician using a particular set of image guidance techniques with enough data to estimate the total diagnostic dose for a specific treatment scenario, (2) identify ways to reduce the total imaging dose without sacrificing essential imaging information, and (3) recommend optimization strategies to trade off imaging dose with improvements in therapeutic dose delivery. The end goal is to enable the design of image guidance regimens that are as effective and efficient as possible.
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            Radiation dose from cone beam computed tomography for image-guided radiation therapy.

            To perform a comprehensive study on organ absorbed doses and effective doses from cone beam computed tomography (CBCT) for three different treatment sites.
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              Investigation into image quality and dose for different patient geometries with multiple cone-beam CT systems.

              To provide quantitative and qualitative image quality metrics and imaging dose for modern Varian On-board Imager (OBI) (ver. 1.5) and Elekta X-ray Volume Imager (XVI) (ver. 4.5R) cone-beam computed tomography (CBCT) systems in a clinical adaptive radiation therapy environment by accounting for varying patient thickness.
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                Author and article information

                Contributors
                pascal.hauri2@uzh.ch
                Journal
                J Appl Clin Med Phys
                J Appl Clin Med Phys
                10.1002/(ISSN)1526-9914
                ACM2
                Journal of Applied Clinical Medical Physics
                John Wiley and Sons Inc. (Hoboken )
                1526-9914
                02 August 2017
                September 2017
                : 18
                : 5 ( doiID: 10.1002/acm2.2017.18.issue-5 )
                : 364-368
                Affiliations
                [ 1 ] Department of Physics University of Zurich Zurich Switzerland
                [ 2 ] Radiotherapy Hirslanden Hirslanden Medical Center Aarau Switzerland
                Author notes
                [*] [* ] Author to whom correspondence should be addressed. Pascal Hauri

                E‐mail: pascal.hauri2@ 123456uzh.ch

                Article
                ACM212150
                10.1002/acm2.12150
                5875828
                28766828
                674d79cd-fb5c-4a29-b960-1347a8a86133
                © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 03 May 2017
                : 13 June 2017
                : 28 June 2017
                Page count
                Figures: 2, Tables: 2, Pages: 5, Words: 3429
                Funding
                Funded by: Swiss Cancer League
                Award ID: KFS‐3249‐08‐2013
                Categories
                87.57.uq, 87.57.Q-
                Technical Note
                Technical Notes
                Custom metadata
                2.0
                acm212150
                September 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.3.4 mode:remove_FC converted:29.03.2018

                abdomen,cone beam ct,effective dose,radiation therapy
                abdomen, cone beam ct, effective dose, radiation therapy

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