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IPEM topical report 2: the first UK survey of dose indices from radiotherapy treatment planning computed tomography scans for adult patients

Davis, Anne T, Earley, James, Edyvean, Sue, Findlay, Una, Lindsay, Rebecca, Nisbet, Andrew, Palmer, Antony L, Plaistow, Rosaleen, Williams, Matthew Geraint Joseph and Wood, Tim J (2018) IPEM topical report 2: the first UK survey of dose indices from radiotherapy treatment planning computed tomography scans for adult patients Physics in Medicine and Biology, 63 (18), 185008.

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CT scans are an integral component of modern radiotherapy treatments, enabling the accurate localisation of the treatment target and organs-at-risk, and providing the tissue density information required for dose calculations in the treatment planning system. For these reasons, it is important to ensure exposures are optimised to give the required clinical image quality with doses that are as low as reasonably achievable. However, there is little guidance on dose levels in radiotherapy CT imaging either within the UK or internationally. This IPEM topical report presents the results of the first UK wide survey of dose indices in radiotherapy CT planning scans. Patient dose indices were collected for prostate, gynaecological, breast, 3D-lung, 4D-lung, brain and head/neck scans. Median values per scanner and examination type were calculated and national dose reference levels and 'achievable levels' of CT dose index (CTDIvol), dose-length-product (DLP) and scan length are proposed based on the third quartile and median values of these distributions, respectively. A total of 68 radiotherapy CT scanners were included in this audit. The proposed dose reference levels for CTDIvol and DLP are; prostate 16 mGy and 570, gynaecological 16 mGy and 610, breast 10 mGy and 390, 3D-lung 14 mGy and 550, 4D-lung 63 mGy and 1750, brain 50 mGy and 1500 and head/neck 49 mGy and 2150 Significant variations in dose indices were noted, with head/neck and 4D-lung yielding a factor of eighteen difference between the lowest and highest dose scanners. There was also evidence of some clustering in the data by scanner manufacturer, which may be indicative of a lack of local optimisation of individual systems to the clinical task. It is anticipated that providing this data to the UK and wider radiotherapy community will aid the optimisation of treatment planning CT scan protocols.

Item Type: Article
Divisions : Faculty of Engineering and Physical Sciences > Physics
Authors :
Davis, Anne T
Earley, James
Edyvean, Sue
Findlay, Una
Lindsay, Rebecca
Palmer, Antony L
Plaistow, Rosaleen
Williams, Matthew Geraint Joseph
Wood, Tim J
Date : 10 September 2018
DOI : 10.1088/1361-6560/aacc87
Copyright Disclaimer : © 2018 Institute of Physics and Engineering in Medicine. As the Version of Record of this article is going to be/has been published on a subscription basis, this Accepted Manuscript will be available for reuse under a CC BY-NC-ND 3.0 licence after a 12 month embargo period. Although reasonable endeavours have been taken to obtain all necessary permissions from third parties to include their copyrighted content within this article, their full citation and copyright line may not be present in this Accepted Manuscript version. Before using any content from this article, please refer to the Version of Record on IOPscience once published for full citation and copyright details, as permission may be required. All third party content is fully copyright protected, unless specifically stated otherwise in the figure caption of the Version of Record.
Uncontrolled Keywords : Diagnostic reference levels (DRLs); Radiotherapy CT; UK audit
Depositing User : Clive Harris
Date Deposited : 03 Jul 2018 08:13
Last Modified : 15 Jun 2019 02:08

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