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. 2020 Aug;21(8):263-271.
doi: 10.1002/acm2.12944. Epub 2020 Jun 9.

The helically-acquired CTDIvol as an alternative to traditional methodology

Stephanie M Leon  1 , Robert J Kobistek  2 , Edmond A Olguin  1 , Zhongwei Zhang  1 , Izabella L Barreto  1 , Bryan C Schwarz  1
Affiliations

The helically-acquired CTDIvol as an alternative to traditional methodology

Stephanie M Leon et al. J Appl Clin Med Phys. 2020 Aug.

Abstract

Purpose: Most clinical computed tomography (CT) protocols use helical scanning; however, the traditional method for CTDIvol measurement replaces the helical protocol with an axial scan, which is not easily accomplished on many scanners and may lead to unmatched collimation settings and bowtie filters. This study assesses whether CTDIvol can be accurately measured with a helical scan and determines the impact of pitch, collimation width, and excess scan length.

Methods: CTDIvol was measured for 95 helical protocols on 31 CT scanners from all major manufacturers. CTDIvol was measured axially, then again helically, with the scan range set to the active area of the pencil chamber seen on the localizer image. CTDIvol measurements using each method were compared to each other and to the scanner-displayed CTDIvol . To test the impact of scan length, the study was repeated on four scanners, with the scan range set to the phantom borders seen on the localizer.

Results: It was not possible to match the collimation width between the axial and helical modes for 12 of the 95 protocols tested. For helical and axial protocols with matched collimation, the difference between the two methods averaged below 1 mGy with a correlation of R2 = 0.99. The difference between the methods was not statistically significant (P = 0.81). The traditional method produced four measurements that differed from the displayed CTDIvol by >20%; no helical measurements did. The accuracy of the helical CTDIvol was independent of protocol pitch (R2 = 0.0) or collimation (R2 = 0.0). Extending the scan range to the phantom borders increased the measured CTDIvol by 2.1%-9.7%.

Conclusion: There was excellent agreement between the two measurement methods and to the displayed CTDIvol , without protocol or vendor dependence. The helical CTDIvol measurement can be accomplished more easily than the axial method on many scanners and is reasonable to use for QC purposes.

Keywords: CTDI; CTDIvol; computed tomography; helical acquisition.

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Conflict of interest statement

No conflict of interest.

Figures

Fig. 1
Fig. 1
Topogram of the computed tomography dose index phantom with pencil chamber inserted. The air volume of the chamber is used to set the scan range.
Fig. 2
Fig. 2
Linear regression for scans with matched collimation using (a) the head phantom and (b) the body phantom.
Fig. 3
Fig. 3
Bland–Altman plot showing differences between the helical and axial computed tomography dose index measurement methods.
Fig. 4
Fig. 4
Percent difference between measured and scanner‐displayed CTDIvol values. The bold line marks the American College of Radiology and TJC limit of 20%.
Fig. 5
Fig. 5
Differences between axial and helical measurements as a function of collimation width.
Fig. 6
Fig. 6
Differences between axial and helical measurements as a function of helical pitch.
See this image and copyright information in PMC

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