Methods of CT dose estimation in whole-body 18F-FDG PET/CT

UNLABELLED: We evaluated the effective dose (ED) of the CT component of whole-body PET/CT using software dedicated to CT dose estimation and from dose-length product (DLP) values to establish practical methods of ED estimation. METHODS: Eighty adult patients who underwent (18)F-FDG whole-body PET/CT were divided into groups A and B, each consisting of 20 men and 20 women. In group A, ED of the CT component was calculated using CT-Expo for 6 anatomic regions separately, and whole-body ED was obtained by summing the regional EDs (CT-Expo method). DLP was calculated for each of the 6 regions and multiplied by a corresponding conversion factor described in International Commission on Radiological Protection publication 102 to obtain the ED for each region (regional DLP method). Whole-body ED was also calculated as the product of a whole-body DLP value provided by the scanner automatically and a conversion factor (simple DLP method). Moreover, the ED/DLP values were calculated using whole-body ED estimated by the CT-Expo method and the scanner-derived DLP, to optimize the conversion factor. In group B, the optimized conversion factor was applied for the estimation of ED by the simple DLP method. RESULTS: In group A, the regional DLP method allowed an accurate estimation of mean whole-body ED as a result of counterbalance of mild overestimation in men and mild underestimation in women, regarding the CT-Expo method as a standard. The simple DLP method using a conversion factor for the trunk (0.015 mSv/mGy/cm) caused overestimation. On the basis of the ED/DLP values in group A, a modified conversion factor of 0.013 mSv/mGy/cm and sex-specific conversion factors of 0.012 and 0.014 mSv/mGy/cm for men and women, respectively, were determined. In group B, the use of the modified conversion factor improved accuracy, and the use of sex-specific conversion factors eliminated sex-dependent residual errors. CONCLUSION: ED of the CT component of whole-body PET/CT can be assessed by multiplying the scanner-derived DLP by a conversion factor optimized for whole-body PET/CT.