Radiation dosimetry considerations for skeletal survey imaging of multiple myeloma

Abstract Purpose This paper aims to review the dosimetry and utility of currently implemented imaging modalities for assessment of multiple myeloma and consider the role of tin filtration computed tomography (CT) as a potential replacement to current standard practice. Methods Radiation output of tin CT was measured experimentally and used for software-based dose calculation. Resultant effective dose was then compared to calculated planar radiography doses and published doses of other imaging modalities. Results Based on example patient parameters used for modalities and 14 projection planar radiography site protocols, doses are comparable between planar radiography and tin filtration CT (approximately 0.9 and 1.0 mSv respectively). Both studies carried a reduced radiation burden compared to Expected Pathologically Increased Contrast-CT (EPIC-CT), FDG-PET and MIBI SPECT/CT (5.7, 11.1–20.0 and 13.0 mSv respectively). Conclusion Tin filtered CT provided visualisation of multiple myeloma at doses comparable to planar radiography and where available may be a suitable alternative, following due consideration of patient specific justification and optimisation in line with best practice.