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Comparison of 12 surrogates to characterize CT radiation risk across a clinical population.

Publication ,  Journal Article
Ria, F; Fu, W; Hoye, J; Segars, WP; Kapadia, AJ; Samei, E
Published in: Eur Radiol
September 2021

OBJECTIVES: Quantifying radiation burden is essential for justification, optimization, and personalization of CT procedures and can be characterized by a variety of risk surrogates inducing different radiological risk reflections. This study compared how twelve such metrics can characterize risk across patient populations. METHODS: This study included 1394 CT examinations (abdominopelvic and chest). Organ doses were calculated using Monte Carlo methods. The following risk surrogates were considered: volume computed tomography dose index (CTDIvol), dose-length product (DLP), size-specific dose estimate (SSDE), DLP-based effective dose (EDk ), dose to a defining organ (ODD), effective dose and risk index based on organ doses (EDOD, RI), and risk index for a 20-year-old patient (RIrp). The last three metrics were also calculated for a reference ICRP-110 model (ODD,0, ED0, and RI0). Lastly, motivated by the ICRP, an adjusted-effective dose was calculated as [Formula: see text]. A linear regression was applied to assess each metric's dependency on RI. The results were characterized in terms of risk sensitivity index (RSI) and risk differentiability index (RDI). RESULTS: The analysis reported significant differences between the metrics with EDr showing the best concordance with RI in terms of RSI and RDI. Across all metrics and protocols, RSI ranged between 0.37 (SSDE) and 1.29 (RI0); RDI ranged between 0.39 (EDk) and 0.01 (EDr) cancers × 103patients × 100 mGy. CONCLUSION: Different risk surrogates lead to different population risk characterizations. EDr exhibited a close characterization of population risk, also showing the best differentiability. Care should be exercised in drawing risk predictions from unrepresentative risk metrics applied to a population. KEY POINTS: • Radiation risk characterization in CT populations is strongly affected by the surrogate used to describe it. • Different risk surrogates can lead to different characterization of population risk. • Healthcare professionals should exercise care in ascribing an implicit risk to factors that do not closely reflect risk.

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Published In

Eur Radiol

DOI

EISSN

1432-1084

Publication Date

September 2021

Volume

31

Issue

9

Start / End Page

7022 / 7030

Location

Germany

Related Subject Headings

  • Young Adult
  • Tomography, X-Ray Computed
  • Thorax
  • Radiation Dosage
  • Nuclear Medicine & Medical Imaging
  • Monte Carlo Method
  • Humans
  • Benchmarking
  • Adult
  • 3202 Clinical sciences
 

Citation

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Ria, F., Fu, W., Hoye, J., Segars, W. P., Kapadia, A. J., & Samei, E. (2021). Comparison of 12 surrogates to characterize CT radiation risk across a clinical population. Eur Radiol, 31(9), 7022–7030. https://doi.org/10.1007/s00330-021-07753-9
Ria, Francesco, Wanyi Fu, Jocelyn Hoye, W Paul Segars, Anuj J. Kapadia, and Ehsan Samei. “Comparison of 12 surrogates to characterize CT radiation risk across a clinical population.Eur Radiol 31, no. 9 (September 2021): 7022–30. https://doi.org/10.1007/s00330-021-07753-9.
Ria F, Fu W, Hoye J, Segars WP, Kapadia AJ, Samei E. Comparison of 12 surrogates to characterize CT radiation risk across a clinical population. Eur Radiol. 2021 Sep;31(9):7022–30.
Ria, Francesco, et al. “Comparison of 12 surrogates to characterize CT radiation risk across a clinical population.Eur Radiol, vol. 31, no. 9, Sept. 2021, pp. 7022–30. Pubmed, doi:10.1007/s00330-021-07753-9.
Ria F, Fu W, Hoye J, Segars WP, Kapadia AJ, Samei E. Comparison of 12 surrogates to characterize CT radiation risk across a clinical population. Eur Radiol. 2021 Sep;31(9):7022–7030.
Journal cover image

Published In

Eur Radiol

DOI

EISSN

1432-1084

Publication Date

September 2021

Volume

31

Issue

9

Start / End Page

7022 / 7030

Location

Germany

Related Subject Headings

  • Young Adult
  • Tomography, X-Ray Computed
  • Thorax
  • Radiation Dosage
  • Nuclear Medicine & Medical Imaging
  • Monte Carlo Method
  • Humans
  • Benchmarking
  • Adult
  • 3202 Clinical sciences