Redefining Radiation Metrics: Evaluating Actual Doses in Computed Tomography Scans

Background: Computed tomography (CT) contributes significantly to the collective dose from medical sources, raising concerns about potential health risks. However, existing radiation dose estimation tools, such as volume computed tomography dose index (CTDIvol), dose-length product (DLP), effective dose (ED), and size-specific dose estimate (SSDE), have limitations in accurately reflecting patient exposure. This study introduces a new parameter, size-specific dose-length product (DLPss), aiming to enhance the precision of radiation dose estimation in real-life scenarios. Methods: A retrospective analysis of 134 chest CT studies was conducted. Relationships between CTDIvol and anthropometric parameters were examined, and SSDE was calculated based on effective diameter. Additionally, the novel parameter, DLPss, was introduced, considering scan length and cross-sectional dimensions. Results: Analysis reveals variations in scan length, effective diameter, and CTDIvol between genders. Strong correlations were observed between CTDIvol and effective diameter, particularly in men. The average CTDIvol for the entire group was 7.83 +/- 2.92 mGy, with statistically significant differences between women (7.38 +/- 3.23 mGy) and men (8.30 +/- 2.49 mGy). SSDE values showed significant gender differences, with men exhibiting higher values. The average SSDE values for women and men were 9.15 +/- 2.5 mGy and 9.6 +/- 2.09 mGy, respectively, with a statistically significant difference (p = 0.03). The newly introduced DLPss values ranged around 343.90 +/- 81.66 mGy<middle dot>cm for the entire group, with statistically significant differences between women (323.53 +/- 78.69 mGy<middle dot>cm) and men (364.89 +/- 79.87 mGy<middle dot>cm) (p < 0.05), providing a comprehensive assessment of total radiation dose. Conclusion: The study highlights the need for accurate radiation dose estimation, emphasizing the impact of CT examination parameters on dose variability. The proposed DLPss parameter offers a promising approach to enhancing precision in assessing radiation risk during CT scans. Further research is warranted to explore additional parameters for a comprehensive understanding of radiation exposure and to optimize imaging protocols for patient safety.