AUTHOR=Porzio Massimiliano , Anam Choirul
TITLE=Real-time fully automated dosimetric computation for CT images in the clinical workflow: A feasibility study
JOURNAL=Frontiers in Oncology
VOLUME=12
YEAR=2022
URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.798460
DOI=10.3389/fonc.2022.798460
ISSN=2234-943X
ABSTRACT=BackgroundCurrently, the volume computed tomography dose index (CTDIvol), the most-used quantity to express the output dose of a computed tomography (CT) patient’s dose, is not related to the real size and attenuation properties of each patient. The size-specific dose estimates (SSDE), based on the water-equivalent diameter (DW) overcome those issues. The proposed methods found in the literature do not allow real-time computation of DW and SSDE.
PurposeThis study aims to develop a software to compute DW and SSDE in a real-time clinical workflow.
MethodIn total, 430 CT studies and scans of a water-filled funnel phantom were used to compute accuracy and evaluate the times required to compute the DW and SSDE. Two one-sided tests (TOST) equivalence test, Bland–Altman analysis, and bootstrap-based confidence interval estimations were used to evaluate the differences between actual diameter and DW computed automatically and between DW computed automatically and manually.
ResultsThe mean difference between the DW computed automatically and the actual water diameter for each slice is −0.027% with a TOST confidence interval equal to [−0.087%, 0.033%]. Bland–Altman bias is −0.009% [−0.016%, −0.001%] with lower limits of agreement (LoA) equal to −0.0010 [−0.094%, −0.068%] and upper LoA equal to 0.064% [0.051%, 0.077%]. The mean difference between DW computed automatically and manually is −0.014% with a TOST confidence interval equal to [−0.056%, 0.028%] on phantom and 0.41% with a TOST confidence interval equal to [0.358%, 0.462%] on real patients. The mean time to process a single image is 13.99 ms [13.69 ms, 14.30 ms], and the mean time to process an entire study is 11.5 s [10.62 s, 12.63 s].
ConclusionThe system shows that it is possible to have highly accurate DW and SSDE in almost real-time without affecting the clinical workflow of CT examinations.