A comprehensive Monte Carlo study of CT dose metrics proposed by the AAPM Reports 111 and 200
Authors: Costa Paulo R. , Nersissian Denise Y. , Umisedo Nancy K. , Gonzales Alejandro H. L. , Fernández‐Varea José M. 
Published: November 2021

AbstractPurposeA Monte Carlo (MC) modeling of single axial and helical CT scan modes has been developed to compute single and accumulated dose distributions. The radiation emission characteristics of an MDCT scanner has been modeled and used to evaluate the dose deposition in infinitely long head and body PMMA phantoms. The simulated accumulated dose distributions determined the approach to equilibrium function, H(L). From these curves, dose‐related information was calculated for different head and body clinical protocols.MethodsThe PENELOPE/penEasy package has been used to model the single axial and helical procedures and the radiation transport of photons and electrons in the phantoms. The bowtie filters, heel effect, focal‐spot angle, and fan‐beam geometry were incorporated. Head and body protocols with different pitch values were modeled for x‐ray spectra corresponding to 80, 100, 120, and 140 kV. The analytical formulation for the single dose distributions and experimental measurements of single and accumulated dose distributions were employed to validate the MC results. The experimental dose distributions were measured with OSLDs and a thimble ion chamber inserted into PMMA phantoms. Also, the experimental values of the along the center and peripheral axes of the CTDI phantom served to calibrate the simulated single and accumulated dose distributions.ResultsThe match of the simulated dose distributions with the reference data supports the correct modeling of the heel effect and the radiation transport in the phantom material reflected in the tails of the dose distributions. The validation of the x‐ray source model was done comparing the CTDI ratios between simulated, measured and CTDosimetry data. The average difference of these ratios for head and body protocols between the simulated and measured data was in the range of 13–17% and between simulated and CTDosimetry data varied 10–13%. The distributions of simulated doses and those measured with the thimble ion chamber are compatible within 3%.In this study, it was demonstrated that the efficiencies of the measurements in head phantoms with nT = 20 mm and 120 kV are 80.6% and 87.8% at central and peripheral axes, respectively. In the body phantoms with = 40 mm and 120 kV, the efficiencies are 56.5% and 86.2% at central and peripheral axes, respectively. In general terms, the clinical parameters such as pitch, beam intensity, and voltage affect the Deq values with the increase of the pitch decreasing the Deq and the beam intensity and the voltage increasing its value. The H(L) function does not change with the pitch values, but depends on the phantom axis (central or peripheral).ConclusionsThe computation of the pitch‐equilibrium dose product, , evidenced the limitations of the method to determine the dose delivered by a CT scanner. Therefore, quantities derived from the propagate this limitation. The developed MC model shows excellent compatibility with both measurements and literature quantities defined by AAPM Reports 111 and 200. These results demonstrate the robustness and versatility of the proposed modeling method.