Size-specific dose estimation in the Korean lung cancer screening project: Does a 32-cm diameter phantom represent a standard-sized patient in korean population?

Eun Young Kim, Tae Jung Kim, Jin Mo Goo, Hyae Young Kim, Ji Won Lee, Soojung Lee, Jun Tae Lim, Yeol Kim

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Objective: The purposes of this study were to evaluate size-specific dose estimate (SSDE) of low-dose CT (LDCT) in the Korean Lung Cancer Screening (K-LUCAS) project and to determine whether CT protocols from Western countries are appropriate for lung cancer screening in Korea. Materials and Methods: For participants (n = 256, four institutions) of K-LUCAS pilot study, volume CT dose index (CTDI vol ) using a 32-cm diameter reference phantom was compared with SSDE, which was recalculated from CTDI vol using size-dependent conversion factor (f-size) based on the body size, as described in the American Association of Physicists in Medicine Report 204. This comparison was subsequently assessed by body mass index (BMI) levels (underweight/normal vs. overweight/ obese), and automatic exposure control (AEC) adaptation (yes/no). Results: Size-specific dose estimate was higher than CTDI vol (2.22 ± 0.75 mGy vs. 1.67 ± 0.60 mGy, p < 0.001), since the f-size was larger than 1.0 for all participants. The ratio of SSDE to CTDI vol was higher in lower BMI groups; 1.26, 1.37, 1.43, and 1.53 in the obese (n = 103), overweight (n = 70), normal (n = 75), and underweight (n = 4), respectively. The ratio of SSDE to CTDI vol was greater in standard-sized participants than in large-sized participants independent of AEC adaptation; with AEC, SSDE/CTDI vol in large-vs. standard-sized participants: 1.30 ± 0.08 vs. 1.44 ± 0.08 (p < 0.001) and without AEC, 1.32 ± 0.08 vs. 1.42 ± 0.06 (p < 0.001). Conclusion: Volume CT dose index based on a reference phantom underestimates radiation exposure of LDCT in standard-sized Korean participants. The optimal radiation dose limit needs to be verified for standard-sized Korean participants.

Original languageEnglish
Pages (from-to)1179-1186
Number of pages8
JournalKorean Journal of Radiology
Issue number6
StatePublished - 1 Nov 2018



  • Early detection
  • Low-dose CT
  • Radiation dosage
  • Radiation dose

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