asada yasuki

BACKGROUND: Cardiac amyloidosis requires quantitative assessment using technetium-99m pyrophosphate (99mTc-PYP) single-photon emission computed tomography (SPECT)/computed tomography (CT) for adequate discrimination and evaluation of disease extent. This study aimed to evaluate the utility of standardized uptake value (SUV) analysis using 99mTc-PYP SPECT/CT in pathologically-confirmed transthyretin amyloid cardiomyopathy (ATTR-CM). The study also explored the relationship between local uptake heterogeneity and indicators of cardiac impairment. METHODS: Forty patients diagnosed via heart biopsy and genetic analysis (20 ATTR-CM; 4 light-chain amyloidosis, 16 non-amyloidosis) were enrolled. The mean SUVs of the heart and aorta were measured using SPECT images. Discrimination performance was evaluated by comparing each SUV, the heart-to-aorta ratio (rSUVH/Ao), and the heart-to-contralateral-lung ratio with pathological findings serving as the gold standard. Polar maps were analyzed to assess local SUV distribution in patients with ATTR-CM. The coefficient of variation (COV) of myocardial uptake, difference score between the septum and lateral wall (%DS), base-to-apex variability, and total cardiac SUV were calculated and compared with echocardiographic parameters. RESULTS: All metrics were significantly different between the ATTR-CM and non-amyloidosis groups. The rSUVH/Ao effectively differentiated patients with ATTR-CM from those with light-chain or non-amyloidosis. Local myocardial SUV distribution correlated with impaired cardiac function. Notably, COV showed significant correlations with e' (R = 0.782) and E/e' (R =  - 0.625), linking heterogeneity to myocardial stiffness and diastolic dysfunction. Larger %DS, which predominantly reflected the ATTR-CM pattern of high septal uptake, correlated significantly with thinner walls (average wall thickness, R =  - 0.655; relative wall thickness, R =  - 0.486). As the total cardiac SUV increased, the %DS decreased (reflecting more homogeneous distribution), and global longitudinal strain worsened (R = 0.614). These observations indicated that greater impairment was associated with a higher disease burden. CONCLUSIONS: This study demonstrated that quantitative SPECT analysis provides a valuable tool for the diagnostic evaluation and differentiation of ATTR-CM. The rSUVH/Ao offers high discriminatory performance. Local heterogeneity and total myocardial uptake are closely related to the disease burden and extent, as reflected by structural and functional abnormalities on echocardiography. These findings suggest potential relevance to the non-invasive assessment of these aspects of the disease at a single time point.

PURPOSE: The computed tomography (CT) numbers of key organs and biological structures are important for phantom production. This study aimed to provide basic data on the CT numbers of actual organs, including the placenta, amniotic fluid, fetal bones, and fetal organs. Additionally, the abdominal circumference of pregnant women and skin surface-to-fetus distance were measured. METHODS: Maternal and fetal anatomical data were obtained from the imaging data of 14 pregnant patients who had previously undergone abdominal and pelvic CT examinations. All anatomical measurements were performed on a workstation using the CT images of each patient. The imaging data of the 14 pregnant patients did not include repeated data from the same individuals. RESULTS: For each organ, the average CT numbers did not significantly differ across tube voltage or gestational age groups. The average CT numbers of the fetal brain, lungs, liver, and caput femoris were 22.2, 28.9, 55.3, and 504.9 HU, respectively. The average values for the fetal depth and maternal abdominal circumference were 28.0 and 861.5 mm, respectively. CONCLUSIONS: The CT numbers of the placenta, amniotic fluid, and fetal organs are similar to those of adult soft tissues and should be represented by equivalent materials. However, the fetal lung phantom should not be made of the same material used for adult lung phantoms; instead, it should consist of materials simulating soft tissue. Because the position of the fetus varies among individuals, determining the measurement point inside the phantom requires a customizable design, particularly for pregnant women with minimal subcutaneous fat.

Anthropomorphic phantoms are often used to estimate organ absorbed doses. However, the material composition of these phantoms is not identical to that of the human body, which may cause errors in the measurement results. The purpose of this study was to analyze the material composition of several anthropomorphic torso phantoms using dual energy computed tomography (DECT), and to clarify the differences in attenuation characteristics among the phantoms. Anthropomorphic torso phantoms (ATOM, RANDO, and PBU-60) from different manufacturers were scanned with DECT. The target organs were lung, soft tissue, liver, bone, and bone surface, and a spectral Hounsfield unit curve (HU curve) was created from the relationship between energy and CT values. Ideal CT values were estimated from the mass attenuation coefficient and density proposed by the International Commission on Radiation Units and Measurements report 44 (ideal value) and compared with the values of each phantom. There were large differences in attenuation characteristics among the phantoms for soft tissue, liver, and bone. The respective ideal, ATOM, RANDO, and PBU-60 CT values of soft tissue were 59.82, 14.17, 34.22, and - 70.11 at 45 keV; and 53.13, 24.41, 3.97, and - 5.75 at 70 keV. The phantom closest to the ideal value may differ depending on the energy. Differences in HU curve and CT values indicate that some organs in the phantom have different material composition and attenuation characteristics to human tissues. When the phantoms available for dosimetry are limited, it is important to understand the attenuation characteristics of each phantom used.

When exposed to X-rays, scintillators emit visible luminescence. X-ray-mediated optogenetics employs scintillators for remotely activating light-sensitive proteins in biological tissue through X-ray irradiation. This approach offers advantages over traditional optogenetics, allowing for deeper tissue penetration and wireless control. Here, we assessed the short-term safety and efficacy of candidate scintillator materials for neuronal control. Our analyses revealed that lead-free halide scintillators, such as Cs3Cu2I5, exhibited significant cytotoxicity within 24 h and induced neuroinflammatory effects when injected into the mouse brain. In contrast, cerium-doped gadolinium aluminum gallium garnet (Ce:GAGG) nanoparticles showed no detectable cytotoxicity within the same period, and injection into the mouse brain did not lead to observable neuroinflammation over four weeks. Electrophysiological recordings in the cerebral cortex of awake mice showed that X-ray-induced radioluminescence from Ce:GAGG nanoparticles reliably activated 45% of the neuronal population surrounding the implanted particles, a significantly higher activation rate than europium-doped GAGG (Eu:GAGG) microparticles, which activated only 10% of neurons. Furthermore, we established the cell-type specificity of this technique by using Ce:GAGG nanoparticles to selectively stimulate midbrain dopamine neurons. This technique was applied to freely behaving mice, allowing for wireless modulation of place preference behavior mediated by midbrain dopamine neurons. These findings highlight the unique suitability of Ce:GAGG nanoparticles for X-ray-mediated optogenetics. The deep tissue penetration, short-term safety, wireless neuronal control, and cell-type specificity of this system offer exciting possibilities for diverse neuroscience applications and therapeutic interventions.

This study aimed to assess fetal radiation exposure in pregnant women undergoing computed tomography (CT) and rotational angiography (RA) examinations for the diagnosis of pelvic trauma. In addition, this study aimed to compare the dose distributions between the two examinations. Surface and average fetal doses were estimated during CT and RA examinations using a pregnant phantom model and real-time dosemeters. The pregnant model phantom was constructed using an anthropomorphic phantom, and a custom-made abdominal phantom was used to simulate pregnancy. The total average fetal dose received by pregnant women from both CT scans (plain, arterial and equilibrium phases) and a single RA examination was ~60 mGy. Because unnecessary repetition of radiographic examinations, such as CT or conventional 2D angiography can increase the radiation risk, the irradiation range should be limited, if necessary, to reduce overall radiation exposure.

PURPOSE: Organ dose evaluation is important for optimizing cone beam computed tomography (CBCT) scan protocols. However, an evaluation method for various CBCT scanners is yet to be established. In this study, we developed scanner-independent conversion coefficients to estimate organ doses using appropriate peak dose (f(0)) indices. METHODS: This study included various scanners (angiography scanners and linear accelerators) and protocols for the head and body (thorax, abdomen, and pelvis) scan regions. f(0) was measured at five conventional positions (center position (f(0)c) and four peripheral positions (f(0)p) at 90° intervals) in the CT dose index (CTDI) phantom. To identify appropriate measurement positions for organ dose estimation, various f(0) indices were considered. Organ doses were measured by using optically stimulated luminescence dosimeters positioned in an anthropomorphic phantom. Thereafter, the conversion coefficients were calculated from each obtained f(0) value and organ or tissue dose using a linear fit for all scanners, and the coefficient of variation (CV) of the conversion coefficients was calculated for each organ or tissue. The f(0) index with the minimum CV value was proposed as the appropriate index. RESULTS: The appropriate f(0) index was determined as f(0)c for the body region and a maximum of four f(0)p values for the head region. Using the proposed conversion coefficients based on the appropriate f(0) index, the organ/tissue doses were well estimated with a mean error of 14.2% across all scanners and scan regions. CONCLUSIONS: The proposed scanner-independent coefficients are useful for organ dose evaluation using CBCT scanners.

Effective dose is sometimes used to compare medical radiation exposure to patients and natural radiation for providing explanations about radiation exposure to patients, but its calculation is lengthy and requires dedicated measuring devices. The purpose of this study was to identify the most suitable conversion coefficient for conversion of easily measurable dose to effective dose in posterior-anterior chest radiography, and to evaluate its accuracy by direct measurement. We constructed an examination environment using Monte Carlo simulation, and evaluated the variation in conversion coefficients from incident air kerma (IAK), entrance-surface air kerma (ESAK), and air kerma-area product (KAP) to effective dose when the irradiation field size and radiation quality were changed. Effective doses were also measured directly using thermoluminescence dosimeters and compared with the effective dose obtained from conversion coefficients. The KAP conversion coefficient most effectively suppressed the effect of irradiation field size, and was then used to set conversion coefficients for various half-value layers. The optimal conversion coefficient was 0.00023 [mSv/(mGy·cm2)] at 120 kVp (half-value layer = 5.5 mmAl). Evaluation of the direct measurements obtained with various radiation qualities revealed that the accuracy of the conversion coefficient was maintained at ≤ 11%. The proposed conversion coefficient can be easily calculated even in facilities that do not have equipment for measuring effective dose, and might enable the use of effective dose for providing explanations about radiation exposure to patients.

We aimed to verify whether the image quality of large low-contrast objects can be improved using visual model-based iterative reconstruction (VMR) while maintaining the visibility of conventional filtered back projection (FBP) and reducing radiation dose through physical and visual evaluation. A 64-row multi-slice CT system with SCENARIA View (FUJIFILM healthcare Corp. Tokyo, Japan) was used. The noise power spectrum (NPS), task-based transfer function (TTF), and signal-to-noise ratio (SNR) were physically evaluated. A low contrast object as a substitute for a liver mass was visually evaluated. In the noise measurement, STD1 showed an 18% lower noise compared to FBP. STR4 was able to reduce noise by 58% compared to FBP. The NPS of VMR was similar to those of FBP from low to high spatial frequency. The NPS of VMR reconstructions showed a similar variation with frequency as FBP reconstructions. STD1 showed the highest 10% TTF, and higher 10% TTF was observed with lower VMR level. The SNR of VMR was close to that of FBP, and higher SNR was observed with higher VMR level. In the results of the visual evaluation, there was no significant difference in visual evaluation between STD1 and FBP (p = 0.99) and between STD2 and FBP (p = 0.56). We found that the NPS of VMR images was similar to that of FBP images, and it can reduce noise and radiation dose by 25% and 50%, respectively, without decreasing the visual image quality compared to FBP.

Abstract During fetal computed tomography (CT) imaging, because of differences in the pregnancy period and scanning conditions, different doses of radiation are absorbed by the fetus. We propose a correction coefficient for determining the fetal size-specific dose estimate (SSDE) from the CT dose index (CTDI) displayed on the console at tube voltages of 80–135 kVp. The CTDIs corresponding to pregnant women and fetuses were evaluated using a Monte Carlo (MC) simulation, and the ratio of these CTDIs was defined as the Fetus-factor. When the effective diameter of a fetus was approximately 10 cm, the Fetus-factor was 1.0. The estimated pregnant SSDE was multiplied by the Fetus-factor to estimate the fetal SSDE, which was compared with the fetal dose obtained by the MC simulation of the image of the fetal CT examination. The fetal dose could be estimated with an error of 31.5% in fetal examinations conducted using helical CT.

At the diagnostic reference level (DRL) related to medical radiation, DRL quantity for general radiography is the entrance surface dose (ESD). Calculation of the ESD in medical radiography requires the backscatter factor (BSF), but derivation of the BSF requires assessment of an irradiated simulation of a human body. The present study used optically stimulated luminescence (OSL) dosimeters and an anthropomorphic phantom as the irradiated body, and the BSF was calculated for different half value layer (HVL)s and field sizes. The need for different BSFs for different regions was also investigated by derivationing of the BSFs for different regions. The pelvis of a RANDO phantom was irradiated under the conditions of the HVL of 2.0, 3.1, and 4.6 mmAl; tube current of 200 mA; irradiation time of 0.1 s; source surface distance of 100 cm; and field sizes of 10 × 10 cm2, 20 cm2, 30 cm2, and 40 cm2. Measurement in air was performed under the same conditions. Several threads were stretched through the air with tissue paper placed on them and the nanoDot dosimeters placed on the paper. Four dosimeters were placed, and measurement was performed 5 times under each set of conditions. The compared radiographed regions were the skull, chest, and pelvis. The BSF increased with increasing HVL size and with increasing field size. The larger the HVL, the larger the difference between field sizes of 10 × 10 cm2and 40 × 40 cm2and the larger the increase in BSF relative to the increase in field size. The BSF differed by region, from large to small in the order chest, pelvis, and skull. The results thus showed that the BSF differs by the radiographed region. Thus, it is desirable to determine the BSF in each radiographed region by investigation with an anthropomorphic phantom.

This study aimed to compare the dose and noise level of four tube voltages in abdominal computerized tomography (CT) examinations in different abdominal circumference sizes of pregnant women. Fetal radiation doses were measured with two anthropomorphic pregnant phantoms and real-time dosimeters of photoluminescence sensors using four tube voltages for abdominal CT. The noise level was measured at the abdomen of two anthropomorphic pregnant phantoms. In the large pregnant phantom, the mean fetal doses performed using 120 and 135 kV were statistically significantly lower than the lower tube voltages (P < 0.05). In the small pregnant phantom, the mean fetal dose performed by 100, 120, and 135 kV was significantly lower than the lowest tube voltage tested (P < 0.05). The ratios of the peripheral mean dose to the centric mean dose showed that the ratios of 80 kV were the highest and those for 135 kV were the lowest in both pregnant phantoms. The ratios of the peripheral mean dose to the centric mean dose decreased as the tube voltage increased. Compared with low tube voltages, high tube voltages such as 120 and 135 kV could reduce radiation doses to the fetus without compromising the image uniformity in abdominal CT examinations during pregnancy. On low tube voltage protocols, the dose near the maternal skin surface may be increased in large pregnant women because of reduced penetration of the x rays.

Organ-effective modulation (OEM) is a computed tomography scanning technique that reduces the exposure dose to organs at risk. Ultrasonography is commonly used for prenatal imaging, but its reliability is reported to be limited. Radiography and computed tomography (CT) are reliable but pose risk of radiation exposure to the pregnant woman and her fetus. Although there are many reports on the exposure dose associated with fetal CT scans, no reports exist on OEM use in fetal CT scans. We measured the basic characteristics of organ-effective modulation (X-ray output modulation angle, maximum X-ray output modulation rate, total X-ray output modulation rate, and noise modulation) and used them in a Monte Carlo simulation to evaluate the effect of this technique on fetal CT scans in terms of image quality and exposure dose to the pregnant woman and fetus. Using ImPACT MC software, Monte Carlo simulations of OEMON and OEMOFF were run on 8 cases involving fetal CT scans. We confirmed that the organ-effective modulation X-ray output modulation angle was 160°; the X-ray output modulation rate increased with increasing tube current; and no modulation occurred at tube currents of 80 mA or below. Our findings suggest that OEM has only a minimal effect in reducing organ exposure in pregnant women; therefore, it should be used on the anterior side (OEMON,front) to reduce the exposure dose to the fetus.

Diagnostic reference levels (DRLs 2015) in Japan were first published in 2017, on the Japan Network for Research and Information on Medical Exposures network. Medical facilities in Japan are now presumably reconsidering radiation doses at their facilities and approaching protection optimisation through the application of DRLs 2015. However, since more than 3 years have elapsed since publication, radiation doses received by patients in Japan may have diverged from DRLs 2015. We therefore undertook the present study. Based on our questionnaire survey implemented in 2017, we estimated the entrance skin dose (ESD) under general radiography fields and the mean glandular dose (MGD) under mammography, to compile a report on the doses received by patients under general radiography fields and mammography, and to propose new DRLs as replacements for DRLs 2015. Radiation doses under general radiography fields and mammography were estimated from the results of the 2017 questionnaire survey and applied to determine new DRLs at 75% values of dose distributions in general radiography fields and at 95% values of dose distributions in mammography. Among all the modes for general radiography fields and mammography, median ESD and MGD were significantly smaller with flat panel detector systems than with computed radiography systems. Comparison of the results with DRLs 2015 values showed a trend toward decreases in all imaging methods of the general radiography fields and mammography ranging from 5.0% (child chest radiography) to 31.7% (skull radiography). Moreover, responses showed that DRLs 2015 were recognised and used for comparison at many facilities. We have described the doses received by patients in general radiography fields and mammography in 2017 and proposed new DRLs as replacements for DRLs 2015. The DRLs we proposed for general radiography fields and mammography were determined to be lower than DRLs 2015 for all modes.

The aim of this study was to investigate differences in volume computed tomography dose index (CTDIvol) and dose-length product (DLP) values according to facility size in Japan. A questionnaire survey was sent to 3000 facilities throughout Japan. Data from each facility were collected including bed number, computed tomography (CT) scan parameters employed and the CTDIvol and/or DLP values displayed on the CT scanner during each examination. The CTDIvol and DLP for 11 adult and 6 paediatric CT examinations were surveyed. Comparison of CTDIvol and DLP values of each examination according to facility size revealed key differences in CT dose between small and large facilities. This study highlights the importance of lowering the dose of coronary artery examination with contrast agent in smaller facilities and of lowering the dose of adult and paediatric head CT without contrast agent in larger facilities. The results of this study are valid in Japan.

Presently, the scanning start angle of the X-ray tube of X-ray computed tomography (CT) scanners cannot be controlled. As a result, there is room for reducing patient dose because the peaks of the dose distributions may overlap during multiphasic CT imaging. This study investigated methods of dose reduction by performing a Monte Carlo simulation of the X-ray tube scanning start angle and locally absorbed dose in multiphasic CT imaging. In the Monte Carlo simulation, the largest decrease in the absorbed dose was seen, when the scanning start angle between the phases was±180°. Even though with present X-ray CT scanners, the scanning start angle cannot be controlled, it is possible to decrease the absorbed dose by taking the orbital synchronized scanning and scanning range into consideration. In future we hope that, we will be able to easily reduce the dose by controlling the scanning start angle.

This study sought to optimise the swallowing computed tomography (SCT) scan protocol for use with the new wide-area detector-row CT (ADCT) scanner and to estimate patient dose in terms of the organ-absorbed dose and the effective dose. The conventional ADCT (ADCTViSION) and the new ADCT (ADCTGENESIS) scanner were compared using: (1) the organ-absorbed dose and the effective dose, with a phantom study, (2) the detailed organ-absorbed doses of the neck region, using a Monte Carlo simulation and (3) a relative visual quality analysis. The effective energy differed significantly between the ADCTViSION (50 keV) and the ADCTGENESIS (57 keV). The effective doses were 2.9 and 1.9 mSv, respectively. Compared with the ADCTViSION, the absorbed dose was reduced by 34% with the ADCTGENESIS. With the ADCTGENESIS, the tube current could be reduced from 40 to 30 mA. With the optimised scan protocol, a further 25% dose reduction can be achieved.

The present study aimed to propose local diagnostic reference levels (DRLs) formulated by calculating entrance surface doses for general radiography at 20 facilities of Aichi prefecture in Japan, by comparing these values with DRLs established in Japan in 2015 (DRLs 2015) and assessing radiation dose differences among facilities. X-ray outputs (half-value layer and air kerma) of each facility were measured with a non-invasive type of detector. The results were employed to formulate local DRLs based on the 75th percentiles of dose distributions. These local DRLs were lower than the DRLs 2015 for all examinations. If proposed local DRLs from other 46 prefectures can be collected, this paper can be used to benefit the next effort to draft better DRL for Japan.

The use of diagnostic reference levels (DRLs) is currently recommended, and dose evaluation is considered to be important for establishing a Japanese radiological protection system in radiological medicine. Children, in particular, are sensitive to radiation, and their exposure levels must be taken into account. The DRL for the entrance surface dose (ESD) used in pediatric chest X-ray examinations in Japan is 0.2 mGy. However, the bodies of infants and young children show major changes with rapidly developing organs. Thus, the possibility that organ development may also be affected by radiation exposure should be taken into account. Therefore, radiological technologists must be conservative in setting radiographic conditions for pediatric examinations. The objective of this study was to evaluate the doses used in pediatric chest X-ray examinations at our hospital and compare them with the current DRLs, considering the assumption that setting conditions individually for different ages and subject thicknesses and performing more detailed dose evaluations will help reduce radiation exposure. The study was carried out to estimate the ESDs in 163 pediatric patients who underwent frontal or lateral chest X-ray examinations at our hospital. All doses were lower than 0.2 mGy, the dose recommended in the Japanese DRLs 2015. The doses showed a strong correlation with age, but a weaker correlation with subject thickness. These results suggest that instead of considering a common DRL for all children, the DRL should be evaluated on the basis of age.

OBJECTIVE:: To propose a new set of Japanese diagnostic reference levels (DRLs) and achievable doses (ADs) for 2017 and to verify the usefulness of Japanese DRLs (DRLs 2015) for CT, by investigating changes in the volume CT dose index (CTDIvol) from 2014 to 2017. METHODS:: Detailed information on the CT scan parameters used throughout Japan were obtained by questionnaire survey. The CTDIvol and dose-length product for the 11 commonest adult and 6 commonest paediatric CT examinations were surveyed and compared with 2014 data and DRLs 2015. RESULTS:: Evaluations of adult head (helical), and abdomen and pelvis without contrast agent, paediatric chest without contrast agent, and abdomen and pelvis without contrast agent showed a slightly lower mean CTDIvol in 2017 than in 2014 (t-test, p < 0.05). The interquartile range of CTDIvol for all 2017 examinations was lower than in 2014. CONCLUSIONS:: This study verified the lower mean, 75th percentile, and interquartile range by investigating changes in the CTDIvol from 2014 to 2017. The DRLs 2015 contributed to CT radiation dose reduction. ADVANCES IN KNOWLEDGE:: The widespread implementation of iterative reconstruction algorithms and low-tube voltage in CT scanners is likely to facilitate further reduction in the CT radiation dose used in Japan. Although radiological technologists may require further education on appropriate CTDIvol and DLP usage, the DRLs 2015 greatly contributed to the reduction of the CT radiation dose used in Japan.

The International Commission on Radiological Protection recommends adaptation of the diagnostic reference levels as an indicator of optimization of protection, and diagnostic reference levels of 2015 were also published in Japan in 2015 (Japan DRLs 2015). The entrance surface dose (ESD) is evaluated to the published standard subject thickness in Japan DRLs 2015. However, the standard radiographic settings of each facility may not be a radiographic condition of the standard subject thickness of Japan DRLs 2015. We measure and record the thickness of the subject in every examination, and it can solve this problem, but it is difficult to carry out it in the actual clinical scene. In this study, we aimed to estimate the subject thickness by using chest clinical images and to calculate ESD for each radiography. We evaluated and compared with Japan DRLs 2015 using these data. The subject thickness was estimated from 200 cases of digital imaging and communications in medicine (DICOM) image obtained by both the frontal and lateral views of the chest radiography. Also, at the same time, the radiographic settings were acquired from the information of the DICOM tag. The subject thickness was 23.60 cm on the average, and the median of the ESD was 0.104 mGy. Also, the median of the ESD at the standard subject thickness of 20 cm in Japan DRLs 2015 was 0.075 mGy. The ESD can be calculated without measuring the body thickness of the patient of every examination by using the method of this study.

The first diagnostic reference levels (DRLs 2015) in Japan were published in June 2015. The purpose of this study was to compare the calculated entrance surface doses with the values of DRLs 2015, and evaluate differences in patient exposure among facilities. Semiconductor dosimeter was installed, and dosimetry was performed using equipment and radiographic condition of each facility. As a result, a dose higher than the value of DRLs 2015 was used in 12 kinds of examination. In child chest examination, the doses of the three facilities (0.26 mGy, 0.28 mGy, 0.60 mGy) exceeded the value of DRLs 2015 (0.2 mGy). Review of the radiographic condition is necessary because the doses exceeding DRLs 2015 tended to have a high current time product. The examination with the largest difference between facilities was the lateral of thoracic spine, with a difference of about 46 times, and the examination with the smallest difference was the ankle joint, with a difference of about three times. When reviewing, it is necessary to focus mainly on examinations that have a large difference between facilities. In the future, it can be said that it is necessary to set diagnostic reference range (DRR) or achievable dose (AD) to understand how high or low dose of the own facility are compared with facilities nationwide.

To obtain patient entrance surface dose in X-ray photography, a calculation method based on measured exposure or air kerma radiated from X-ray tube is generally used. Two factors are necessary for this calculation: (1) exposure/air kerma to absorb dose conversion factor and (2) back-scatter factor (BSF) based on X-ray quality and on field size. These BSFs are commonly obtained by interpolation from existent data which were given for a water phantom whose entrance surface is flat. Since patient's surface in X-ray photograph is not flat, some error may occur when existent BSF is used in this calculation. In this article, BSF for water phantom with cylindrical surface and elliptic cylinder surface were calculated by means of the Monte Carlo simulation. And these BSFs were compared with BSF for flat surface phantom. As a result (1) radius of curvature of cylindrical phantom or horizontal axis of elliptic cylinder phantom is smaller, (2) half value layer of X-ray is larger, (3) field size is larger, difference of these BSF with that for flat surface phantom tends to be larger. Maximum difference by calculation condition assumed in this article was more than 10%. The cause of this difference is because scattering volume in irradiated body of cylindrical or elliptic cylinder phantom is smaller than flat surface phantom. To obtain patient entrance surface dose more precisely, it is necessary to use BSF respectively calculated for phantom resembling patient's body such as cylindrical or elliptic cylinder phantom by means of the Monte Carlo simulation.

Currently, the glandular dose is evaluated quantitatively on the basis of the measured data using phantom, and not in a dose based on the mammary gland structure of an individual patient. However, mammary gland structures of the patients are different from each other and mammary gland dose of an individual patient cannot be obtained by the existing methods. In this study, we present an automated estimation method of mammary gland dose by means of mammary structure which is measured automatically using mammogram. In this method, mammary gland structure is extracted by Gabor filter; mammary region is segmented by the automated thresholding. For the evaluation, mammograms of 100 patients diagnosed with category 1 were collected. Using these mammograms we compared the mammary gland ratio measured by proposed method and visual evaluation. As a result, 78% of the total cases were matched. Furthermore, the mammary gland ratio and average glandular dose among the patients with same breast thickness was matched well. These results show that the proposed method may be useful for the estimation of average glandular dose for the individual patients.

This study aimed to estimate breast glandularity in Japanese women using patient exposure conditions and tissue-equivalent materials by a conventional method. Typical glandularities in Japanese women were compared with those in European women to verify the validity of the average glandular dose estimation manual based on the EUREF protocol. Glandularity was estimated from the data of 600 patients and the model breast of the tissue-equivalent materials which had various amounts of glandular contents and thicknesses. The model breasts were measured to examine the relationships between the thickness of the glandular contents and tube loading by using an automatic exposure control system. Then, equations were established to determine glandularity from patient data. The mean glandularity in the highest compressed breast thickness (CBT) group of 36-45 mm was 72%. The mean CBT of the 184 (31%) patients with glandularities exceeding 100% was 31 mm. Glandularities in patients with CBT of 30-70 mm in the present study were higher compared to those in European women by approximately 10-20%. The results suggest that the model breast of European women might not be a suitable reference standard for more than 30% of Japanese women, who have breasts with lower CBT.