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Radiation Exposure in Perfusion CT of the Brain

Ringelstein, Adrian MD*; Lechel, Ursula Dr.; Fahrendorf, Delia M. MD*; Altenbernd, Jens C. MD*; Forsting, Michael PhD, MD*; Schlamann, Marc PhD, MD*

Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e3182a3f9a0

Objective: This study aimed to show the simulation of the radiation exposure of the brain during perfusion measurements multi-detector-CT.

Material and Methods: The effective dose and different organ doses were measured with thermoluminescent dosimeters in an Alderson-Rando phantom and compared with the data of a simulation program (CT-Expo V1.6) for varying scan protocols with different tube voltages (in kilovolts) and constant parameters for tube current (270 mAs), scan length (28.8 mm), scan time (40 seconds), slice thickness (24 × 1.2 mm), and number of scans (40) for multi-detector-CT perfusion measurements of the brain.

Results: The thermoluminescent dosimeter measurements yielded effective doses of 3.8 mSv (80 kV), 8.6 mSv (100 kV), 14.1 mSv (120 kV), and 22.2 mSv (140 kV). These values were in line with the data from the simulation program CT-Expo V1.6. The organ doses varied between 97 and 556 mGy (brain), 10.7 and 80.9 mGy (eye lens), 9.6 and 46 mGy (bone marrow), 1.2 and 6.7 mGy (thyroid gland), and 4.1 to 22.3 mGy (skin). The maximum local skin dose ranged from 355 mGy (80 kV) to 1855 mGy (140 kV) in the directly exposed part of the skin.

Conclusions: The radiation exposure during perfusion measurements of the brain is strongly dependent on the tube voltage and can vary widely even if the other exposure parameters remain constant. Maximum organ doses up to 556 mGy (brain) can be measured. Even if we never reached local organ doses that can cause a direct radiation injury, the review of the tube voltages implemented by the vendor is mandatory beside the limitation of the scanned area by clinical examination and the reduction of the number of scans. Simulation programs are a valuable tool for dose measurements.

Author Information

From the *Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen; and †Department of Medical and Occupational Radiation Protection, Federal Office for Radiation Protection, Neuherberg, Germany.

Received for publication April 8, 2013; accepted July 6, 2013.

Reprints: Adrian Ringelstein, MD, Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany (e-mail:

The authors have no conflicts of interest to declare.

© 2014 by Lippincott Williams & Wilkins