Review
Copyright ©2010 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Radiol. Jul 28, 2010; 2(7): 262-268
Published online Jul 28, 2010. doi: 10.4329/wjr.v2.i7.262
Patient dose considerations in computed tomography examinations
Ioannis A Tsalafoutas, Georgios V Koukourakis
Ioannis A Tsalafoutas, Department of Medical Physics, Agios Savvas Hospital, 171 Alexandras Avenue, 115 22, Athens, Greece
Georgios V Koukourakis, Second Department of Radiation Oncology, Agios Savvas Hospital, 171 Alexandras Avenue, 115 22, Athens, Greece
Author contributions: Tsalafoutas IA made the literature research and wrote the first draft of this manuscript; Koukourakis GV assisted in the literature research, edited the draft and helped in the structure of the manuscript; both authors read and approved the final version of the manuscript.
Correspondence to: Ioannis A Tsalafoutas, PhD, Department of Medical Physics, Agios Savvas Hospital, 171 Alexandras Avenue, 115 22, Athens, Greece. j_tsalas@hotmail.com
Telephone: +30-210-6409448 Fax: +30-210-7644887
Received: April 20, 2010
Revised: June 18, 2010
Accepted: June 25, 2010
Published online: July 28, 2010
Abstract

Ionizing radiation is extensively used in medicine and its contribution to both diagnosis and therapy is undisputable. However, the use of ionizing radiation also involves a certain risk since it may cause damage to tissues and organs and trigger carcinogenesis. Computed tomography (CT) is currently one of the major contributors to the collective population radiation dose both because it is a relatively high dose examination and an increasing number of people are subjected to CT examinations many times during their lifetime. The evolution of CT scanner technology has greatly increased the clinical applications of CT and its availability throughout the world and made it a routine rather than a specialized examination. With the modern multislice CT scanners, fast volume scanning of the whole human body within less than 1 min is now feasible. Two dimensional images of superb quality can be reconstructed in every possible plane with respect to the patient axis (e.g. axial, sagital and coronal). Furthermore, three-dimensional images of all anatomic structures and organs can be produced with only minimal additional effort (e.g. skeleton, tracheobronchial tree, gastrointestinal system and cardiovascular system). All these applications, which are diagnostically valuable, also involve a significant radiation risk. Therefore, all medical professionals involved with CT, either as referring or examining medical doctors must be aware of the risks involved before they decide to prescribe or perform CT examinations. Ultimately, the final decision concerning justification for a prescribed CT examination lies upon the radiologist. In this paper, we summarize the basic information concerning the detrimental effects of ionizing radiation, as well as the CT dosimetry background. Furthermore, after a brief summary of the evolution of CT scanning, the current CT scanner technology and its special features with respect to patient doses are given in detail. Some numerical data is also given in order to comprehend the magnitude of the potential radiation risk involved in comparison with risk from exposure to natural background radiation levels.

Keywords: Computed tomography, Computed tomography dose index, Dose length product, Patient dose, Effective dose, Skin dose, Radiation risk