Use of diagnostic vs low-dose computed tomography in positron emission tomography-CT examinations.
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| Title: | Use of diagnostic vs low-dose computed tomography in positron emission tomography-CT examinations. |
|---|---|
| Authors: | Malekhedayat, Matthew1 (AUTHOR), Stewart, Carly1 (AUTHOR), Chu, Philip W.1 (AUTHOR), Wang, Yifei1 (AUTHOR), Kasraie, Nima2 (AUTHOR), Franc, Benjamin3 (AUTHOR), Smith-Bindman, Rebecca1,4,5 (AUTHOR) Rebecca.Smith-Bindman@ucsf.edu |
| Source: | European Radiology. Sep2025, Vol. 35 Issue 9, p5468-5477. 10p. |
| Subjects: | Computed tomography, Radiation doses, Positron emission tomography computed tomography, Diagnostic imaging, Ionizing radiation |
| Abstract: | Objectives: To examine CT radiation dose variation in PET-CT and understand how often providers use diagnostic vs lower doses for attenuation correction and anatomic localization (AC/AL). Methods: Retrospective, multi-centered study of PET-CT exams from 2010 to 2021. Exams were categorized as body or brain. Radiation dose was quantified using dose length product (DLP), adjusted for patient size (DLPS-ADJ), and for size and scan length (DLPSL-ADJ). DLPS-ADJ variation was assessed by body region and facility. To ascertain whether sites use AC/AL or diagnostic doses, we compared each facility's DLPS-ADJ in CTs from PET-CT vs diagnostic CT exams of analogous body regions (not associated with PET), controlling for scan length using DLPSL-ADJ. Lastly, we categorized exams as likely diagnostic if they used multiple phases and/or contrast to compare dose and frequency with likely non-diagnostic exams. Results: Sixty-four thousand two hundred ten exams included 93% body, 7% brain. Doses were higher and more variable in the body than brain exams (adult mean DLPS-ADJ = 1004 vs 341 mGy-cm, respectively). For body exams, DLPS-ADJ was higher in older children than adults, and there was wide inter-facility variation (median DLPS-ADJ range = 245–2391 mGy-cm). Most facilities used higher CT doses in body PET-CT than in diagnostic CT exams even controlling for scan length. Fifty-three percent of adult and 76% of child body exams were likely diagnostic based on the use of diagnostic techniques. Conclusion: While diagnostic CT is sometimes indicated for PET-CT, body exams generally do not use AC/AL protocols. Doses were higher than previously reported, higher than analogous diagnostic CT exams, and higher in older children than adults when size adjusted. Key Points: Question How does CT radiation dose vary in PET-CT and how often do providers use diagnostic vs lower doses for AC/AL? FindingsMost facilities did not use AC/AL protocols for body PET-CT, and CT effective doses were higher than previously reported. Clinical relevanceThe considerable inter-facility variation observed suggests ample opportunity to reduce ionizing radiation doses for CT in body PET-CT by adopting low-dose (AC/AL) protocols and other dose reduction techniques. [ABSTRACT FROM AUTHOR] |
| Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
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| Items | – Name: Title Label: Title Group: Ti Data: Use of diagnostic vs low-dose computed tomography in positron emission tomography-CT examinations. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Malekhedayat%2C+Matthew%22">Malekhedayat, Matthew</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stewart%2C+Carly%22">Stewart, Carly</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chu%2C+Philip+W%2E%22">Chu, Philip W.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wang%2C+Yifei%22">Wang, Yifei</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kasraie%2C+Nima%22">Kasraie, Nima</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Franc%2C+Benjamin%22">Franc, Benjamin</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Smith-Bindman%2C+Rebecca%22">Smith-Bindman, Rebecca</searchLink><relatesTo>1,4,5</relatesTo> (AUTHOR)<i> Rebecca.Smith-Bindman@ucsf.edu</i> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Sep2025, Vol. 35 Issue 9, p5468-5477. 10p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Computed+tomography%22">Computed tomography</searchLink><br /><searchLink fieldCode="DE" term="%22Radiation+doses%22">Radiation doses</searchLink><br /><searchLink fieldCode="DE" term="%22Positron+emission+tomography+computed+tomography%22">Positron emission tomography computed tomography</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnostic+imaging%22">Diagnostic imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Ionizing+radiation%22">Ionizing radiation</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objectives: To examine CT radiation dose variation in PET-CT and understand how often providers use diagnostic vs lower doses for attenuation correction and anatomic localization (AC/AL). Methods: Retrospective, multi-centered study of PET-CT exams from 2010 to 2021. Exams were categorized as body or brain. Radiation dose was quantified using dose length product (DLP), adjusted for patient size (DLPS-ADJ), and for size and scan length (DLPSL-ADJ). DLPS-ADJ variation was assessed by body region and facility. To ascertain whether sites use AC/AL or diagnostic doses, we compared each facility's DLPS-ADJ in CTs from PET-CT vs diagnostic CT exams of analogous body regions (not associated with PET), controlling for scan length using DLPSL-ADJ. Lastly, we categorized exams as likely diagnostic if they used multiple phases and/or contrast to compare dose and frequency with likely non-diagnostic exams. Results: Sixty-four thousand two hundred ten exams included 93% body, 7% brain. Doses were higher and more variable in the body than brain exams (adult mean DLPS-ADJ = 1004 vs 341 mGy-cm, respectively). For body exams, DLPS-ADJ was higher in older children than adults, and there was wide inter-facility variation (median DLPS-ADJ range = 245–2391 mGy-cm). Most facilities used higher CT doses in body PET-CT than in diagnostic CT exams even controlling for scan length. Fifty-three percent of adult and 76% of child body exams were likely diagnostic based on the use of diagnostic techniques. Conclusion: While diagnostic CT is sometimes indicated for PET-CT, body exams generally do not use AC/AL protocols. Doses were higher than previously reported, higher than analogous diagnostic CT exams, and higher in older children than adults when size adjusted. Key Points: Question How does CT radiation dose vary in PET-CT and how often do providers use diagnostic vs lower doses for AC/AL? FindingsMost facilities did not use AC/AL protocols for body PET-CT, and CT effective doses were higher than previously reported. Clinical relevanceThe considerable inter-facility variation observed suggests ample opportunity to reduce ionizing radiation doses for CT in body PET-CT by adopting low-dose (AC/AL) protocols and other dose reduction techniques. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s00330-025-11391-w Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 5468 Subjects: – SubjectFull: Computed tomography Type: general – SubjectFull: Radiation doses Type: general – SubjectFull: Positron emission tomography computed tomography Type: general – SubjectFull: Diagnostic imaging Type: general – SubjectFull: Ionizing radiation Type: general Titles: – TitleFull: Use of diagnostic vs low-dose computed tomography in positron emission tomography-CT examinations. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Malekhedayat, Matthew – PersonEntity: Name: NameFull: Stewart, Carly – PersonEntity: Name: NameFull: Chu, Philip W. – PersonEntity: Name: NameFull: Wang, Yifei – PersonEntity: Name: NameFull: Kasraie, Nima – PersonEntity: Name: NameFull: Franc, Benjamin – PersonEntity: Name: NameFull: Smith-Bindman, Rebecca IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 09 Text: Sep2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 09387994 Numbering: – Type: volume Value: 35 – Type: issue Value: 9 Titles: – TitleFull: European Radiology Type: main |
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