International Journal of Radiation Oncology * Biology * Physics
Volume 70, Issue 5 , Pages 1579-1587, 1 April 2008

Patient Dose From Megavoltage Computed Tomography Imaging

  • Amish P. Shah, Ph.D.

      Affiliations

    • Department of Radiation Oncology, M. D. Anderson Cancer Center Orlando, Orlando, FL
    • Corresponding Author InformationReprint requests to: Amish P. Shah, Ph.D., Department of Radiation Oncology, M. D. Anderson Cancer Center Orlando, 1400 South Orange Avenue, Orlando, FL 32806. Tel: (321) 841-7058; Fax: (321) 841-7153
  • ,
  • Katja M. Langen, Ph.D.

      Affiliations

    • Department of Radiation Oncology, M. D. Anderson Cancer Center Orlando, Orlando, FL
  • ,
  • Kenneth J. Ruchala, Ph.D.

      Affiliations

    • TomoTherapy, Inc., Madison, WI
  • ,
  • Andrea Cox, Ph.D.

      Affiliations

    • TomoTherapy, Inc., Madison, WI
  • ,
  • Patrick A. Kupelian, M.D.

      Affiliations

    • Department of Radiation Oncology, M. D. Anderson Cancer Center Orlando, Orlando, FL
  • ,
  • Sanford L. Meeks, Ph.D.

      Affiliations

    • Department of Radiation Oncology, M. D. Anderson Cancer Center Orlando, Orlando, FL

Received 7 August 2007; received in revised form 8 November 2007; accepted 9 November 2007. published online 30 January 2008.

Purpose

Megavoltage computed tomography (MVCT) can be used daily for imaging with a helical tomotherapy unit for patient alignment before treatment delivery. The purpose of this investigation was to show that the MVCT dose can be computed in phantoms, and further, that the dose can be reported for actual patients from MVCT on a helical tomotherapy unit.

Methods and Materials

An MVCT beam model was commissioned and verified through a series of absorbed dose measurements in phantoms. This model was then used to retrospectively calculate the imaging doses to the patients. The MVCT dose was computed for five clinical cases: prostate, breast, head/neck, lung, and craniospinal axis.

Results

Validation measurements in phantoms verified that the computed dose can be reported to within 5% of the measured dose delivered at the helical tomotherapy unit. The imaging dose scaled inversely with changes to the CT pitch. Relative to a normal pitch of 2.0, the organ dose can be scaled by 0.67 and 2.0 for scans done with a pitch of 3.0 and 1.0, respectively. Typical doses were in the range of 1.0–2.0 cGy, if imaged with a normal pitch. The maximal organ dose calculated was 3.6 cGy in the neck region of the craniospinal patient, if imaged with a pitch of 1.0.

Conclusion

Calculation of the MVCT dose has shown that the typical imaging dose is approximately 1.5 cGy per image. The uniform MVCT dose delivered using helical tomotherapy is greatest when the anatomic thickness is the smallest and the pitch is set to the lowest value.

Megavoltage computed tomography, MVCT, Imaging dose, Tomotherapy, Helical CT

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 Conflict of interest: M. D. Anderson Cancer Center Orlando has received research funding from TomoTherapy, Inc. K. Ruchala and A. Cox are employees of TomoTherapy, Inc. and have a financial interest in TomoTherapy, Inc. None of the other authors have direct financial interest in TomoTherapy, Inc.

PII: S0360-3016(07)04603-2

doi:10.1016/j.ijrobp.2007.11.048

International Journal of Radiation Oncology * Biology * Physics
Volume 70, Issue 5 , Pages 1579-1587, 1 April 2008