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Tomo Topics - Focus On the Clinical Plane

J Sabol1*, M McNitt-Gray2*, (1) Sussex, WI, (2) David Geffen School of Medicine at UCLA, Los Angeles, CA


MO-B-Diagnostic Room-0 (Monday, 4/19/2021) 12:30 PM - 2:30 PM [Eastern Time (GMT-4)]

The first presentation will focus on the current implementation of tomosynthesis systems, technique selection and impact on image quality, clinical utilization, and dosimetry with some discussion of future trends in clinical and technical development of tomosynthesis techniques. In addition, the impact of image reconstruction technique on image quality will be addressed. With tomosynthesis being applied to many different anatomical exams, understanding of dosimetry techniques and typical dose levels in comparison to projection radiography will be discussed.

The second presentation will focus on CT dosimetry. Current clinical CT dosimetry metrics have substantial limitations, which led to the development of Size Specific Dose Estimates (SSDEs) that account for the effects of patient size. The presentation will describe several key elements related to SSDE including: (a) Water Equivalent Diameter, as described in AAPM Report 220, (b) SSDE for body originally described in AAPM Report 204 and updated with AAPM report 220 and (c) SSDE for head described in AAPM Report 293. This presentation will focus on how these metrics were developed, how they are expected to be calculated and how they might be used clinically in the future.

Learning Objectives:
1. Understand the impact of radiographic tomosynthesis acquisition and reconstruction parameters on image quality.
2. Describe the dosimetric considerations of radiographic tomosynthesis and opportunities for optimization and clinical testing.
3. Review current radiation dose index metrics used in CT Dosimetry and their limitations.
4. Explain how the Size Specific Dose Estimates (SSDEs) for Body and Head overcome some of these limitations and how they can be used in clinical practice.

Funding Support, Disclosures, and Conflict of Interest: Michael McNittGray, PhD, FAAPM, FACR - Institutional research agreement, Siemens Healthineers; Grant recipient, Siemens Healthineers; Member, Scientific Advisory Board, Hura Imaging, Inc


Tomosynthesis, Dose, CT


IM- CT: Radiation dosimetry & risk

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