Factors affecting dose-length product of computed tomography component in whole-body positron emission tomography/computed tomography

Abstract

Abstract In whole-body positron emission tomography (PET)/computed tomography (CT), it is important to optimise the CT radiation dose. We have investigated factors affecting the dose-length product (DLP) of the CT component of whole-body PET/CT and derived equations to predict the DLP. In this retrospective study, 1596 whole-body oncology PET/CT examinations with 18F-fluorodeoxyglucose were analysed. Automatic exposure control was used to modulate radiation dose in CT. Considering age, weight, sex, arm position (up, down, one arm up), scan range (up to the mid-thigh or feet), scan mode (spiral or respiratory-triggered nonspiral) and the presence of a metal prosthesis as potential factors, multivariate analysis was performed to identify independent predictors of DLP and to determine equations to predict DLP. DLP values were predicted using the obtained equations, and compared with actual values. Among body size indices, weight best correlated with DLP in examinations performed under the standard imaging conditions (arms: up; scan range: up to the mid-thigh; scan mode: spiral; and no metal prosthesis). Multivariate analysis indicated that weight, arm position, scan range and scan mode were substantial independent predictors; lowering the arms, extending the scan range and using respiratory-triggered imaging, as well as increasing weight, increased DLP. The degree of the DLP increase tended to increase with increasing weight. The DLP values were predicted using equations that considered these parameters were in excellent agreement with the actual values. The DLP for the CT component of whole-body PET/CT is affected by weight, arm position, scan range and scan mode, and can be predicted with excellent accuracy using these factors.