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Diagnostics
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Optimizing Personalized Radiation Dose in Computed Tomography: Justification and Diagnostic...
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Optimizing Personalized Radiation Dose in Computed Tomography: Justification and Diagnostic Reference Levels

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 1945

Special Issue Editor

Dr. Mohamed Abuzaid

E-Mail Website
Guest Editor
Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
Interests: diagnostic imaging; computed tomography; radiation; radiography; education; radiation safety; radiation protection; digital imaging

Special Issue Information

Dear Colleagues,

This Special Issue focuses on the use of Computed Tomography (CT) to optimize personalized radiation doses and establish diagnostic reference levels (DRLs) for different patient groups. The rapid evolution of CT technology has necessitated approaches that balance high diagnostic quality with the need to minimize radiation exposure, particularly for vulnerable populations such as children and patients requiring multiple scans.

Key areas of interest include the rationale for radiation dosing in clinical practice, with DRLs serving as benchmarks for safe imaging. We particularly encourage submissions that explore advanced techniques for dose management, such as AI-enhanced optimization, automated dose monitoring systems, and personalized imaging protocols.

This issue aims to foster discussion on technologies that improve radiation dose rationale and personalization, addressing the challenges of implementing DRLs in varied clinical settings. Additionally, we will examine strategies for optimizing image quality while reducing radiation exposure, with a focus on innovative reconstruction methods and AI-driven solutions.

We welcome submissions from radiologists, medical physicists, and CT technologists working in both clinical and research settings, particularly those engaged in the development and application of advanced imaging procedures. Original research and comprehensive review articles are highly encouraged.

Dr. Mohamed Abuzaid
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • computed tomography
  • personalized radiation dose
  • computed tomography optimization
  • diagnostic reference levels
  • radiation dose justification
  • CT dose management
  • AI applications in dose management

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Published Papers (2 papers)

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Research

10 pages, 362 KiB  
Article
Optimizing Radiation Dose in High-Resolution Chest CT: The Impact of Patient-Specific Factors and Size-Specific Dose Estimates
by Mohamed Abuzaid
Diagnostics 2025, 15(6), 740; https://doi.org/10.3390/diagnostics15060740 - 16 Mar 2025
Viewed by 619
Abstract
Background/Objectives: High-resolution chest computed tomography (HRCT) is a critical diagnostic tool, but radiation dose optimization remains a significant concern. Traditional dose metrics such as the volume CT dose index (CTDIvol) and dose-length product (DLP) do not adequately account for patient size variations. This [...] Read more.
Background/Objectives: High-resolution chest computed tomography (HRCT) is a critical diagnostic tool, but radiation dose optimization remains a significant concern. Traditional dose metrics such as the volume CT dose index (CTDIvol) and dose-length product (DLP) do not adequately account for patient size variations. This study aimed to assess the radiation dose in HRCT using size-specific dose estimates (SSDEs) and evaluate the influence of patient-specific factors on key dosimetric parameters. Methods: This retrospective cohort study analyzed HRCT scans from 1970 adult patients conducted between September 2022 and February 2024. Radiation dose data, including the CTDIvol, DLP, SSDE, and effective dose, were extracted from the DoseWatch™ software. Patient demographics, scan protocols, and exposure parameters were collected. Descriptive statistics, correlation analyses, and significance testing were conducted using IBM SPSS (Version 26). Results: A significant positive correlation was found between the radiation dose parameters (CTDIvol, DLP, SSDE) and patient body size metrics, particularly BMI (rpb = 0.445, p < 0.01). The SSDE values ranged from 2.7 to 12.4 mGy, providing a more patient-specific dose assessment than traditional indices. Gender differences were observed, with male patients receiving higher radiation doses (p < 0.01). The scanning range exhibited a significant negative correlation with the CTDIvol and SSDE, suggesting dose variations with anatomical coverage. Conclusions: SSDEs provide a more accurate, patient-centered dose assessment in HRCT, allowing for optimized radiation safety strategies. These findings emphasize the need for size-adapted scan protocols to minimize exposure while maintaining diagnostic image quality. The routine integration of SSDE into clinical practice is recommended to enhance individualized dose management in HRCT. Full article
(This article belongs to the Special Issue Optimizing Personalized Radiation Dose in Computed Tomography: Justification and Diagnostic Reference Levels)
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14 pages, 2065 KiB  
Article
Optimizing Radiation Dose and Image Quality in Stroke CT Protocols: Proposed Diagnostic Reference Levels for Multiphase CT Angiography and Perfusion Imaging
by Robert Forbrig, Christoph G. Trumm, Paul Reidler, Wolfgang G. Kunz, Konstantinos Dimitriadis, Lars Kellert, Johannes Rückel, Thomas Liebig and Robert Stahl
Diagnostics 2024, 14(24), 2866; https://doi.org/10.3390/diagnostics14242866 - 20 Dec 2024
Cited by 1 | Viewed by 965
Abstract
Objective: In suspected acute ischemic stroke, it is now reasonable to expand the conventional “stroke protocol” (non-contrast computed tomography (NCCT), arterial CT angiography (CTA), and optionally CT perfusion (CTP)) to early and late venous head scans yielding a multiphase CTA (MP-CTA) to increase [...] Read more.
Objective: In suspected acute ischemic stroke, it is now reasonable to expand the conventional “stroke protocol” (non-contrast computed tomography (NCCT), arterial CT angiography (CTA), and optionally CT perfusion (CTP)) to early and late venous head scans yielding a multiphase CTA (MP-CTA) to increase diagnostic confidence. Diagnostic reference levels (DRLs) have been defined for neither MP-CTA nor CTP. We therefore present dosimetry data, while also considering image quality, for a large, unselected patient cohort. Methods: A retrospective single-center study of 1790 patients undergoing the extended stroke protocol with three scanners (2× dual-source, DSCT; 1× single-source, SSCT) between 07/21 and 12/23 was conducted. For each sequence, we analyzed the radiation dose (volumetric CT dose index (CTDIvol); dose length product; effective dose); objective image quality using manually placed regions of interest (contrast-to-noise ratio (CNR)); and subjective image quality (4-point scale: 1 = non-diagnostic, 4 = excellent). The DRL was defined as the 75% percentile of the CTDIvol distribution. The Kruskal-Wallis test was used initially to test for overall equality of median values in each data group. Single post-test comparisons were performed with Dunn’s test, with an overall statistical significance level of 0.05. Results: Dosimetry values were significantly higher for SSCT (p < 0.001, each). Local DRLs ranged between 37.3 and 49.1 mGy for NCCT, 3.6–5.5 mGy for arterial CTA, 1.2–2.5 mGy each for early/late venous CTA, and 141.1–220.5 mGy for CTP. Protocol adjustment (DSCT-1: CTP) yielded a 28.2% dose reduction. The highest/lowest CNRs (arterial/early venous CTA, respectively) were recorded for SSCT/DSCT-2 (p < 0.001). Subjective image quality was rated excellent except for slightly increased MP-CTA noise at DSCT-2 (median = 3). Conclusions: Our data imply that additive MP-CTA scans only yield a minor increase in radiation exposure, particularly when using DSCT. CTP should be limited to selected patients. Full article
(This article belongs to the Special Issue Optimizing Personalized Radiation Dose in Computed Tomography: Justification and Diagnostic Reference Levels)
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