Investigations of organ and effective doses of abdominal cone-beam computed tomography during transarterial chemoembolization using Monte Carlo simulation

BACKGROUND To investigate the organ dose, effective dose (ED), conversion factor, and the C-arm rotation angle effects on dose variations of abdominal C-arm cone-beam computed tomography (CBCT) during transarterial chemoembolization (TACE). METHODS The organ doses and EDs for abdominal C-arm CBCT were retrospectively calculated according to a Monte Carlo technique for 80 patients. Dose variations from projections, ED to dose-area product (DAP) ratios, and effects of body mass index (BMI) on the ED and ED to DAP ratios were also analyzed. RESULTS The kidney received the highest dose (14.6 ± 1.2 mSv). Organ dose deviations among C-arm rotation angles was highest for stomach (CV = 0.71). The mean ED of the the CBCT run during TACE was 3.5 ± 0.5 mSv, and decreased with increased BMI (R2 = 0.45, p < 0.001). The mean ED to DAP ratio was 0.27 ± 0.04 mSv·Gy- 1·cm- 2 and tended to decrease with increased BMI (R2 = 0.55, p < 0.001). The mean ED to DAP ratios were 0.29 ± 0.02, 0.26 ± 0.02, and 0.23 ± 0.03 mSv·Gy- 1·cm- 2 for patients with BMI < 25 kg/m2, 25-30 kg/m2, and ≥30 kg/m2, respectively. CONCLUSIONS Suitable conversion factors for C-arm CBCT facilitate the use of DAPs for estimating the ED. The patient dose can be varied by adjusting the CBCT rotation angle setting, and dose reduction strategies can be further manipulated.