Academic radiology · 2026
Full-Cohort Organ Dose Assessment from Low-Dose CT Lung Cancer Screening in the National Lung Screening Trial.
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Lee Choonsik, Moroz Brian, Hwang Eui Jin, Hong Hyun Sook, Yoon Soon Ho
Аннотация
RATIONALE AND OBJECTIVES: Organ-specific dose estimates are needed to characterize radiation exposure from repeated low-dose computed tomography (CT) lung cancer screening in the National Lung Screening Trial (NLST). The objective was to estimate study-level doses and participant-level cumulative doses in the NLST CT screening cohort.
MATERIALS AND METHODS: This retrospective dosimetry study included 25,051 NLST CT screening participants from the Lung Screening Study and American College of Radiology Imaging Network components after excluding participants with any examination lacking a valid manufacturer-appropriate tube current-time input. Image-series metadata were linked with age, sex, height, and weight, and then valid records were grouped into 69,601 study-level screening examinations. Organ absorbed doses and effective dose were calculated using the National Cancer Institute dosimetry system for Computed Tomography with sex- and body-size-specific adult phantoms. Scan-range-related dose uncertainty was assessed with 50 stochastic simulations.
RESULTS: Participants underwent a mean of 2.78 study-level screening examinations; the median study-level volume CT dose index was 3.30 mGy. Median (interquartile range) study-level lung, breast, heart wall, active marrow, and effective doses were 3.93 (3.13-4.96), 3.94 (3.14-5.04), 3.94 (3.14-5.01), and 1.26 (0.99-1.60) mGy, and 2.07 (1.65-2.59) mSv, respectively. Corresponding cumulative participant-level doses were 11.30 (8.89-14.50), 11.39 (9.01-14.75), 11.41 (8.93-14.66), and 3.63 (2.79-4.66) mGy, and 5.94 (4.69-7.64) mSv. Scan-range-related dose uncertainty was greatest for thyroid dose (mean coefficient of variation, 21.1%) and low for in-field organs.
CONCLUSION: Using NLST low-dose CT screening data, we estimated participant-level cumulative organ and effective doses and characterized variation across organs and body-size groups.
MATERIALS AND METHODS: This retrospective dosimetry study included 25,051 NLST CT screening participants from the Lung Screening Study and American College of Radiology Imaging Network components after excluding participants with any examination lacking a valid manufacturer-appropriate tube current-time input. Image-series metadata were linked with age, sex, height, and weight, and then valid records were grouped into 69,601 study-level screening examinations. Organ absorbed doses and effective dose were calculated using the National Cancer Institute dosimetry system for Computed Tomography with sex- and body-size-specific adult phantoms. Scan-range-related dose uncertainty was assessed with 50 stochastic simulations.
RESULTS: Participants underwent a mean of 2.78 study-level screening examinations; the median study-level volume CT dose index was 3.30 mGy. Median (interquartile range) study-level lung, breast, heart wall, active marrow, and effective doses were 3.93 (3.13-4.96), 3.94 (3.14-5.04), 3.94 (3.14-5.01), and 1.26 (0.99-1.60) mGy, and 2.07 (1.65-2.59) mSv, respectively. Corresponding cumulative participant-level doses were 11.30 (8.89-14.50), 11.39 (9.01-14.75), 11.41 (8.93-14.66), and 3.63 (2.79-4.66) mGy, and 5.94 (4.69-7.64) mSv. Scan-range-related dose uncertainty was greatest for thyroid dose (mean coefficient of variation, 21.1%) and low for in-field organs.
CONCLUSION: Using NLST low-dose CT screening data, we estimated participant-level cumulative organ and effective doses and characterized variation across organs and body-size groups.