Preface |
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xv | |
Acknowledgments |
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xvii | |
Author |
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xix | |
About the Series |
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xxi | |
Chapter 1 Introduction and History |
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1 | (10) |
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1 | (1) |
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1.2 A Historical View Of CT Dosimetry |
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1 | (5) |
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1 | (1) |
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1.2.2 The Birth of CTDI - 1981 |
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2 | (1) |
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1.2.3 Enter the Regulators - 1989 |
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3 | (1) |
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1.2.4 The Standard Dosimetry Phantoms |
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3 | (1) |
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1.2.5 Enter CTDI100 - 1995 |
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4 | (1) |
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1.2.6 The Advent of Multi-Detector CT (MDCT) - 1998 |
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5 | (1) |
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1.2.7 Enter CTDIvoi (A Misnomer) but an Improvement since It Eliminates nT (N x T) |
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5 | (1) |
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1.2.8 Dose Length Product |
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6 | (1) |
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1.2.9 Helical Scanning - Scanning with Continuous Table Motion - 1990 |
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6 | (1) |
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1.3 Slipping The Surly Bonds Of CTDI |
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6 | (1) |
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1.3.1 An Alternative to the Pencil Chamber - 2003 |
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6 | (1) |
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7 | (1) |
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1.3.3 Limitations of the CTDI-Paradigm and the Pencil Chamber Acquisition |
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7 | (1) |
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1.4 The IEC Attempts To Circumvent The Limitations Of CTDI |
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7 | (2) |
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1.4.1 For Shift-Variant Techniques |
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8 | (1) |
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1.4.2 For the Stationary Phantom/Table |
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8 | (1) |
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8 | (1) |
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1.4.4 Use of the Scanner-Reported CTDI |
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8 | (1) |
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1.4.5 Size-Specific Dose Estimates (SSDE) |
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8 | (1) |
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9 | (2) |
Chapter 2 Derivation of Dose Equations for Shift-Invariant Techniques and the Physical Interpretation of the CTDI-Paradigm |
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11 | (16) |
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11 | (1) |
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2.2 Derivation Of The Dose Equations And The CTDI- Paradigm On The Phantom Central Axis For A Shift- Invariant Helical Technique In Which No Parameters Vary With Z (Constant Tube Current, Pitch, Aperture, Etc.) |
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12 | (3) |
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2.3 Limitations Of THE CTDI-Paradigm: The Requirement For Shift-Invariance |
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15 | (2) |
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2.4 Extension Of The Derivations To Axial Scans And To Helical Scans On The Peripheral Axes |
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17 | (5) |
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2.4.1 Derivation of the Dose Equations for Axial Scans |
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18 | (1) |
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2.4.2 Derivation of the Helical Dose Distribution on the Peripheral Axes |
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19 | (2) |
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2.4.3 Longitudinal Average vs. Angular Average for Helical Scans |
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21 | (1) |
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2.5 Total Energy E Absorbed In The Phantom (And DLP) |
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22 | (3) |
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23 | (1) |
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2.5.2 The Physical Meaning of CTDIfree-in-air |
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24 | (1) |
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2.5.3 Three-Dimensional Calculation of the Total Energy Deposited in the Phantom |
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24 | (1) |
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25 | (1) |
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26 | (1) |
Chapter 3 Experimental Validation of a Versatile System of CT Dosimetry Using a Conventional Small Ion Chamber |
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27 | (26) |
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27 | (1) |
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3.2 Summary Of CT Dose Theory In A Cylindrical Phantom |
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28 | (1) |
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3.3 Accumulated Dose (Or CTDI) Measurements |
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29 | (3) |
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3.3.1 Pencil Chamber Acquisition Method |
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29 | (1) |
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3.3.2 Small Ion Chamber Acquisition Method |
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30 | (1) |
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3.3.3 The Measured Quantity - A Phantom Dose Surrogate |
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31 | (1) |
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3.4 Materials And Methods |
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32 | (1) |
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3.5 Measurements Validating The Precision And Accuracy Of The Dosimetry System Itself |
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33 | (2) |
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3.5.1 Test of the "Stem Effect" for NE 2571 Farmer Chamber |
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33 | (1) |
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3.5.2 Effect of Phantom Cavity on Farmer Chamber Reading |
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33 | (1) |
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3.5.3 Cross Comparison of Ion Chambers |
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33 | (2) |
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3.5.4 Validation of the Manufacturer-Supplied Pencil Chamber Active Length l |
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35 | (1) |
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3.6 Body Phantom Measurements And Results |
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35 | (4) |
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3.6.1 Effect of Phantom Length on CTD/100 |
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35 | (1) |
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3.6.2 Experimental Plan for Demonstration of the Small Ion Chamber Acquisition Method |
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36 | (1) |
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3.6.3 Selection of Scan Parameters for the Small Ion Chamber Acquisition |
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37 | (1) |
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3.6.4 Results of Measurements Made in the 400 mm Long Body Phantom |
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37 | (2) |
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3.7 Analysis Of Body Phantom Data |
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39 | (2) |
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3.7.1 Underestimation of Equilibrium Dose in the 400 mm Phantom Due to Truncation of Integration Length to 100 mm |
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39 | (1) |
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3.7.2 Underestimation of Equilibrium Dose by CTDI100 - Total Shortfall |
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40 | (1) |
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3.7.3 Farmer vs. Pencil Chamber Comparison |
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40 | (1) |
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41 | (2) |
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3.8.1 A Useful Constant Deriving from Conservation of Energy and a Robust Measurement Shortcut |
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41 | (2) |
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3.9 Validation Of Peripheral Axis Data |
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43 | (2) |
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3.9.1 Correcting a Misconception |
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43 | (1) |
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3.9.2 Testing the Sensitivity of the Peripheral Axis Data to Averaging Errors |
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43 | (1) |
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3.9.3 Visualization of the Actual Measurement Field on the Peripheral Axis |
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44 | (1) |
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3.9.4 An Alternate Method to Circumvent the Possibility of Peripheral Axis Averaging Errors |
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45 | (1) |
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3.10 A Suggested New CT Dose Measurement Protocol |
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45 | (2) |
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3.11 The Central Axis Dose Gains In Relative Importance |
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47 | (1) |
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47 | (1) |
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48 | (1) |
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Appendix A: Illustration Of CTDI-Aperture Constancy |
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49 | (1) |
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49 | (1) |
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50 | (3) |
Chapter 4 An Improved Analytical Primary Beam Model for CT Dose Simulation |
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53 | (34) |
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53 | (1) |
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54 | (7) |
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4.2.1 The Simple Geometric Model |
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54 | (1) |
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4.2.2 Detailed Primary Beam Model on the Axis of Rotation |
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55 | (2) |
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4.2.3 Outline of Primary Beam Model Derivation |
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57 | (2) |
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4.2.4 Convolution Approximation for the Tilted Anode |
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59 | (1) |
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60 | (1) |
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4.2.6 Model Application to the "Z-Flying Focal Spot" |
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60 | (1) |
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4.3 Experimental Validation Of The Primary Beam Model On The Axis Of Rotation |
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61 | (2) |
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4.3.1 Materials and Methods |
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61 | (1) |
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4.3.2 Primary Beam Profiles: Measurement vs. Theory |
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61 | (2) |
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4.3.3 Tilted vs. Flat Anode Challenge |
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63 | (1) |
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63 | (1) |
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64 | (2) |
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4.5.1 Defining CTDI-Aperture |
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66 | (1) |
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4.6 Extension Of The Primary Beam Model To The Peripheral Phantom Axes |
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66 | (4) |
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4.6.1 Primary Beam Model for the Peripheral Axes |
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68 | (2) |
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4.6.2 Determination of the Angular Dependence of the Primary Beam Dose Rate A(9) |
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70 | (1) |
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4.7 Model Predictions For Cumulative Dose Distributions |
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70 | (6) |
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4.7.1 Transforming the Helical Dose Equation on a Peripheral Axis into an Axial Format |
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70 | (2) |
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4.7.2 Basic Equations Describing the Accumulated Dose |
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72 | (1) |
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4.7.3 Smoothing Conditions for the Quasi-Periodic Cumulative Dose |
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73 | (1) |
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4.7.4 Simulation of the Accumulated Dose on the Peripheral Axes |
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74 | (1) |
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4.7.5 Experimental vs. Simulated Accumulated Dose Distributions |
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75 | (1) |
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4.8 Cumulative Dose (Or CTDI) Measurements Using A Small Ion Chamber |
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76 | (1) |
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4.9 Summary And Conclusions |
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77 | (1) |
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78 | (1) |
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Appendix A: Details Of Primary Beam Model On The Axis Of Rotation |
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78 | (4) |
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A.1 The "Inverse Square" Correction Term |
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79 | (1) |
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79 | (1) |
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A.3 Uniformity of Phantom Attenuation Across the Slice |
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80 | (1) |
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A.4 Approximation of the Constraint Equation |
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81 | (1) |
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A.5 Solving the Tilted Anode Problem for fp (z) |
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82 | (1) |
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Appendix B: Peripheral Phantom Axes |
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82 | (3) |
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B.1 Heel Effect - Peripheral Axis |
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83 | (1) |
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B.2 Constraint Equation for a Peripheral Axis |
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83 | (2) |
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Glossary Of Model Parameters And Their Magnitudes |
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85 | (1) |
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86 | (1) |
Chapter 5 Cone beam CT Dosimetry: A Unified and Self-Consistent Approach Including All Scan Modalities - With or Without Phantom Motion |
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87 | (30) |
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87 | (1) |
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88 | (7) |
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5.2.1 Conventional CT Scanning Using Table/Phantom Translation: Accumulated Dose Equations for Helical or Axial Scan Trajectories Utilizing Table/Phantom Translation Along z |
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88 | (2) |
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90 | (1) |
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5.2.2.1 Transition from Helical to Stationary Table/Phantom |
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90 | (1) |
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5.2.2.2 The Following Important Points Are Clear From the Foregoing: |
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90 | (1) |
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91 | (1) |
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5.2.3 The Case of the Stationary Phantom |
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91 | (3) |
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5.2.3.1 Relating the Dose and the Dose Distribution in SCBCT to That of Conventional CT |
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91 | (2) |
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5.2.3.2 Measurement of the Central Ray Dose f(0) for a Wide Cone Beam and a Stationary Phantom in SCBCT |
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93 | (1) |
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5.2.4 The Equilibrium Dose Constant Aeq |
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94 | (1) |
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5.3 Numerical Analysis Of Experimental SCBCT Dose Data |
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95 | (3) |
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5.3.1 The Inapplicability of the CTDI-Paradigm and the Pencil Chamber to Stationary Phantom Dosimetry |
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96 | (1) |
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5.3.2 The Approach to Scatter Equilibrium for SCBCT |
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97 | (1) |
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5.3.3 The Approach to Equilibrium Function H(λ) |
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97 | (1) |
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5.4 Modeling The Cone Beam |
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98 | (11) |
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5.4.1 General Considerations |
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98 | (1) |
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98 | (1) |
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5.4.3 A Simple Beam Model Predicting the Observed Dose Data |
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98 | (8) |
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5.4.3.1 The Integral Theorem |
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99 | (1) |
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5.4.3.2 Relation Between Aeq and the Total Energy Deposited in the Phantom (Integral Dose) |
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100 | (1) |
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5.4.3.3 Calculation of the Relevant Stationary Phantom Peak Dose f(0) Using this Model |
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100 | (1) |
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5.4.3.4 The Scatter LSFs Exhibit Surprising Simplicity - the Monte Carlo Model |
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101 | (1) |
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5.4.3.5 Derivation of the Equation for the Peak Dose f(0) Using the Scatter LSF |
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102 | (1) |
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5.4.3.6 The Approach-to-Equilibrium Function H(a) |
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103 | (1) |
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5.4.3.7 The Commonality of the Approach to Equilibrium Function H(a)for Both Stationary Phantom Scanning (e.g., SCBCT) and Conventional Helical or Axial CT Scanning |
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104 | (1) |
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5.4.3.8 Comparison of the Theoretical Equation for H(a) with Experiment |
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104 | (2) |
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5.4.4 Extension to Peripheral Axes |
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106 | (3) |
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5.4.4.1 Derivation of the Expression for f(z) and f(0) on the Peripheral Axis using the LSF |
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106 | (3) |
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5.5 Generating The Complete Data Set For Conventional And Stationary Phantom CT From A Single Measurement Of The Peak Dose F(0) Resulting From A Single Axial Rotation - An Example |
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109 | (2) |
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5.5.1 Crossover to Conventional CT dose |
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111 | (1) |
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5.6 Summary And Conclusions |
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111 | (2) |
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113 | (1) |
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Appendix A: Derivation Of The LSF Formulation For The Peripheral Axis |
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113 | (2) |
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115 | (1) |
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116 | (1) |
Chapter 6 Analytical Equations for CT Dose Profiles Derived Using a Scatter Kernel of Monte Carlo Parentage Having Broad Applicability to CT Dosimetry Problems |
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117 | (24) |
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117 | (3) |
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6.1.1 Summary of Pertinent Results from the Previous Chapter |
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117 | (1) |
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6.1.2 Deriving an Analytical Function Describing the Complete Dose Profile |
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117 | (1) |
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6.1.3 The Utility of the Analytical Dose Profile Function f(z) |
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118 | (2) |
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6.2 Materials And Methods |
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120 | (1) |
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120 | (2) |
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6.3.1 The Primary Beam Component of the Axial Dose Profile fp(z) |
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120 | (1) |
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6.3.2 Derivation of the Scatter Component of the Axial Profile from the Scatter LSF |
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121 | (1) |
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6.3.3 Calculation of the Complete Axial Dose Profile on the Phantom Central Axis |
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121 | (1) |
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6.4 Comparison Of Theory With Experimental Data |
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122 | (5) |
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6.4.1 Primary Beam Function as Measured Free-In-Air |
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122 | (1) |
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6.4.2 Dose Profiles f(z) Measured on the Central Axis of the 32 cm PMMA Body Phantom Including Scatter |
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123 | (2) |
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6.4.3 The Heel Effect and Wide Cone Beams |
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125 | (1) |
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6.4.4 Stationary Phantom CT |
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126 | (1) |
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6.4.5 Helical CT with Wide Cone Beams and with Table Translation - CTDIL Can Again Apply |
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127 | (1) |
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6.5 Deriving Analytical Equations For CTDIL And Related Quantities For Conventional CT Using The Dose Profile Functions Previously Derived (L > a) |
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127 | (5) |
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6.5.1 Providing New Insight into the Physics of CT Dosimetry |
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128 | (2) |
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6.5.1.1 The CTDI Equation - Looking Behind its Integral Facade |
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129 | (1) |
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6.5.2 The Effect of the Weak Coupling Between Scan Length L and Beam Width a for Conventional CT Using Table Translation |
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130 | (1) |
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6.5.3 Application to Problems Beyond the Reach of the CTDI Method |
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130 | (2) |
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6.5.3.1 Understanding and Exploiting the Symmetries Implied by the Convolution |
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130 | (1) |
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6.5.3.2 The Case of a Near-Stationary Phantom for which L < a |
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130 | (1) |
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6.5.3.3 Evaluation of the Accumulated Dose DL(z) for an Arbitrary Value of znot = to 0 |
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131 | (1) |
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6.6 Theoretical Dose Distributions On The Peripheral Axes For Single And Multiple Rotations |
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132 | (3) |
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6.6.1 An Analytical CT Dose Simulator - SIMDOSE |
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132 | (1) |
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6.6.2 Comparison of Theory with the Peripheral Axis Dose Profiles of Mori |
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132 | (3) |
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6.7 Application To Shift-Variant Scan Protocols |
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135 | (1) |
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6.8 Summary And Conclusions |
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136 | (1) |
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137 | (1) |
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Appendix A: Heel Effect Function |
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137 | (1) |
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Appendix B: Scatter Function Using The Full Double-Exponential LSF [ EQ. (6.7A)] |
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138 | (1) |
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138 | (1) |
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138 | (3) |
Chapter 7 Dose Equations for Tube Current Modulation in CT Scanning and the Interpretation of the Associated CTD/voi |
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141 | (28) |
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141 | (1) |
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142 | (1) |
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7.2.1 Review of the Physical Meaning of the Traditional CTDIvol Based on Constant Tube Current (Constant mA) |
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142 | (1) |
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7.2.2 A Brief Review of the Relation of CTDIvol to Patient Dose |
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143 | (1) |
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7.3 Derivation Of The Theoretical Equations For Automatic Tube Current Modulation (TCM) |
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143 | (6) |
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7.3.1 Shift-Invariant Helical Technique Using Constant mA |
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143 | (2) |
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7.3.2 Deriving the Dose Equations for a Shift-Variant TCM Technique |
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145 | (4) |
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7.4 Total Energy Absorbed For Automatic Tube Current Modulation (TCM) |
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149 | (1) |
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7.5 The Trouble With The Reported Values Of CTDIvol |
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150 | (2) |
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7.5.1 Defining CTDITCMvol for a Shift-Variant, Auto TCM Protocol |
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150 | (1) |
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7.5.2 Tube Current Modulation (TCM) Versus Constant Current Summary |
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151 | (1) |
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7.5.2.1 A Pencil Chamber Measurement Has No Utility Whatsoever for Auto TCM nor for Shift-Variant Techniques in General |
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152 | (1) |
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7.6 A General Method For Handling Shift-Variant Protocols |
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152 | (8) |
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7.6.1 Simulation for a Shift-Invariant Constant mA |
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153 | (1) |
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7.6.2 Simulation of Shift-Variant Protocols (such as z-axis TCM) for which the Formulae of the CTDI-Paradigm Eqs (7.1-7.3) are Not Valid |
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154 | (5) |
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7.6.3 Calculation of Average Doses for the Profiles in Figure 7.6 - the Search for Some Commonality of CTDITCMvol and CTDIvol for Constant mA |
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159 | (1) |
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7.7 Derivation Of Some New Analytical Equations Treating Energy And Accumulated Dose |
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160 | (3) |
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7.7.1 Restricting the Derivation to the Cen |
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160 | (1) |
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161 | (1) |
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7.7.3 The IEC Version of a "local CTDIvol(z)" and Global CTDITCMvol for Tube Current Modulation (TCM) |
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162 | (1) |
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7.8 Summary And Conclusions |
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163 | (1) |
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7.8.1 The Total Energy Absorbed E (Integral Dose) and DLP are Robust between Auto TCM and Constant mA Protocols (but Only for the Same Scan Length L= vto) |
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163 | (1) |
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7.8.2 The Scanner-Reported Value of "CTDIvol" Is Not Robust in the Dose Domain |
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164 | (1) |
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164 | (1) |
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165 | (1) |
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166 | (3) |
Chapter 8 Dose Equations for Shift-Variant CT Acquisition Modes Using Variable Pitch, Tube Current, and Aperture, and the Meaning of their Associated CTDIvol |
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169 | (22) |
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169 | (1) |
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8.2 Materials And Methods |
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170 | (1) |
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170 | (8) |
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8.3.1 Accumulated Dose for a Shift-Invariant Scan (Constant Tube Current and Pitch) |
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171 | (2) |
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8.3.2 Accumulated Dose Equation for Tube Current Modulation TCM [ Variable i(z), Constant Pitch] |
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173 | (1) |
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8.3.3 Accumulated Dose Equation for Variable Pitch (Pitch Modulation or PM) at Constant Current |
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174 | (3) |
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8.3.3.1 Table Kinematics for Variable Pitch |
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175 | (1) |
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8.3.3.2 Using a Helical Shuttle as a Specific Example for Illustration of Table Kinematics |
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176 | (1) |
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8.3.3.3 Summary for TCM and PM |
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177 | (1) |
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8.3.4 Accumulated Dose for Concurrent Tube Current and Pitch Modulation (Concurrent TCM and PM) |
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177 | (1) |
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8.4 Summary Of Equations For Various Scan Protocols |
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178 | (1) |
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8.5 Total Energy E Absorbed In The Phantom (And DLP) |
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178 | (1) |
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8.6 Variable Z-Collimator Aperture |
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179 | (1) |
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180 | (5) |
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8.7.1 Shift-Invariant Manual Technique - Constant Tube Current and Pitch |
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181 | (1) |
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8.7.2 Variable Tube Current or Variable Pitch |
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181 | (1) |
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8.7.3 Helical Shuttle (Variable Pitch, Constant Tube Current) |
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181 | (2) |
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8.7.3.1 Short Helical Shuttle |
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181 | (1) |
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8.7.3.2 Helical Shuttle vs. Cone Beam |
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182 | (1) |
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8.7.4 Summary of Accumulated Dose Distributions for All Simulated CT Protocols in a Single Figure |
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183 | (2) |
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8.8 Summary And Conclusions |
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185 | (1) |
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8.8.1 The Trouble with Scanner-Reported Values of CTDIvol for Shift- Variant Scan Techniques |
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185 | (1) |
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186 | (1) |
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187 | (1) |
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188 | (3) |
Chapter 9 Stationary Table CT Dosimetry and Anomalous Scanner- Reported Values of CTDIvol |
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191 | (14) |
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191 | (1) |
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9.2 The Stationary Phantom Problem - And Its Solution |
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191 | (4) |
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9.2.1 Analysis Using a Simulation |
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191 | (2) |
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9.2.2 The Scanner-Reported CTDIvol |
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193 | (1) |
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9.2.3 Clinical Examples of Anomalous Values of CTDIvol |
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194 | (1) |
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9.2.4 Total Energy Absorbed E and DLP |
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195 | (1) |
|
9.3 Appropriate Stationary Phantom Dose Equations - The Fix Is Easy |
|
|
195 | (2) |
|
9.4 Relation Of Scanner-Reported Dose Indices To Actual Patient Dose |
|
|
197 | (2) |
|
9.4.1 Size-Specific Dose Estimates (SSDE) |
|
|
198 | (1) |
|
9.4.2 Anomalous Values of SSDE |
|
|
199 | (1) |
|
9.5 CTDI100 For Wide Beams (IEC Version) - Cracking The "Ctdi Enigma" Code |
|
|
199 | (3) |
|
9.6 Summary And Conclusions |
|
|
202 | (1) |
|
|
203 | (2) |
Chapter 10 Future Directions of CT Dosimetry and A Book Summary |
|
205 | (4) |
|
|
205 | (2) |
|
10.1.1 Estimation of Organ Doses |
|
|
205 | (1) |
|
10.1.1.1 Tube Current Modulation (TCM) and SSDE |
|
|
205 | (1) |
|
10.1.2 Understanding Risks from CT Exams |
|
|
206 | (1) |
|
10.1.2.1 The Gambler's Fallacy |
|
|
207 | (1) |
|
10.1.2.2 Death by Coefficient |
|
|
207 | (1) |
|
|
207 | (1) |
|
|
208 | (1) |
Index |
|
209 | |