Assessing the Clinical Utility of Quantitative Computed Tomography With a Routinely Used Diagnostic Computed Tomography Scanner in a Cancer Center

The purpose of this study was to characterize quantitative computed tomography (QCT) in our multi-detector computed tomography (MDCT) scanner with regard to the influence of the QCT phantom on dose and the influence of varying mA and CIRS phantom size on bone mineral density (BMD) measurements. We accomplish this by scanning a commercially available QCT phantom and a corresponding quality assurance phantom. To assess the feasibility of having the QCT phantom in place while patients are being scanned, we measured radiation dose difference in a CT body phantom with and without the QCT phantom on the CT table and also, with and without the use of dose modulation programs. We also analyzed reconstructed QCT phantom images with the manufacturer's software to measure BMD. Although patient characteristics may be different, leading to different mA values, the influence of the QCT phantom on the dose to patients was minimal when compared with doses measured without the phantom in place. Average BMD measurements were not significantly affected by varying mA, for a fixed-size phantom. The average BMD exhibited a weak dependence on computerized imaging reference systems (CIRS) torso phantom size, with a propensity for decreasing BMD with increasing size. Measurement precision was unaffected by varying CIRS size. Having the ability to measure bone density as part of the routine management of cancer patients, with no added cost, time, or radiation dose, will allow for the prospective evaluation of bone mineral changes. We believe that this ability will facilitate the detection of abnormal bone loss and will lead to better management of this loss and, thus, reduce the complications and associated morbidity in these cancer survivors.