基于有效直径与水当量直径的SSDE算法在 不同人群CT检查中的应用进展
Application Progress of SSDE Algorithm Based on Effective Diameter and Water-Equivalent Diameter in CT Examinations of Different Populations
摘要: 体型特异性剂量估算(SSDE)是CT剂量学领域的重要进展，可精准校正传统容积CT剂量指数(CTDIvol)无法反映不同体型患者实际吸收剂量的不足，对辐射敏感性更高的儿童患者尤为重要。SSDE通过有效直径(Deff)或水当量直径(Dw)计算尺寸转换因子，实现个体化辐射剂量估算，其中Dw兼顾几何尺寸与组织衰减特性，准确性更优。该技术已广泛应用于儿科与成人CT检查，可优化诊断参考水平、开展患者特异性辐射风险评估、平衡图像质量与辐射剂量；深度学习与自动化工具显著简化SSDE计算流程，但仍面临计算标准化、临床流程整合、个体病理差异影响等挑战。未来需推进计算方法标准化、深化自动化集成、优化组织与病理校正模型，推动CT辐射防护与质量管理水平提升。
Abstract: Size-Specific Dose Estimate (SSDE) is a crucial advancement in CT dosimetry, which corrects the limitation that the conventional volume CT dose index (CTDIvol) fails to accurately reflect the actual absorbed dose in patients with various body sizes, especially for pediatric patients with higher radiation sensitivity. SSDE realizes individualized radiation dose estimation by calculating the size conversion factor using effective diameter (Deff) or water-equivalent diameter (Dw). Dw is more accurate since it takes both geometric dimensions and tissue attenuation characteristics into account. This technique has been widely applied in pediatric and adult CT examinations, contributing to optimizing diagnostic reference levels, performing patient-specific radiation risk assessment, and balancing image quality and radiation dose. Deep learning and automated tools have greatly simplified the SSDE calculation process, yet challenges remain including calculation standardization, clinical workflow integration, and the impact of individual pathological differences. Future efforts should promote the standardization of calculation methods, deepen automated integration, and optimize correction models for tissue and pathological variations, so as to improve the level of CT radiation protection and quality management.
文章引用：何子寅, 牛洪涛. 基于有效直径与水当量直径的SSDE算法在 不同人群CT检查中的应用进展[J]. 临床医学进展, 2026, 16(6): 169-176. https://doi.org/10.12677/acm.2026.1662207

参考文献

[1] Almuqbil, K., Abuhaimed, A., Abanomy, A., et al. (2024) Estimation of Size-Specific Dose Estimate (SSDE) of CT Scans Using an Effective Diameter Electron Density. European Journal of Radiology, 172, Article 111311. [Google Scholar] [CrossRef] [PubMed]
[2] Inoue, Y. (2023) Radiation Dose Management in Computed Tomography: Introduction to the Practice at a Single Facility. Tomography, 9, 955-966. [Google Scholar] [CrossRef] [PubMed]
[3] Kalra, M.K., Sodickson, A.D. and Mayo-Smith, W.W. (2015) CT Radiation: Key Concepts for Gentle and Wise Use. RadioGraphics, 35, 1706-1721. [Google Scholar] [CrossRef] [PubMed]
[4] Sulemana, H., Mumuni, A.N. and Abubakari, I.O.M. (2024) Establishment of Baseline Size-Specific Dose Estimate (SSDE) for Paediatric Head Computed Tomography (CT) Examinations. Egyptian Journal of Radiology and Nuclear Medicine, 55, Article No. 238. [Google Scholar] [CrossRef] 
[5] 许书聪, 郝文瀚, 袁新宇, 等. 基于水当量直径体型特异性剂量估计在儿童头部CT检查中的价值[J]. 中华放射医学与防护杂志, 2022, 42(1): 69-72.
[6] Parikh, R.A., Wien, M.A., Novak, R.D., Jordan, D.W., Klahr, P., Soriano, S., et al. (2017) A Comparison Study of Size-Specific Dose Estimate Calculation Methods. Pediatric Radiology, 48, 56-65. [Google Scholar] [CrossRef] [PubMed]
[7] Khawaja, R.D.A., Singh, S., Vettiyil, B., Lim, R., Gee, M., Westra, S., et al. (2015) Simplifying Size-Specific Radiation Dose Estimates in Pediatric CT. American Journal of Roentgenology, 204, 167-176. [Google Scholar] [CrossRef] [PubMed]
[8] Karmazyn, B., Ai, H., Klahr, P., Ouyang, F. and Jennings, S.G. (2016) How Accurate Is Size-Specific Dose Estimate in Pediatric Body CT Examinations? Pediatric Radiology, 46, 1234-1240. [Google Scholar] [CrossRef] [PubMed]
[9] Franck, C., Vandevoorde, C., Goethals, I., Smeets, P., Achten, E., Verstraete, K., et al. (2015) The Role of Size-Specific Dose Estimate (SSDE) in Patient-Specific Organ Dose and Cancer Risk Estimation in Paediatric Chest and Abdominopelvic CT Examinations. European Radiology, 26, 2646-2655. [Google Scholar] [CrossRef] [PubMed]
[10] Burton, C.S. and Al‐Ward, S. (2023) Estimating Size Specific Dose Estimate from Computed Tomography Radiograph Localizer with Radiation Risk Assessment. Journal of Applied Clinical Medical Physics, 24, e13989. [Google Scholar] [CrossRef] [PubMed]
[11] Honorio da Silva, E., Baffa, O., Elias, J. and Buls, N. (2021) Conversion Factor for Size Specific Dose Estimation of Head CT Scans Based on Age, for Individuals from 0 up to 18 Years Old. Physics in Medicine & Biology, 66, Article ID: 085011. [Google Scholar] [CrossRef] [PubMed]
[12] 梁保辉, 陈志, 徐榭. CT检查个体化辐射剂量估算研究现状[J]. 辐射防护, 2017, 37(2): 153-160.
[13] Ghetti, C., Ortenzia, O., Palleri, F. and Sireus, M. (2016) Definition of Local Diagnostic Reference Levels in a Radiology Department Using a Dose Tracking Software. Radiation Protection Dosimetry, 175, 38-45. [Google Scholar] [CrossRef] [PubMed]
[14] Anam, C., Haryanto, F., Widita, R., Arif, I. and Dougherty, G. (2016) A Fully Automated Calculation of Size-Specific Dose Estimates (SSDE) in Thoracic and Head CT Examinations. Journal of Physics: Conference Series, 694, Article ID: 012030. [Google Scholar] [CrossRef] 
[15] Anam, C., Mahdani, F.R., Dewi, W.K., Sutanto, H., Triadyaksa, P., Haryanto, F., et al. (2021) An Improved Method for Automated Calculation of the Water‐Equivalent Diameter for Estimating Size‐Specific Dose in CT. Journal of Applied Clinical Medical Physics, 22, 313-323. [Google Scholar] [CrossRef] [PubMed]
[16] Gabusi, M., Riccardi, L., Aliberti, C., Vio, S. and Paiusco, M. (2016) Radiation Dose in Chest CT: Assessment of Size-Specific Dose Estimates Based on Water-Equivalent Correction. Physica Medica, 32, 393-397. [Google Scholar] [CrossRef] [PubMed]
[17] Boos, J., Kröpil, P., Bethge, O.T., Aissa, J., Schleich, C., Sawicki, L.M., et al. (2017) Accuracy of Size-Specific Dose Estimate Calculation from Center Slice in Computed Tomography. Radiation Protection Dosimetry, 178, 8-19. [Google Scholar] [CrossRef] [PubMed]
[18] Porzio, M. and Anam, C. (2022) Real-Time Fully Automated Dosimetric Computation for CT Images in the Clinical Workflow: A Feasibility Study. Frontiers in Oncology, 12, Article 798460. [Google Scholar] [CrossRef] [PubMed]
[19] Payne, S. and Badawy, M. (2023) Comparison of Average Water Equivalent Diameter Values between Ctcontour and Vendor-Specific Estimates in CT Dosimetry. Physica Medica, 114, Article ID: 103142. [Google Scholar] [CrossRef] [PubMed]
[20] Zhang, D., Liu, X., Duan, X., Bankier, A.A., Rong, J. and Palmer, M.R. (2020) Estimating Patient Water Equivalent Diameter from CT Localizer Images—A Longitudinal and Multi‐Institutional Study of the Stability of Calibration Parameters. Medical Physics, 47, 2139-2149. [Google Scholar] [CrossRef] [PubMed]
[21] Anam, C., Fujibuchi, T., Toyoda, T., Sato, N., Haryanto, F., Widita, R., et al. (2017) A Simple Method for Calibrating Pixel Values of the CT Localizer Radiograph for Calculating Water-Equivalent Diameter and Size-Specific Dose Estimate. Radiation Protection Dosimetry, 179, 158-168. [Google Scholar] [CrossRef] [PubMed]
[22] Kidoh, M., Utsunomiya, D., Oda, S., Nakaura, T., Funama, Y., Yuki, H., et al. (2016) Breast Dose Reduction for Chest CT by Modifying the Scanning Parameters Based on the Pre-Scan Size-Specific Dose Estimate (SSDE). European Radiology, 27, 2267-2274. [Google Scholar] [CrossRef] [PubMed]
[23] Sapignoli, S., Roggio, A., Boschini, A., Guida, F., Merlo, C., Paiusco, M., et al. (2022) Size-Specific Dose Estimates for Pediatric Head CT Protocols Based on the AAPM Report TG-293. Physica Medica, 100, 26-30. [Google Scholar] [CrossRef] [PubMed]
[24] Akhilesh, P., Pathan, M.S., Sharma, S.D. and Sapra, B.K. (2025) Size Specific Dose Estimates and Effective Dose in Multiphase Abdomen-Pelvis CT Examinations. Radiation Physics and Chemistry, 226, Article ID: 112269. [Google Scholar] [CrossRef] 
[25] Steiniger, B., Klippel, C., Teichgräber, U., Reichenbach, J.R. and Fiebich, M. (2022) Can the Size-Specific Dose Estimate Be Derived from the Body Mass Index? A Feasibility Study. Radiation Protection Dosimetry, 198, 325-333. [Google Scholar] [CrossRef] [PubMed]
[26] Van Hedent, S., Tatsuoka, C., Carr, S., Laukamp, K.R., Eck, B., Große Hokamp, N., et al. (2020) Impact of Patient Size and Radiation Dose on Accuracy and Precision of Iodine Quantification and Virtual Noncontrast Values in Dual-Layer Detector CT—A Phantom Study. Academic Radiology, 27, 409-420. [Google Scholar] [CrossRef] [PubMed]
[27] Osman, N.D., Abdulkadir, M.K., Shuaib, I.L. and Nasirudin, R.A. (2024) Evaluation of a New Predictive Equation for Automated Calculation of Size-Specific Dose Estimate (SSDE) in CT Imaging. Radiography, 30, 237-244. [Google Scholar] [CrossRef] [PubMed]
[28] Pace, E., Caruana, C.J., Bosmans, H., Cortis, K., D’Anastasi, M. and Valentino, G. (2022) CTContour: An Open-Source Python Pipeline for Automatic Contouring and Calculation of Mean SSDE along the Abdomino-Pelvic Region for CT Images; Validation on Fifteen Systems. Physica Medica, 103, 190-198. [Google Scholar] [CrossRef] [PubMed]
[29] Juszczyk, J., Badura, P., Czajkowska, J., Wijata, A., Andrzejewski, J., Bozek, P., et al. (2021) Automated Size-Specific Dose Estimates Using Deep Learning Image Processing. Medical Image Analysis, 68, Article ID: 101898. [Google Scholar] [CrossRef] [PubMed]
[30] Ruenjit, S., Siricharoen, P. and Khamwan, K. (2024) Automated Size‐Specific Dose Estimates Framework in Thoracic CT Using Convolutional Neural Network Based on U‐Net Model. Journal of Applied Clinical Medical Physics, 25, e14283. [Google Scholar] [CrossRef] [PubMed]
[31] Benmessaoud, M., Dadouch, A., Maghnouj, A., Lemmassi, A., Tahiri, M., El-ouardi, Y., et al. (2023) Establishment of Local Diagnostic Reference Levels for Paediatric Abdominal-Pelvis and Chest-Abdominal-Pelvis Computed Tomography in Morocco: Suggests the Need for Improved Optimization Efforts. Radiation Protection Dosimetry, 199, 1129-1141. [Google Scholar] [CrossRef] [PubMed]
[32] Singh, R., Sharma, A., McDermott, S., Homayounieh, F., Rastogi, S., Flores, E.J., et al. (2019) Comparison of Image Quality and Radiation Doses between Rapid KV-Switching and Dual-Source DECT Techniques in the Chest. European Journal of Radiology, 119, Article ID: 108639. [Google Scholar] [CrossRef] [PubMed]
[33] Debray, M., Dauriat, G., Khalil, A., Leygnac, S., Tubiana, S., Grandjean, A., et al. (2015) Diagnostic Accuracy of Low-Ma Chest CT Reconstructed with Model Based Iterative Reconstruction in the Detection of Early Pleuro-Pulmonary Complications Following a Lung Transplantation. European Radiology, 26, 3138-3146. [Google Scholar] [CrossRef] [PubMed]
[34] Terzis, R., Reimer, R.P., Nelles, C., Celik, E., Caldeira, L., Heidenreich, A., et al. (2023) Deep-Learning-Based Image Denoising in Imaging of Urolithiasis: Assessment of Image Quality and Comparison to State-of-the-Art Iterative Reconstructions. Diagnostics, 13, Article 2821. [Google Scholar] [CrossRef] [PubMed]
[35] Kim, S.H. (2019) Effective Radiation Dose Reduction in Computed Tomography with Iterative Reconstruction in Patients with Urinary Stone. Journal of Computer Assisted Tomography, 43, 877-883. [Google Scholar] [CrossRef] [PubMed]
[36] Brady, S.L. and Shulkin, B.L. (2015) Ultralow Dose Computed Tomography Attenuation Correction for Pediatric PET CT Using Adaptive Statistical Iterative Reconstruction. Medical Physics, 42, 558-566. [Google Scholar] [CrossRef] [PubMed]
[37] Fitousi, N. (2017) Patient Dose Monitoring Systems: A New Way of Managing Patient Dose and Quality in the Radiology Department. Physica Medica, 44, 212-221. [Google Scholar] [CrossRef] [PubMed]
[38] Gress, D.A., Dickinson, R.L., Erwin, W.D., Jordan, D.W., Kobistek, R.J., Stevens, D.M., et al. (2017) AAPM Medical Physics Practice Guideline 6.a.: Performance Characteristics of Radiation Dose Index Monitoring Systems. Journal of Applied Clinical Medical Physics, 18, 12-22. [Google Scholar] [CrossRef] [PubMed]
[39] Abuhaimed, A. and Martin, C.J. (2020) Estimation of Size-Specific Dose Estimates (SSDE) for Paediatric and Adults Patients Based on a Single Slice. Physica Medica, 74, 30-39. [Google Scholar] [CrossRef] [PubMed]

为你推荐