Computation of energy imparted in diagnostic radiology

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Abstract
Energy imparted is a measure of the total ionizing energy deposited in the patient during a radiologic examination and may be used to quantify the patient dose in diagnostic radiology. Values of the energy imparted per unit exposure-area product, omega (z), absorbed by a semi-infinite water phantom with a thickness z, were computed for x-ray spectra with peak x-ray tube voltages ranging from 50-140 kV and with added filtration, ranging from 1-6 mm aluminum. For a given phantom thickness and peak x-ray tube voltage, the energy imparted was found to be directly proportional to the x-ray beam half-value layer (HVL) expressed in millimeters of aluminum. Values of omega (z) were generated for constant waveform x-ray tube voltages and an anode angle of 12 degrees, and were fitted to the expression omega (z) = alpha x HVL + beta. Fitted alpha and beta parameters are provided that permit the energy imparted to be determined for any combination of tube voltage, half-value layer, and phantom thickness from the product of the entrance skin exposure (free-in-air) and the corresponding x-ray beam area. The results obtained using our method for calculating energy imparted were compared with values of energy imparted determined using Monte Carlo techniques and anthropomorphic phantoms for a range of diagnostic examinations. At 60, 80, and 120 kV, absolute values of energy imparted obtained using our method differed by 8%, 10%, and 12%, respectively, from the corresponding results of Monte Carlo computations obtained for an anthropomorphic phantom. The method described in this paper permits a simple determination of energy imparted for any type of diagnostic x-ray examination which may be used to compare the radiologic risks from differing types of x-ray examinations, optimize imaging techniques with respect to the patient dose, or estimate the patient effective dose equivalent.