Anatomy-Weighted CTDIvol from Routine CT Metadata: A Patient-Specific, Multi-Vendor Study Using Deep-Learning Segmentation.

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Abstract

<b>Background/Objectives:</b> The volume computed tomography (CT) dose index (CTDIvol) is a scanner output, not an organ dose, and cannot express how tube-current modulation varies along a patient. An organ-specific weighted CTDIvol addressing this has been reported before, in single-institution cohorts and often from inputs routine archives do not retain. New here is not the quantity but what an open, multi-vendor operationalisation reveals: whether its inputs survive archive curation and what the fallback costs when they do not. <b>Methods:</b> Forty abdominal CT series, ten per manufacturer, were drawn from the Cancer Imaging Archive and twelve organs segmented with TotalSegmentator at inference. Of 480 requested organ-series combinations, 455 were produced. A rule-based acquisition-constancy criterion admitted 39 series. <b>Results:</b> Modulation weights spanned 0.59 to 1.69, so the index departs from the whole-scan CTDIvol by up to 70% within one acquisition. A recorded CTDIvol survived in 29 of 40 archived headers and was reconstructable in 5 and unavailable in 6, availability differing markedly between manufacturers. Forcing that reconstruction on series that did retain a value agreed to within 12% on three scanner models and diverged by 58% and 84% on two others. Estimated organ mass was broadly consistent with International Commission on Radiological Protection (ICRP) Publication 89 for liver and kidneys. <b>Conclusions:</b> This index is not an absorbed dose; the implementation is open.

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