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Patient specific dose evaluation and reporting is becoming increasingly important for x-ray imaging systems. Even imaging systems with lower patient dose such as CBCT scanners for extremities can benefit from accurate and size-specific dose assessment and reporting. This paper presents CTDI dose measurements performed on a prototype CBCT extremity imaging system across a range of body part sizes (5, 10, 16, and 20 cm effective diameter) and kVp (70, 80, and 90 kVp - with 0.1 mm Cu added filtration). The ratio of the CTDI measurements for the 5, 10, and 20 cm phantoms to the CTDI measurements for the 16 cm phantom were calculated and results were compared to size-specific dose estimates conversion factors (AAPM Report 204), which were evaluated on a conventional CT scanner. Due to the short scan nature of the system (220 degree acquisition angle), the dependence of CTDI values on the initial angular orientation of the phantom with respect to the imager was also evaluated. The study demonstrated that for a 220 degree acquisition sequence, the initial angular position of the conventional CTDI phantom with respect to the scanner does not significantly affect CTDI measurements (varying by less than 2% overall across the range of possible initial angular positions). The size-specific conversion factor was found to be comparable to the Report 204 factors for the large phantom size (20 cm) but lower, by up to 12%, for the 5 cm phantom (i.e., 1.35 for CBCT vs 1.54 for CT). The factors dependence on kVp was minimal, but dependence on kVp was most significant for smaller diameters. These results indicate that specific conversion factors need to be used for CBCT systems with short scans in order to provide more accurate dose reporting across the range of body sizes found in extremity scanners.
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