Advanced Monte Carlo Modeling of Automatic Exposure Control Vulnerabilities: Patient Positioning and Metallic Artifact Effects on Emergency CAP CT Dose Distribution.

Mounir Lahlali, Morad El Kafhali, Rajaa Sebihi, Aziz Elkhatib

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Article in Journal of imaging informatics in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

4 authors.

Mounir LahlaliHigh Energy Physics Laboratory-Modeling and Simulation (HEPL-MS), Faculty of Sciences, Mohammed V University, Rabat, Morocco.

Morad El KafhaliPhysical Sciences and Engineering, Innovative Research and Applied Physics (IRAP), Faculty of Sciences, Moulay Ismail University, Meknes, Morocco. m.elkafhali@edu.umi.ac.ma.ORCID http://orcid.org/0000-0003-4177-4515

Rajaa SebihiHigh Energy Physics Laboratory-Modeling and Simulation (HEPL-MS), Faculty of Sciences, Mohammed V University, Rabat, Morocco.

Aziz ElkhatibHealth Sciences and Technology Laboratory, Higher Institute of Health Sciences, Hassan 1er University, Settat, Morocco.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study investigates the influence of arm positioning and metallic objects on radiation dose distribution during emergency CT scans, where time-critical workflows demand both speed and precision. Sub-optimal arm positioning and metallic artifacts can significantly alter dose patterns and compromise patient safety. Five clinical cases undergoing chest, abdomen, and pelvis (CAP) CT scans with automatic exposure control (AEC) at 120 kVp were analyzed using GATE/Geant4 Monte Carlo simulations. Patient-specific voxel models were generated from clinical CT datasets, and the scanner was modeled with z-axis tube current modulation. Variations in arm position (arms raised, crossed, or positioned alongside the torso) and the presence of metallic objects such as belts, keys, and necklaces were simulated. Dose maps were extracted in voxel format, and patient-specific CTDIvol-like metrics were computed and compared with scanner-reported CTDIvol values. Significant dose alterations were observed due to non-optimal arm positioning and metallic artifacts. Cases 1 and 4, both with metallic belts, exhibited elevated pelvic doses of 3.448 × 10⁻

Indexed as

CT scanDICOM phantomDose distributionGATE/GEANT 4Metal artifactsMonte Carlo

Identifiers

PMID42258116

DOI10.1016/j.jmir.2025.102062

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.