Automatic exposure control based on tube current modulation (TCM) can effectively reduce dose while maintaining image quality. Conventional TCM uses total exposure from the tube and noise in the center of CT slices as surrogates of dose and image quality, respectively. In this abstract, we present an automated method to optimize TCM at the organ level, offering increased flexibility and aligning with the concept of organ-specific radiation risk assessment. We applied our method to a retrospective CT dataset and incorporated automatic organ segmentation, Monte Carlo simulation for dose calculation, and an empirical model for noise estimation. This method was fully automated and readily scalable to massive clinical data, allowing the generation of ground-truth data for any data-driven approach to prospective planning, including methods utilizing scout images.
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