CT-auto exposure control on cerebral 3D-CT angiography: dose reduction and optimized image SD for inspection purposes

Consideration of the usefulness of a size-specific dose estimate in pediatric CT examination

Computed tomography (CT) has recently been utilized in various medical settings, and technological advances have resulted in its widespread use. However, medical radiation exposure associated with CT scans accounts for the largest share of examinations using radiation; thus, it is important to understand the organ dose and effective dose in detail. The CT dose index and dose-length product are used to evaluate the organ dose. However, evaluations using these indicators fail to consider the age and body type of patients. In this study, we evaluated the effective dose based on the CT examination data of 753 patients examined at our hospital using the size-specific dose estimate (SSDE) method, which can calculate the exposure dose with consideration of the physique of a patient. The results showed a large correlation between the SSDE conversion factor and physique, with a larger exposure dose in patients with a small physique when a single scan is considered. Especially for children, the SSDE conversion factor was found to be 2 or more. In addition, the patient exposed to the largest dose in this study was a 10-year-old, who received 40.4 mSv (five series/examination). In the future, for estimating exposure using the SSDE method and in cohort studies, the diagnostic reference level of SSDE should be determined and a low-exposure imaging protocol should be developed to predict the risk of CT exposure and to maintain the quality of diagnosis with better radiation protection of patients.

Image quality at low tube voltage (70 kV) and sinogram-affirmed iterative reconstruction for computed tomography in infants with congenital heart disease

BACKGROUND

Lower tube voltage has advantages for CT angiography, such as improved contrast

OBJECTIVE

To evaluate the image quality of low-voltage (70 kV) CT for congenital heart disease and the ability of sinogram-affirmed iterative reconstruction to improve image quality.

MATERIALS AND METHODS

Forty-six children with congenital heart disease (median age: 109 days) were examined using dual-source CT. Scans were performed at 80 kV and 70 kV in 21 and 25 children, respectively. A nonionic iodinated contrast medium (300 mg I/ml) was used for the 80-kV protocol. The contrast medium was diluted to 75% (225 mgI/mL) with saline for the 70-kV protocol. Image noise was measured in the two protocols for each group by extracting the standard deviations of a region of interest placed on the descending aorta. We then determined whether sinogram-affirmed iterative reconstruction reduced the image noise at 70 kV.

RESULTS

There was more noise at 70 kV than at 80 kV (29 ± 12 vs 20 ± 4.8; P < 0.01). Sinogram-affirmed iterative reconstruction with grade 4 strength settings improved the noise (20 ± 5.9; P < 0.01) for the 70-kV group.

CONCLUSION

Sinogram-affirmed iterative reconstruction improved the image quality of CT in congenital heart disease.