Carotid CTA: Radiation Exposure and Image Quality with the Use of Attenuation-Based, Automated Kilovolt Selection

Abstract

BACKGROUND AND PURPOSE:CTA is considered the imaging modality of choice in evaluating the supraaortic vessels in many institutions, but radiation exposure remains a matter of concern. The objective of the study was to evaluate a fully automated, attenuationbased kilovolt selection algorithm in carotid CTA in respect to radiation dose and image quality compared with a standard 120-kV protocol.

Effect of Automated Attenuation-based Tube Voltage Selection on Radiation Dose at CT: An Observational Study on a Global Scale

“…The effect of ATVS on radiation exposure was particularly profound for CT angiographic applications, which is in line with previous reports on the efficacy of ATVS for CT angiography (14,19,22,23). The benefit of low-tubevoltage acquisitions is most pronounced for CT angiography because of the enhanced iodine attenuation at low tube voltage, where photon energies approximate the k-edge of iodine.…”

“…The initially generated database recorded 2 598 022 CT interactions, including topogram acquisition, bolus tracking, CT testing, and diagnostic by the scout image acquisition with information on the body region and type of examination to automatically select the combination of tube voltage and tube current that will produce the desired contrast-to-noise ratio (CNR) with the lowest radiation dose (13) (Fig 1). The available data on the efficacy of ATVS are mostly limited to relatively small single-center experiences for specific indications (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24).…”

Imaging the Parasinus Region with a Third-Generation Dual-Source CT and the Effect of Tin Filtration on Image Quality and Radiation Dose

“…13,14 The dose-reduction potential is highest in CT angiography because of the high vascular attenuation. [15][16][17][18] In nonenhanced CT, there is less potential of dose reduction by using low-kilovolt protocols, though the CT numbers of bone increase with decreasing kilovolt settings and the higher image noise in low kilovolts is a limiting factor. We demonstrated that the Sn100-kV protocol provided superior image quality compared with 70-to 90-kV protocols at equivalent dose levels.…”

Automated Tube Potential Selection as a Method of Dose Reduction for CT of the Neck: First Clinical Results

“…For objective image quality higher attenuation values are indicated but even a marginally higher BN and SNR in the level of the larynx. The dose reduction in previous studies that focused on vascular imaging (Schwarz 2013;Winklehner 2011;Goetti 2012;Eller 2013) or staging in cancer patients (Eller 2012;Gnannt 2012), a reduction of 11% to 40% was achieved with the use of Care kV. Automatically selected tube potentials showed a significant correlation with BMI.…”