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

Spearman, James V.; Schoepf, U. Joseph; Rottenkolber, Marietta; Driesser, Ivo; Canstein, Christian; Thierfelder, Kolja M.; Krazinski, Aleksander W.; Cecco, Carlo N. De; Meinel, Felix G.

doi:10.1148/radiol.2015141507

Cited by 39 publications

(28 citation statements)

References 32 publications

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“…These results are in contrast to a study by Spearman et al [ 29 ], who evaluated the effect of ATVS on CT radiation dose, including all body regions and types of CT examinations in 164,323 unique CTs from all across the world. They observed, in non-enhanced chest CTs, a non-significant decrease in CTDI vol of -2.2%, but a significant decrease for enhanced chest CT of -14.3% [ 29 ]. In their study, however, they were not able to verify whether ATVS was consistently applied correctly with the appropriate settings [ 29 ].…”

Section: Discussioncontrasting

confidence: 91%

Automated tube voltage selection in pediatric non-contrast chest CT

et al. 2018

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BackgroundModern CT scanners provide automatic dose adjustment systems, which are promising options for reducing radiation dose in pediatric CT scans. Their impact on patient dose, however, has not been investigated sufficiently thus far.ObjectiveTo evaluate automated tube voltage selection (ATVS) in combination with automated tube current modulation (ATCM) in non-contrast pediatric chest CT, with regard to the diagnostic image quality.Materials and methodsThere were 160 non-contrast pediatric chest CT scans (8.7±5.4 years) analyzed retrospectively without and with ATVS. Correlations of volume CT Dose Index (CTDIvol) and effective diameter, with and without ATVS, were compared using Fisher’s z-transformation. Image quality was assessed by mean signal-difference-to-noise ratios (SDNR) in the aorta and in the left main bronchus using the independent samples t-test. Two pediatric radiologists and a general radiologist rated overall subjective Image quality. Readers’ agreement was assessed using weighted kappa coefficients. A p value <0.05 was considered significant.ResultsCTDIvol correlation with the effective diameter was r = 0.62 without and r = 0.80 with ATVS (CI: -0.04 to -0.60; p = 0.025). Mean SDNR was 10.88 without and 10.03 with ATVS (p = 0.0089). Readers’ agreement improved with ATVS (weighted kappa between pediatric radiologists from 0.1 (0.03–0.16) to 0.27 (0.09–0.45) with ATVS; between general and each pediatric radiologist from 0.1 (0.06–0.14) to 0.12 (0.05–0.20), and from 0.22 (0.11–0.34) to 0.36 (0.24–0.49)).ConclusionATVS, combined with ATCM, results in a radiation dose reduction for pediatric non-contrast chest CT without a loss of diagnostic image quality and prevents errors in manual tube voltage setting, and thus protecting larger children against an unnecessarily high radiation exposure.

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Section: Discussioncontrasting

confidence: 91%

Automated tube voltage selection in pediatric non-contrast chest CT

et al. 2018

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“…The patients were examined on the third-generation dual-source CT system (SOMATOM Force, Siemens Healthcare, Forchheim, Germany) [ 7 ] in dual-source, helical acquisition mode at a gantry rotation time of 0.25 s / rotation, pitch 1.9, 0.75 mm section thickness and 192 x 0.6 mm detector rows. In all examinations, automated attenuation-based tube voltage selection (CAREkV, Siemens Healthcare) [ 8 ] and tube current modulation along the z axis (CAREDose, Siemens Healthcare) was used with a quality reference tube voltage of 100 kV and a quality reference tube current time product of 220 mAs. The scan range covered the entire pulmonary parenchyma, extending from the costophrenic angle to the level of the pulmonary apex.…”

Section: Methodsmentioning

confidence: 99%

High-Pitch CT Pulmonary Angiography in Third Generation Dual-Source CT: Image Quality in an Unselected Patient Population

Sabel¹,

Buric²,

Karara³

et al. 2016

PLoS ONE

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ObjectivesTo investigate the feasibility of high-pitch CT pulmonary angiography (CTPA) in 3rd generation dual-source CT (DSCT) in unselected patients.MethodsForty-seven patients with suspected pulmonary embolism underwent high-pitch CTPA on a 3rd generation dual-source CT scanner. CT dose index (CTDIvol) and dose length product (DLP) were obtained. Objective image quality was analyzed by calculating signal-to-noise-ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality on the central, lobar, segmental and subsegmental level was rated by two experienced radiologists.ResultsMedian CTDI was 8.1 mGy and median DLP was 274 mGy*cm. Median SNR was 32.9 in the central and 31.9 in the segmental pulmonary arteries. CNR was 29.2 in the central and 28.2 in the segmental pulmonary arteries. Median image quality was “excellent” in central and lobar arteries and “good” in subsegmental arteries according to both readers. Segmental arteries varied between “excellent” and “good”. Image quality was non-diagnostic in one case (2%), beginning in the lobar arteries. Thirteen patients (28%) showed minor motion artifacts.ConclusionsIn third-generation dual-source CT, high-pitch CTPA is feasible for unselected patients. It yields excellent image quality with minimal motion artifacts. However, compared to standard-pitch cohorts, no distinct decrease in radiation dose was observed.

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“…However, a previous global observational study showed various tube potentials selection (from 80 kVp to 140 kVp) for cerebral or carotid CTA (27).…”

Section: Discussionmentioning

confidence: 99%

“…The CT scanner used in a previous global study (27) had a maximum tube current capacity of 500 mA. For high radiation exposure setting or fast acquisition of CT images by using accelerated rotation time and high helical pitch, excess tube current capacity may be needed.…”

Section: Discussionmentioning

confidence: 99%

“…Using the attenuation profile, the algorithm calculates various combinations of tube potential and tube current that will generate the desired contrast-to-noise radio (CNR) with the lowest radiation dose. Then, the algorithm selects the most dose-efficient combination of tube potential and tube current in accordance with the examination type as follows: CTA imaging, post-contrast imaging for soft tissue enhancement, or non-contrast imaging (20)(21)(22)(25)(26)(27).…”

Section: Technical Background Of the Automatic Tube Potential Selectimentioning

confidence: 99%

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Attenuation-Based Automatic Tube Potential Selection in Cerebral Computed Tomography Angiography: Effects on Radiation Exposure and Image Quality

Choi

Kim

Kang

et al. 2018

J Korean Soc Radiol

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Objective:To investigate the feasibility of using the attenuation-based automatic tube potential selection (ATPS) algorithm for cerebral computed tomography angiography (CTA) and to assess radiation dose, vascular attenuation, and image quality compared to a conventional fixed 120-kVp protocol. Materials and Methods: Among 36 volunteers for cerebral CTA, a total of 18 were scanned with fixed 120 kVp and 140 effective mAs using automatic tube current modulation. The other 18 were scanned with an ATPS algorithm. Radiation doses, attenuation, contrast-to-noise ratio (CNR) of the cerebral arteries, subjective scores for arterial attenuation, edge sharpness of the artery, visibility of small arteries, venous contamination, image noise, and overall image quality were compared between the groups. Results: The volume CT dose index and effective dose of the ATPS group were lower than those of the fixed 120-kVp group. The ATPS group had significantly higher arterial attenuation and no significant difference in CNR, compared with the fixed 120-kVp. The ATPS group had higher subjective scores for arterial attenuation, edge sharpness of the artery, visibility of small arteries, and overall image quality. Conclusion: The ATPS algorithm for the cerebral CTA reduced radiation dose by 43% while maintaining image quality and improved the attenuation of cerebral arteries by selecting lower tube potential.

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

Abstract: ATVS significantly reduces radiation dose across most, but not all, body regions and types of CT examinations.

Cited by 39 publications

References 32 publications

Automated tube voltage selection in pediatric non-contrast chest CT

Automated tube voltage selection in pediatric non-contrast chest CT

High-Pitch CT Pulmonary Angiography in Third Generation Dual-Source CT: Image Quality in an Unselected Patient Population

Attenuation-Based Automatic Tube Potential Selection in Cerebral Computed Tomography Angiography: Effects on Radiation Exposure and Image Quality

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