Evaluation of radiation dose and image quality following changes to tube potential (kVp) in conventional paediatric chest radiography

Ramanaidu, S.; Maria, Rainov; Ng, Kwan Hoong; George, James St.; Kumar, G

doi:10.2349/biij.2.3.e35

Cited by 10 publications

(8 citation statements)

References 11 publications

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“…Tube current is just one parameter that can be modified to reduce radiation exposure from CT. Other strategies to reduce dose include limited scanning (e.g., lower edge of liver to pelvis) [26], adjustments in peak kilovoltage [27], and the use of new iterative reconstruction technology [28, 29]. These approaches, combined with computer-simulated tube current reduction used in this study, represent potential future directions in CT dose-reduction research.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Conventional and Simulated Reduced–Tube Current MDCT for Evaluation of Suspected Appendicitis in the Pediatric Population

Swanick

Gaca

Hollingsworth

et al. 2013

American Journal of Roentgenology

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OBJECTIVE The purpose of this study was to compare CT with conventional and simulated reduced–tube current in the evaluation for acute appendicitis in children. MATERIALS AND METHODS Validated noise-addition (tube current–reduction) software was used to create 50% and 75% tube current reductions in 60 CT examinations performed for suspected appendicitis, resulting in 180 image sets. Three blinded pediatric radiologists scored the randomized studies for the following factors: presence of the normal appendix or appendicitis (5-point scale; 1 = definitely absent and 5 = definitely present), presence of alternate diagnoses, and overall image quality (1 = nondiagnostic and 5 = excellent). Truth was defined by the interpretation of the conventional examination. RESULTS For conventional examinations, the total number of reviews (60 cases × 3 readers = 180) in which the normal appendix was identified was 120 of 180 (66.7%), compared with 108 of 180 (60%) in the 50% (p = 0.19) and 91 of 180 (50.6%) in the 75% (p = 0.002) tube current–reduction groups. Appendicitis was identified in a total of 39 of 180 (21.7%), 38 of 180 (21.1%), and 37 of 180 (20.6%) examinations, respectively (p > 0.05). This translates to sensitivities of 97% and 95% for the 50% and 75% tube current–reduction groups, respectively. Alternate diagnoses were detected in 14%, 16%, and 13% of scans, respectively. Compared with conventional–tube current examinations, reader confidence and assessment of image quality were significantly decreased for both tube current–reduction groups. CONCLUSION Simulated tube current–reduction technology provides for systematic evaluation of diagnostic thresholds. Application of this technology in the setting of suspected appendicitis shows that tube current can be reduced by at least 50% without significantly affecting diagnostic quality, despite a decrease in reader confidence and assessment of image quality.

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Section: Discussionmentioning

confidence: 99%

Comparison of Conventional and Simulated Reduced–Tube Current MDCT for Evaluation of Suspected Appendicitis in the Pediatric Population

Swanick

Gaca

Hollingsworth

et al. 2013

American Journal of Roentgenology

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“…The '15%' and '10-kVp' rules are used to govern these techniques, stating that an increase in tube potential, measured as kilovoltage peak (kVp), by 15% or 10-kVp requires the milliamperage seconds (mAs) value (which indicates the product of the tube current and exposure time) to be halved in order to keep the detector dose constant. [2][3][4][8][9][10] There are a large number of studies in the literature that confirm high kVp, low mAs techniques are effective in reducing patient radiation doses with digital imaging systems. 8,9,[11][12][13][14][15][16][17] These dose saving abilities, however, are not infinite; some studies show that as the kVp reaches higher values (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4][8][9][10] There are a large number of studies in the literature that confirm high kVp, low mAs techniques are effective in reducing patient radiation doses with digital imaging systems. 8,9,[11][12][13][14][15][16][17] These dose saving abilities, however, are not infinite; some studies show that as the kVp reaches higher values (i.e. above 100 kVp), the dose reductions decrease and eventually taper off.…”

Section: Introductionmentioning

confidence: 99%

“…Traditionally, when film-screen systems were used, an increase in kVp meant a loss of image contrast and overall image quality. 1,4,5,7,8,16 Currently, there is disagreement within the literature about how kVp selection effects image quality and contrast on digital imaging systems. Some sources, including Bushong's textbook 'Radiologic Science for Technologists: Physics, Biology and Protection', 2 state that kVp has no effect on resulting image contrast.…”

Section: Introductionmentioning

confidence: 99%

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An evaluation of the effect of tube potential on clinical image quality using direct digital detectors for pelvis and lumbar spine radiographs

Peacock

Steward

Riley

2020

J of Medical Radiation Sci

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Introduction: High kVp techniques, 15% or 10-kVp rules, are well-known dose reduction methods. Traditionally, the use of high tube potential (i.e. increased kVp) is associated with decreased radiographic contrast and overall image quality. Recent studies suggest contrast and image quality are not heavily reliant on kVp with digital systems. This study aims to assess the effects of the high tube potential technique on clinical radiographic image quality when using digital systems, to validate high kVp as a dose saving technique. Methods: A selection of comparable pelvis and lumbar spine radiographs were collected from the hospital's picture archiving and communication system (PACS), with technical factors recorded. All clinical radiographs were assessed by 5 senior radiographers using a 15-point visual grading analysis (VGA) rubric. Results: For 40 AP pelvis radiographs and 40 lateral lumbar spine radiographs, reduction in the dose area product (DAP) with higher kVp is seen. Average pelvis DAP at 75 kVp = 14.06 mGy.cm 2 ; 85 kVp = 7.47 mGy.cm 2. Average lumbar spine DAP at 80 kVp = 15.76 mGy.cm 2 ; 90 kVp = 14.83 mGy.cm 2. Image quality and contrast scores showed no statistically significant difference between the high and low kVp groups (z = 0.06 and 0.12, respectively). Average pelvis VGA score at 75 kVp = 11.26; 85 kVp = 12.55. Average lumbar spine VGA score at 80 kVp = 9.23; 90 kVp = 10.64. Conclusions: The high tube potential techniques allowed for reduced patient radiation doses whilst showing no degradation of diagnostic image quality in a clinical setting. This study successfully validates the high kVp technique as a useful tool for reducing patient radiation doses whilst maintaining high diagnostic image quality for digital pelvis and lumbar spine radiography.

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“…This concern has led researchers to explore optimization techniques. Although results differ, they most commonly suggest antiscatter grid removal, changes in tube voltage (kVp), and the use of x-ray beam filtration 4,5,6,7,8,9,10,11 . The literature portrays a need to reduce the number of high-dose imaging procedures performed on children in order to keep the dose ALARA 12 .…”

Section: Introductionmentioning

confidence: 99%

Dose assessment of digital tomosynthesis in pediatric imaging

2009

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We investigated the potential for digital tomosynthesis (DT) to reduce pediatric x-ray dose while maintaining image quality. We utilized the DT feature (VolumeRad TM) on the GE Definium TM 8000 flat panel system installed in the Winnipeg Children's Hospital. Facial bones, cervical spine, thoracic spine, and knee of children aged 5, 10, and 15 years were represented by acrylic phantoms for DT dose measurements. Effective dose was estimated for DT and for corresponding digital radiography (DR) and computed tomography (CT) patient image sets. Anthropomorphic phantoms of selected body parts were imaged by DR, DT, and CT. Pediatric radiologists rated visualization of selected anatomic features in these images. Dose and image quality comparisons between DR, DT, and CT determined the usefulness of tomosynthesis for pediatric imaging. CT effective dose was highest; total DR effective dose was not always lowest-depending how many projections were in the DR image set. For the cervical spine, DT dose was close to and occasionally lower than DR dose. Expert radiologists rated visibility of the central facial complex in a skull phantom as better than DR and comparable to CT. Digital tomosynthesis has a significantly lower dose than CT. This study has demonstrated DT shows promise to replace CT for some facial bones and spinal diagnoses. Other clinical applications will be evaluated in the future.

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Evaluation of radiation dose and image quality following changes to tube potential (kVp) in conventional paediatric chest radiography

Cited by 10 publications

References 11 publications

Comparison of Conventional and Simulated Reduced–Tube Current MDCT for Evaluation of Suspected Appendicitis in the Pediatric Population

Comparison of Conventional and Simulated Reduced–Tube Current MDCT for Evaluation of Suspected Appendicitis in the Pediatric Population

An evaluation of the effect of tube potential on clinical image quality using direct digital detectors for pelvis and lumbar spine radiographs

Dose assessment of digital tomosynthesis in pediatric imaging

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