Image quality and radiation dose of brain computed tomography in children: effects of decreasing tube voltage from 120 kVp to 80 kVp

Park, Ji Eun; Choi, Young Hun; Cheon, Jung Eun; Kim, Woo Sun; Kim, In One; Cho, Hyun Suk; Ryu, Young Jin; Kim, Yu Jin

doi:10.1007/s00247-017-3799-8

Cited by 24 publications

(29 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A study by Pien et al (2011) stated that applying iterative reconstruction in an objective and subjective image quality assessments resulted in reduced image noise even with low tube voltage being used [36,37]. The mean image noise in this study's CT brain was in line with Park et al (2017), and was within a plausible range. With the advancement of artificial intelligence, iterative reconstruction with deep learning-based image has significantly reduce radiation dose and improve image quality.…”

Section: Discussionmentioning

confidence: 49%

“…Nowadays, most CT scanners come equipped with iterative reconstruction algorithms to reduce image noise. A study by Pien et al (2011) stated that applying iterative reconstruction in an objective and subjective image quality assessments resulted in reduced image noise even with low tube voltage being used [ 36 , 37 ]. The mean image noise in this study’s CT brain was in line with Park et al (2017), and was within a plausible range.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Reference Level of Radiation Dose and Image Quality among Paediatric CT Examinations in A Tertiary Hospital in Malaysia

et al. 2020

View full text Add to dashboard Cite

Pediatrics are more vulnerable to radiation and are prone to dose compared to adults, requiring more attention to computed tomography (CT) optimization. Hence, diagnostic reference levels (DRLs) have been implemented as part of optimization process in order to monitor CT dose and diagnostic quality. The noise index has recently been endorsed to be included as a part of CT optimization in the DRLs report. In this study, we have therefore set local DRLs for pediatric CT examination with a noise index as an indicator of image quality. One thousand one hundred and ninety-two (1192) paediatric patients undergoing CT brain, CT thorax and CT chest-abdomen-pelvis (CAP) examinations were analyzed retrospectively and categorized into four age groups; group 1 (0–1 year), group 2 (1–5 years), group 3 (5–10 years) and group 4 (10–15 years). For each group, data such as the volume-weighted CT dose index (CTDIvol), dose-length product (DLP) and the effective dose (E) were calculated and DRLs for each age group set at 50th percentile were determined. Both CT dose and image noise values between age groups have differed significantly with p-value < 0.05. The highest CTDIvol and DLP values in all age groups with the lowest noise index value reported in the 10–15 age group were found in CT brain examination. In conclusion, there was a significant variation in doses and noise intensity among children of different ages, and the need to change specific parameters to fit the clinical requirement.

show abstract

Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Diagnostic Reference Level of Radiation Dose and Image Quality among Paediatric CT Examinations in A Tertiary Hospital in Malaysia

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Each reader reviewed a full axial image stack for each series with fixed window level and width settings. As attenuation values (HU) vary with tube voltage [21], the fixed window level (WL) for each reconstruction energy was visually identified by a neuroradiologist (MW) and set to maintain similar attenuation uniformity between series. The settings were as follows: 40-50 keV (WL 50), 60-70 keV (WL 45), 80-110 keV and NCT (WL 40), and 120-140 keV (WL 35).…”

Section: Phase 1 Designmentioning

confidence: 99%

Virtual monochromatic dual-energy CT reconstructions improve detection of cerebral infarct in patients with suspicion of stroke

et al. 2020

View full text Add to dashboard Cite

Purpose Early infarcts are hard to diagnose on non-contrast head CT. Dual-energy CT (DECT) may potentially increase infarct differentiation. The optimal DECT settings for differentiation were identified and evaluated. Methods One hundred and twenty-five consecutive patients who presented with suspected acute ischemic stroke (AIS) and underwent non-contrast DECT and subsequent DWI were retrospectively identified. The DWI was used as reference standard. First, virtual monochromatic images (VMI) of 25 patients were reconstructed from 40 to 140 keV and scored by two readers for acute infarct. Sensitivity, specificity, positive, and negative predictive values for infarct detection were compared and a subset of VMI energies were selected. Next, for a separate larger cohort of 100 suspected AIS patients, conventional non-contrast CT (NCT) and selected VMI were scored by two readers for the presence and location of infarct. The same statistics for infarct detection were calculated. Infarct location match was compared per vascular territory. Subgroup analyses were dichotomized by time from last-seen-well to CT imaging. Results A total of 80-90 keV VMI were marginally more sensitive (36.3-37.3%) than NCT (32.4%; p > 0.680), with marginally higher specificity (92.2-94.4 vs 91.1%; p > 0.509) for infarct detection. Location match was superior for VMI compared with NCT (28.7-27.4 vs 19.5%; p < 0.010). Within 4.5 h from last-seen-well, 80 keV VMI more accurately detected infarct (58.0 vs 54.0%) and localized infarcts (27.1 vs 11.9%; p = 0.004) than NCT, whereas after 4.5 h, 90 keV VMI was more accurate (69.3 vs 66.3%). Conclusion Non-contrast 80-90 keV VMI best differentiates normal from infarcted brain parenchyma.

show abstract

“…Further reduction in tube voltage to 80 kV used in patients aged 0–4 in conjunction with ASIR 50% may also have increased image noise. While Park et al . were able to demonstrate a decreased tube voltage of 80 kVp provided paediatric CT brain scans with comparable image quality, no studies have combined both ASIR and an equivalent reduced tube voltage of 80kV.…”

Section: Discussionmentioning

confidence: 99%

Retrospective review of CT brain image quality, diagnostic adequacy and radiation dose in a paediatric population imaged at a non‐paediatric tertiary hospital

et al. 2019

View full text Add to dashboard Cite

Introduction: Minimising radiation exposure in paediatric imaging examinations whilst maintaining acceptable diagnostic quality continues to present a challenge. The aims of this study were to assess institutional compliance of paediatric CT brain (CTB) examinations performed in an adult hospital with ARPANSA radiation dose recommendations and to compare qualitative CTB diagnostic acceptability with objective imaging parameters and radiation dose. Methods: A retrospective review of 115 consecutive paediatric CTB examinations was undertaken at an adult tertiary referral centre in Australia over a 2year period. Dose length product (DLP) was compared with the ARPANSA standards. CTB image quality was subjectively classified by two neuroradiologists independently, with discordant results resolved by consensus. Objective assessment of image quality included measurements of signal-to-noise (SNR) and contrast-to-noise ratios (CNR) of grey and white matter. Results: All patient scans complied with ARPANSA DLP recommendations; however, 10 out of 115 scans were classified as being of diagnostically suboptimal image quality. These scans had significantly lower mean DLP values compared with diagnostically adequate examinations (105.1 vs 379.2 mGy.cm; P < 0.0001). CTB scans of adequate diagnostic quality, when compared to suboptimal scans, had significantly higher CNR (1.8 vs 1.1; P < 0.0001) and SNR in grey (7.1 vs 4.6; P < 0.0001) and white matter (5.6 vs 3.8; P < 0.0001). Conclusion: All CTB examinations in this series complied with the ARPANSA DLP recommendations; however, 9% were of suboptimal diagnostic image quality. While it is important to minimize unnecessary radiation exposure, our results suggest that excessively low DLP values can lead to suboptimal diagnostic image quality.

show abstract

Image quality and radiation dose of brain computed tomography in children: effects of decreasing tube voltage from 120 kVp to 80 kVp

Abstract: In pediatric non-enhanced brain CT scans, a decrease in tube voltage from 120 kVp to 80 kVp resulted in improved gray-white matter contrast, comparable image quality and decreased radiation dose.

Cited by 24 publications

References 16 publications

Diagnostic Reference Level of Radiation Dose and Image Quality among Paediatric CT Examinations in A Tertiary Hospital in Malaysia

Diagnostic Reference Level of Radiation Dose and Image Quality among Paediatric CT Examinations in A Tertiary Hospital in Malaysia

Virtual monochromatic dual-energy CT reconstructions improve detection of cerebral infarct in patients with suspicion of stroke

Retrospective review of CT brain image quality, diagnostic adequacy and radiation dose in a paediatric population imaged at a non‐paediatric tertiary hospital

Contact Info

Product

Resources

About