Organ-based tube current modulation and bismuth eye shielding in pediatric head computed tomography

Markart, Stefan; Fischer, Tim; Wildermuth, Simon; Dietrich, Tobias Johannes; Alkadhi, Hatem; Leschka, Sebastian; Guesewell, Sabine; Ditchfield, Michael; Oezden, Ismail; Lutters, G.; Waelti, Stephan

doi:10.1007/s00247-022-05410-x

Cited by 6 publications

(3 citation statements)

References 30 publications

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“…CARE kV and CARE Dose 4D can be used separately to adjust scanning voltage ( 14 - 18 ) and reduce radiation dose ( 6 - 10 ), which has been confirmed in multiple previous studies. However, there is an expectation whether the combined implementation of CARE kV and CARE Dose 4D may yield improved outcomes in clinical practice.…”

Section: Introductionsupporting

confidence: 65%

“…However, in pediatric clinics, children’s sensitivity to ionizing radiation is significantly higher than that of adults ( 4 ), making it important to follow the principle of as low as reasonably achievable (ALARA) when performing CT examinations ( 5 ). Recently, the use of CARE Dose 4D, iterative reconstruction, and various postprocessing technologies ( 6 - 9 ) has helped reduce the radiation dose during CT, particularly in children. For example, the use of 70-kV voltage has reduced the radiation dose by approximately 50% in CT angiography (CTA) examinations for children ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

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Optimizing image quality and minimizing radiation dose in pediatric abdominal multiphase contrast-enhanced computed tomography: a study on CARE kV and CARE Dose 4D

Tian,

Chang,

Dilixiati

et al. 2024

Quant Imaging Med Surg

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Background Multiphase contrast-enhanced computed tomography (CECT) is a commonly used modality in pediatric computed tomography (CT) scans. However, the purposes and focus of each phase, such as CT angiography (CTA), and parenchymal phase, are different. In routine practice, the same scanning parameters are used for all phases, resulting in unnecessary radiation exposure for children. Accurately and rapidly adjusting the scanning parameters for each phase of CECT is challenging in clinical settings. This retrospective cross-sectional study was designed to investigate the feasibility of using both CARE kV and CARE Dose 4D to reduce the radiation dose while maintaining diagnostic quality in multiphase CECT scans of children. Methods Overall, 57 children (33 males and 24 females) who underwent multiphase abdominal CECT in Xinjiang Hospital of Beijing Children’s Hospital with an average age of 6.52±4.30 years (range, 0.1–15 years), were enrolled. The tube voltage was automatically modulated using CARE kV. The tube current was automatically modulated using CARE Dose 4D. Different dose saving optimization indices (DI) were used for the three phases: a DI value of 3 was used for the unenhanced CT phase, a DI value of 12 was used for the CTA phase, and a DI value of 7 was used for the parenchymal phase. The tube voltage and volume CT dose index (CTDI vol ) were recorded for each phase. Two reviewers subjectively evaluated the overall image quality and noise level of the three phases using a 5-point Likert scale (1–2 points: unqualified, 3 points: qualified, 4 points: better, 5 points: best). The CT and noise values of the descending aorta, liver, and back muscle were measured objectively. The voltage distribution and the image quality and CTDI vol in each phase were compared. Results The most selected tube voltage in the unenhanced CT, CTA, and parenchymal phases was 100 kV (49/57, 85.96%), 70 kV (36/57, 63.16%), and 80 kV (32/57, 56.14%), respectively. The differences between the three phases were statistically significant (P<0.001). The CTDI vol values of the three phases were 3.99±1.99, 2.02±1.71, and 3.18±2.10 mGy, respectively, with a significant difference between the three phases (P<0.001). The CTDI vol decreased linearly as the DI value increased. All images met the diagnostic requirements. The overall quality scores for the three phases were 4.24±0.42, 4.41±0.49, and 4.50±0.45, respectively, with no significant linear relationship with the change in the DI. Conclusions The combined use of CARE Dose 4D and CARE kV could effectively reduce the radiation dose in children during multiphase abdominal CECT without compromising the diagnostic image quality.

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Section: Introductionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Optimizing image quality and minimizing radiation dose in pediatric abdominal multiphase contrast-enhanced computed tomography: a study on CARE kV and CARE Dose 4D

Tian,

Chang,

Dilixiati

et al. 2024

Quant Imaging Med Surg

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show abstract

“…A plethora of dose reduction concepts have been proposed for EID-CT in recent decades, such as automated tube voltage selection [ 33 ], sector- or organ-based tube current modulation [ 34 ], adaptive collimation [ 35 ], camera-based patient positioning [ 36 ], and spectral shaping via tin prefiltration [ 37 ], just to name a few. While these concepts have been integrated into a first-generation dual-source PCCT system approved for clinical imaging (Naeotom Alpha, Siemens Healthineers, Forchheim, Germany), the constructional superiority of the detector itself sets PCCT apart from EID-CT scanners in prior generations.…”

Section: Radiation Dose Reductionmentioning

confidence: 99%