Tailoring protocols for chest CT applications: when and how?

Individualization of computed tomography protocols for suspected pulmonary embolism: a national investigation of routines

“…As emphasized by the International Commission on Radiological Protection, 42 the use of ATCM does not totally free the operator from selection of scan parameters. The various approaches to reduce radiation doses mentioned in the literature 19,23,[29][30][31][32][33] were used to different extents in the participating hospitals. The use of a lower tube potential was the most commonly used approach, with almost all hospitals using a tube potential of 100 kVp or even lower, probably because of the high number of studies confirming the effectiveness of this method in dose reduction without compromising image quality.…”

“…18 The use of CTPA in radiation-sensitive patients such as pregnant patients and female adolescents makes tailoring the CT protocol to the patient crucial to achieve the highest cost-benefit ratio in terms of the radiation dose and amount of contrast agent needed to obtain the required image quality. This goal can be achieved by patient-centered imaging, 19,20 which involves the use of patient-tailored CT scan protocols. Tailoring the imaging protocol to the patient is crucial for providing accurate information to the physician.…”

“…28 Along with pediatric patients, another group who might benefit from radiation dose reduction are pregnant patients because of the rapid cell multiplication in both the fetus and mother. 29 Various approaches have been used to reduce radiation doses, 19,23,[29][30][31][32][33] such as reducing the scan length, lowering the kilovoltage peak settings, using automatic tube current modulation (ATCM), and using iterative reconstruction. ATCM is a widespread dose-reduction measure [30][31][32][33] that allows the use of different tube currents (mA) along the z-axis depending on patient size and different attenuations depending on body regions.…”

“…29 Another effective dose-reduction measure that is especially suitable for CTPA is the use of a lower tube potential. 19,23,[30][31][32][33] Previous studies have shown the feasibility of reducing the tube potential to 80 kVp. [35][36][37][38] Reducing the tube potential also provides the possibility of lowering the amount of iodinated contrast agent.…”

Imaging protocols for CT chest: A recommendation

“…Routine CECT chest essentially retains the same parameters as NCCT with administration of intravenous contrast. Usually a scan delay of 55-70 seconds is kept following administration of contrast to allow for optimal enhancement of soft tissues[16] [Figure 8]. Contrast is usually delivered using hand injection with optional use of power injector and bolus chase.…”