Trends in radiation dose and image quality for pediatric patients with a multidetector CT and a third-generation dual-source dual-energy CT

Agostini, Andrea; Mari, A.; Lanza, Cecilia; Schicchi, Nicolò; Borgheresi, Alessandra; Maggi, Stefania; Giovagnoni, Andrea

doi:10.1007/s11547-019-01037-5

Cited by 25 publications

(20 citation statements)

References 25 publications

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“…Concluding, a compromise including preserved image sharpness within lung parenchyma, with minimally blurred mediastinal structures in the face of a median dose reduction of more than 90% may be acceptable when performing serial CT controls in severely ill young patients [26].…”

Section: Discussionmentioning

confidence: 99%

Proposal of a low-dose, long-pitch, dual-source chest CT protocol on third-generation dual-source CT using a tin filter for spectral shaping at 100 kVp for CoronaVirus Disease 2019 (COVID-19) patients: a feasibility study

et al. 2020

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Aim To subjectively and objectively evaluate the feasibility and diagnostic reliability of a low-dose, long-pitch dual-source chest CT protocol on third-generation dual-source CT (DSCT) with spectral shaping at 100Sn kVp for COVID-19 patients. Materials and methods Patients with COVID-19 and positive swab-test undergoing to a chest CT on third-generation DSCT were included. The imaging protocol included a dual-energy acquisition (HD-DECT, 90/150Sn kVp) and fast, lowdose, long-pitch CT, dual-source scan at 100Sn kVp (LDCT). Subjective (Likert Scales) and objective (signal-to-noise and contrast-to-noise ratios, SNR and CNR) analyses were performed; radiation dose and acquisition times were recorded. Nonparametric tests were used. Results The median radiation dose was lower for LDCT than HD-DECT (Effective dose, ED: 0.28 mSv vs. 3.28 mSv, p = 0.016). LDCT had median acquisition time of 0.62 s (vs 2.02 s, p = 0.016). SNR and CNR were significantly different in several thoracic structures between HD-DECT and LDCT, with exception of lung parenchyma. Qualitative analysis demonstrated significant reduction in motion artifacts (p = 0.031) with comparable diagnostic reliability between HD-DECT and LDCT. Conclusions Ultra-low-dose, dual-source, fast CT protocol provides highly diagnostic images for COVID-19 with potential for reduction in dose and motion artifacts.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Section: Discussionmentioning

confidence: 99%

Proposal of a low-dose, long-pitch, dual-source chest CT protocol on third-generation dual-source CT using a tin filter for spectral shaping at 100 kVp for CoronaVirus Disease 2019 (COVID-19) patients: a feasibility study

et al. 2020

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“…13 While the proven value of spectral CT is continuously rising, 14 there are only a few studies focused on spectral CT applications for pediatric imaging. 9,15,16 For this unique population, imaging applications concentrated on a different domain of clinical questions compared to those of adult patients is of interest. In addition, research of different technical aspects that are related to image quality are of importance, specifically, with respect to the smaller sizes of pediatric patients, and, perhaps more importantly, their sensitivity to ionizing radiation and the obligation to use lower doses.…”

Section: Introductionmentioning

confidence: 99%

“…While the proven value of spectral CT is continuously rising, 14 there are only a few studies focused on spectral CT applications for pediatric imaging 9,15,16 . For this unique population, imaging applications concentrated on a different domain of clinical questions compared to those of adult patients is of interest.…”

Section: Introductionmentioning

confidence: 99%

Spectral CT quantification stability and accuracy for pediatric patients: A phantom study

Shapira

Mei

Noël

2021

J Applied Clin Med Phys

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Background: Spectral computed tomography (spectral CT) provides access to clinically relevant measures of endogenous and exogenous materials in patients. For pediatric patients, current spectral CT applications include lesion characterization, quantitative vascular imaging, assessments of tumor response to treatment, and more. Objective: The aim of this study is a comprehensive investigation of the accuracy and stability of spectral quantifications from a spectral detector-based CT system with respect to different patient sizes and radiation dose levels relevant for the pediatric population. Materials and methods: A spectral CT phantom with tissue-mimicking materials and iodine concentrations relevant for pediatric imaging was scanned on a spectral detector CT system using a standard pediatric abdominal protocol at 100%, 67%, 33% and 10% of the nominal radiation dose level. Different pediatric patient sizes were simulated using supplemental 3D-printed extension rings. Virtual mono-energetic, iodine density, effective atomic number, and electron density results were analyzed for stability with respect to radiation dose and patient size. Results: Compared to conventional CT imaging, a pronounced improvement in the stability of attenuation measurements across patient size was observed when using virtual mono-energetic images. Iodine densities were within 0.1 mg/ml, effective atomic numbers were within 0.26 atomic numbers and electron density quantifications were within AE1.0% of their respective nominal values. Relative to the nominal dose clinical protocol, differences in attenuation of all tissue-mimicking materials were maintained below 1.6 HU for a 33% dose reduction, below 2.7 HU for a 67% dose reduction and below 3.7 HU for a 90% dose reduction, for all virtual mono-energetic energies equal to or greater than 50 keV. Iodine, and effective atomic number quantifications were stable to within 0.1 mg/ml and 0.06 atomic numbers, respectively, across all measured dose levels. Conclusion: Spectral CT provides accurate and stable material quantification with respect to radiation dose reduction (up to 90%) and differing pediatric patient size. The observed consistency is an important step towards quantitative pediatric imaging at low radiation exposure levels.

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“…Iodine specific maps allow to quantify iodine uptake in each voxel in order to detect even a little enhancement in a lesion, parenchyma or in the wall of hollow organs (15)(16)(17)(18)(19). Thanks to the new algorithms VNC images have a contrast to noise ratio (CNR) and Hounsfield Unit (HU) accuracy similar to true non-contrast (TNC) ones; in this way, a true scan before administration of contrast medium can be avoided, reducing the radiation dose to the patient (7,20,21). These tools have been investigated in different fields, improving diagnostic possibilities (22,23).…”

Section: Introductionmentioning

confidence: 99%

Dual energy CT in gland tumors: a comprehensive narrative review and differential diagnosis

Gentili¹,

Guerrini²,

Mazzei³

et al. 2020

Gland Surg

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Dual energy CT (DECT)with image acquisition at two different photon X-ray levels allows the characterization of a specific tissue or material/elements, the extrapolation of virtual unenhanced and monoenergetic images, and the quantification of iodine uptake; such special capabilities make the DECT the perfect technique to support oncological imaging for tumor detection and characterization and treatment monitoring, while concurrently reducing the dose of radiation and iodine and improving the metal artifact reduction. Even though its potential in the field of oncology has not been fully explored yet, DECT is already widely used today thanks to the availability of different CT technologies, such as dual-source, singlesource rapid-switching, single-source sequential, single-source twin-beam and dual-layer technologies.Moreover DECT technology represents the future of the imaging innovation and it is subject to ongoing development that increase according its clinical potentiality, in particular in the field of oncology. This review points out recent state-of-the-art in DECT applications in gland tumors, with special focus on its potential uses in the field of oncological imaging of endocrine and exocrine glands.

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Trends in radiation dose and image quality for pediatric patients with a multidetector CT and a third-generation dual-source dual-energy CT

Cited by 25 publications

References 25 publications

Proposal of a low-dose, long-pitch, dual-source chest CT protocol on third-generation dual-source CT using a tin filter for spectral shaping at 100 kVp for CoronaVirus Disease 2019 (COVID-19) patients: a feasibility study

Proposal of a low-dose, long-pitch, dual-source chest CT protocol on third-generation dual-source CT using a tin filter for spectral shaping at 100 kVp for CoronaVirus Disease 2019 (COVID-19) patients: a feasibility study

Spectral CT quantification stability and accuracy for pediatric patients: A phantom study

Dual energy CT in gland tumors: a comprehensive narrative review and differential diagnosis

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