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Purpose: The study aimed to evaluate the image quality in terms of signal-to-noise ratio (SNR) and dose to the lens of the eye and the other nearby organs from the CT brain scan using an automatic tube current modulation (ATCM) system with or without CT gantry tilt is needed.Methods: An anthropomorphic phantom was scanned with different settings including use of different ATCM, fixed tube current time product (mAs) settings and degree angles of gantry tilt. Gafchromic film XR-QA2 was used to measure absorbed dose of the organs. Relative doses and SNR for the various scan settings were compared with the reference setting of the fixed 330 mAs.Results: Average absorbed dose for the lens of the eyes varied from 8.7 to 21.7 mGy. The use of the ATCM system with the gantry tilt resulted in up to 60% decrease in the dose to the lens of the eye. SNR significantly decreased while tilting the gantry using the fixed mAs techniques, compared to that of the reference setting. However, there were no statistical significant differences for SNRs between the reference setting and all ATCM settings.Conclusions: Compared to the reference setting of the fixed effective mAs, using the ATCM system and appropriate tilting, the gantry resulted in a substantial decrease in the dose to the lens of the eye while preserving signal-to-noise ratio. CT brain examination should be carefully controlled to optimize dose for lens of the eye and image quality of the examination. [ABSTRACT FROM AUTHOR]

Purpose: To compare different methods available in the literature for estimating radiation dose to the conceptus (Dconceptus) against a patient-specific Monte Carlo (MC) simulation and a commercial software package (CSP).Method: Eight voxel models from abdominopelvic CT exams of pregnant patients were generated. Dconceptus was calculated with an MC framework including patient-specific longitudinal tube current modulation (TCM). For the same patients, dose to the uterus, Duterus, was calculated as an alternative for Dconceptus, with a CSP that uses a standard-size, non-pregnant phantom and a generic TCM curve. The percentage error between Duterus and Dconceptus was studied. Dose to the conceptus and percent error with respect to Dconceptus was also estimated for three methods in the literature.Results: The percentage error ranged from -15.9% to 40.0% when comparing MC to CSP. When comparing the TCM profiles with the generic TCM profile from the CSP, differences were observed due to patient habitus and conceptus position. For the other methods, the percentage error ranged from -30.1% to 13.5% but applicability was limited.Conclusions: Estimating an accurate Dconceptus requires a patient-specific approach that the CSP investigated cannot provide. Available methods in the literature can provide a better estimation if applicable to patient-specific cases.Key Points: • A patient's internal anatomy affects the dose to the conceptus. • Conceptus position has an influence on its dose estimation. • Patient anatomy and specific TCM must be considered for accurate conceptus dosimetry. • D uterus to a standard-size phantom should not be used as D conceptus . [ABSTRACT FROM AUTHOR]

The construction of a voxel model of seven year-old male anatomy from a low resolution whole body CT scan acquired with a PET-CT scanner is described. The model is referred to as WILLIAM. The model was used to compare the Monte Carlo calculated relative organ doses with and without tube current modulation from simulated CAP and chest CT examinations. Tube current modulation was simulated in both the angular (x-y plane) and axial (along the z axis) senses. For organs that are located wholly within the scanned anatomy, significant relative dose reductions of approximately 43 to 62 % were calculated when tube current modulation was simulated compared to Monte Carlo calculations that did not include tube current modulation. Organs located outside of the directly irradiated anatomy, experienced a decrease in their relative dose of between 33 and 38 % when tube current modulation was simulated. [ABSTRACT FROM AUTHOR]

Our objective was to investigate the differences in behavior of tube current modulation (TCM) techniques for thoracic CT examinations between male and female anthropomorphic phantoms. The phantoms were scanned with an automatic exposure control system in the longitudinal (z-) and angular-longitudinal (xyz-) TCM, in addition to the fixed-mA which was used as a reference. Axial dose distributions were measured at the levels of the breasts and the diaphragm, and longitudinal dose distributions were measured from the thoracic-inlet level to the diaphragm level at the center and periphery of the phantoms by use of eight solid-state detectors. Image noise was quantitatively measured continuously from the top to the bottom images of the phantoms. With the male phantom, the percentage of average absorbed dose with the xyz-TCM mode compared to the z-TCM mode was 90.2 % at the level of the nipples. This value was significantly smaller than that for the female phantom (95.6 %, P < 0.0001). With either phantom, the percentage of absorbed doses in the longitudinal direction with the xyz-TCM mode compared to the z-TCM mode at the center of the phantom was almost the same as the percent ratio at the periphery of the phantom. Therefore, the effect of xyz-TCM was less pronounced with the female phantom, especially on the reduction of the breast dose. The increase of image noise at the level of the supraclavicular fossa (in the male phantom) and at the level of the diaphragm (both phantoms) could not be avoided with the use of TCM techniques. [ABSTRACT FROM AUTHOR]

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The aim of our study was to evaluate attenuation-based tube current adaptation in coronary calcium scoring using ECG-gated multi-detector-row CT (MDCT). A total of 262 patients underwent non-enhanced cardiac MDCT. Group 1 was scanned using a standard protocol with 120 kV and 150 mAs(eff). Groups 2-4 were scanned using an attenuation-based dose-adaptation template (CARE Dose) with different effective reference mAs settings (150, 180, 210 mAs(eff)). Body-mass index (BMI) and CT-dose index values were calculated for each patient. Image noise and subjective image quality were assessed. Regression analysis was performed, and the variation coefficient of image noise was determined. Compared to the standard scan protocol a dose reduction of 31.1% for group 2 and 20.1% for group 3 was observed. Measurement variation of image noise was smaller for the attenuation-based dose adaptation protocols (group 2-4) (16.2-17.1%) compared to the standard scan protocol (32.3%). Regression analysis of groups 2-4 showed better correlation with improved dose usage based on BMI (all P

Background: For the optimum application of tube current modulation in paediatric CT it is important to know the influences of different imaging parameters on it. Objective: This phantom study was performed to evaluate the influences of tube voltage and scan direction on combined tube current modulation, which is a combination of angular and z-axis modulation. Materials and methods: Sixteen-slice spiral CT with combined tube current modulation was performed using four different phantoms (one adult-size anthropomorphic phantom and three cone-shaped acryl phantoms) at three different tube voltages (80, 100 and 120 kVp) and two scan directions (craniocaudal and caudocranial). Effective tube current—time product (mAs) was chosen to maintain a consistent CTDIvol for each phantom. Other parameters, including detector collimation, slice width, pitch, reconstruction algorithm, scan field of view, and scan range were identical for each phantom. Changes in CTDIvol and mAs resulting from the modulation were calculated and compared. Results: Changes in CTDIvol and mAs resulting from the modulation were different among the three tube voltages. In larger phantoms the greatest reductions (-6.1±3.9% in CTDIvol and -12.5±4.0% in mAs) were obtained with 120 kVp, whereas in smaller phantoms they were obtained with 80 kVp (-2.8±0.9% in CTDIvol and -2.5±4.9% in mAs). Smaller CTDIvol (2.4±0.9 mGy vs. 2.5±1.0 mGy, P=0.017) and mAs (57.2±40.4 mAs vs. 61.4±43.2 mAs, P=0.002) were used in caudocranial scans than in craniocaudal scans with the modulation. Conclusion: Combined tube current modulation is influenced by tube voltage and scan direction depending on phantom profile. [ABSTRACT FROM AUTHOR]

Background: Dose reduction by combined tube current modulation has not been evaluated in pediatric low-dose CT. Objective: This study was performed to evaluate tube current reduction in non-ECG-gated heart CT angiography in children by combined tube current modulation, and to assess the effects of body weight, age, sex, and scan direction on tube current reduction. Materials and methods: From September 2004 to January 2005, non-ECG-gated heart CT examinations were performed with combined tube current modulation in 50 children (median age 1 year, range 1 month to 16 years; M/F 29/21) with congenital heart disease. Sixteen-slice spiral CT studies were obtained using a weight-based low-dose protocol (80 kVp, 50-160 effective mA). CT scans were obtained in the craniocaudal direction when leg veins (n=36) were used for IV injection of contrast agent and in the caudocranial direction when arm veins (n=13) were used. In one child who underwent a Fontan operation, both arm and leg veins were used. We calculated tube current reduction by combined tube current modulation and evaluated the effects of body weight, age, sex, and scan technique on tube current reduction. The quality of CT angiography images was visually evaluated by an experienced pediatric radiologist. Results: Overall tube current reduction by combined tube current modulation was 15.8±11.1%. The reduction was variable among five body weight groups (9.3±7.9% for <4.9 kg, 14.3±9.3% for 5.0-9.9 kg, 16.4±12.5% for 10.0-19.9 kg, 25.8±9.8% for 20.0-39.9 kg, 15.9±12.7% for 40.0-59.9 kg) and was significantly different among the five groups (P=0.017). When eight children in the 40.0-59.9-kg group were excluded, age showed a significant positive correlation with tube current reduction (γ=0.4, P=0.003). There was no significant difference in tube current reduction between boys and girls. Tube current reduction was significantly greater for the caudocranial scan (21.2±9.2%) than for the craniocaudal scan (14.2±11.3%) (P=0.049). All CT angiography images were of diagnostic quality. Conclusions: Combined tube current modulation reduced tube current in pediatric non-ECG-gated heart CT by 15.8% without degradation of image quality. With our CT protocol, for body weights up to 39.9 kg, age showed a significant positive correlation with tube current reduction, but there was a lower dose-saving effect in children heavier than 40 kg. Tube current reduction was not affected by sex, but was affected by scan direction. [ABSTRACT FROM AUTHOR]