A cross-sectional study on the correlation of image quality, effective dose, and body composition with thyroid, chest, and abdominal computed tomography scans

Background: The rapid increase in the use of radiodiagnostic examinations in China, especially computed tomography (CT) scans, has led to these examinations being the largest artificial source of per capita effective dose (ED). This study conducted a retrospective analysis of the correlation between image quality, ED, and body composition in 540 cases that underwent thyroid, chest, or abdominal CT scans. The aim of this analysis was to evaluate the correlation between the parameters of CT scans and body composition in common positions of CT examination (thyroid, chest, and abdomen) and ultimately inform potential measures for reducing radiation exposure. Methods: This study included 540 patients admitted to Fudan University Shanghai Cancer Center from January 2015 to December 2019 who underwent both thyroid or chest or abdominal CT scan and body composition examination. Average CT values and standard deviation (SD) values were collected for the homogeneous areas of the thyroid, chest, or abdomen, and the average CT values and SD values of adjacent subcutaneous fat tissue were measured in the same region of interest (ROI). All data were measured three times, and the average was taken to calculate the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for each area. The dose-length product (DLP) was recorded, and the ED was calculated with the following: formula ED = k x DLP. Dual-energy X-ray was used to determine body composition and obtain indicators such as percentage of spinal and thigh muscle. Pearson correlation coefficient was used to analyze the correlations between body composition indicators, height, weight, body mass index (BMI), and ED. Results: The correlation coefficients between the SNR of abdominal CT scan and weight, BMI, and body surface area (BSA) were -0.470 (P=0.001), -0.485 (P=0.001), and -0.437 (P=0.002), representing a moderate correlation strength with statistically significant differences. The correlation coefficients between the ED of chest CT scans and weight, BMI, spinal fat percentage, and BSA were 0.488 (P=0.001), 0.473 (P=0.002), 0.422 (P=0.001), and 0.461 (P=0.003), respectively, indicating a moderate correlation strength with statistical differences. There was a weak statistically significant correlation between the SNR, CNR, and ED of the other scans with each physical and body composition index (P=0.023). Conclusions: There were varying degrees of correlation between CT image quality and ED and physical and body composition indices, which may inform novel solutions for reducing radiation exposure.