Topogram-based automated selection of the tube potential and current in thoraco-abdominal trauma CT - a comparison to fixed kV with mAs modulation alone

被引:29
作者
Frellesen, Claudia [1 ]
Stock, Wenzel [1 ]
Kerl, J. Matthias [1 ]
Lehnert, Thomas [1 ]
Wichmann, Julian L. [1 ]
Nau, Christoph [2 ]
Geiger, Emanuel [2 ]
Wutzler, Sebastian [2 ]
Beeres, Martin [1 ]
Schulz, Boris [1 ]
Bodelle, Boris [1 ]
Ackermann, Hanns [3 ]
Vogl, Thomas J. [1 ]
Bauer, Ralf W. [1 ,4 ]
机构
[1] Clin Goethe Univ, Dept Diagnost & Intervent Radiol, D-60590 Frankfurt, Germany
[2] Clin Goethe Univ, Dept Trauma Hand & Reconstruct Surg, D-60590 Frankfurt, Germany
[3] Clin Goethe Univ, Dept Biostat & Math Modelling, D-60590 Frankfurt, Germany
[4] Klinikum Goethe Univ, Inst Diagnost & Intervent Radiol, D-60590 Frankfurt, Germany
关键词
Automated tube potential selection; Automated mA modulation; Polytrauma; Thoraco-abdominal CT; Dose reduction; BODY COMPUTED-TOMOGRAPHY; SEVERE BLUNT TRAUMA; IMAGE-QUALITY; RADIATION-EXPOSURE; MULTIPLE TRAUMA; DOSE REDUCTION; ABDOMINAL CT; MANAGEMENT; CANCER; RISKS;
D O I
10.1007/s00330-014-3197-7
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
To investigate the impact of automated attenuation-based tube potential selection on image quality and exposure parameters in polytrauma patients undergoing contrast-enhanced thoraco-abdominal CT. One hundred patients were examined on a 16-slice device at 120 kV with 190 ref.mAs and automated mA modulation only. Another 100 patients underwent 128-slice CT with automated mA modulation and topogram-based automated tube potential selection (autokV) at 100, 120 or 140 kV. Volume CT dose index (CTDIvol), dose-length product (DLP), body diameters, noise, signal-to-noise ratio (SNR) and subjective image quality were compared. In the autokV group, 100 kV was automatically selected in 82 patients, 120 kV in 12 patients and 140 kV in 6 patients. Patient diameters increased with higher kV settings. The median CTDIvol (8.3 vs. 12.4 mGy; -33 %) and DLP (594 vs. 909 mGy cm; -35 %) in the entire autokV group were significantly lower than in the group with fixed 120 kV (p < 0.05 for both). Image quality remained at a constantly high level at any selected kV level. Topogram-based automated selection of the tube potential allows for significant dose savings in thoraco-abdominal trauma CT while image quality remains at a constantly high level. aEuro cent Automated kV selection in thoraco-abdominal trauma CT results in significant dose savings aEuro cent Most patients benefit from a 100-kV protocol with relevant DLP reduction aEuro cent Constantly good image quality is ensured aEuro cent Image quality benefits from higher kV when arms are positioned downward.
引用
收藏
页码:1725 / 1734
页数:10
相关论文
共 26 条
[1]   Influence of Arm Positioning on Radiation Dose for Whole Body Computed Tomography in Trauma Patients [J].
Bayer, Joerg ;
Pache, Gregor ;
Strohm, Peter C. ;
Zwingmann, Joern ;
Blanke, Philipp ;
Baumann, Tobias ;
Suedkamp, Norbert P. ;
Hammer, Thorsten .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2011, 70 (04) :900-905
[2]   Application of multislice spiral CT (MSCT) in multiple injured patients and its effect on diagnostic and therapeutic algorithms [J].
Boehm, T ;
Alkadhi, H ;
Schertler, T ;
Baumert, B ;
Roos, J ;
Marincek, B ;
Wildermuth, S .
ROFO-FORTSCHRITTE AUF DEM GEBIET DER RONTGENSTRAHLEN UND DER BILDGEBENDEN VERFAHREN, 2004, 176 (12) :1734-1742
[3]   Current concepts - Computed tomography - An increasing source of radiation exposure [J].
Brenner, David J. ;
Hall, Eric J. .
NEW ENGLAND JOURNAL OF MEDICINE, 2007, 357 (22) :2277-2284
[4]   Estimated risks of radiation-induced fatal cancer from pediatric CT [J].
Brenner, DJ ;
Elliston, CD ;
Hall, EJ ;
Berdon, WE .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2001, 176 (02) :289-296
[5]   Arm Raising at Exposure-controlled Multidetector Trauma CT of Thoracoabdominal Region: Higher Image Quality, Lower Radiation Dose [J].
Brink, Monique ;
de lange, Frank ;
Oostveen, Luuk J. ;
Dekker, Helena M. ;
Kool, Digna R. ;
Deunk, Jaap ;
Edwards, Michael J. R. ;
van Kuijk, Cornelis ;
Kamman, Richard L. ;
Blickman, Johan G. .
RADIOLOGY, 2008, 249 (02) :661-670
[6]   Cardiac Computed Tomography Angiography With Automatic Tube Potential Selection Effects on Radiation Dose and Image Quality [J].
Ghoshhajra, Brian B. ;
Engel, Leif-Christopher ;
Karolyi, Mihaly ;
Sidhu, Manavjot Singh ;
Wai, Bryan ;
Barreto, Mitya ;
Shanmugam, Uthamalingam ;
Hoffmann, Udo ;
Brady, Thomas J. ;
Kalra, Manudeep ;
Abbara, Suhny .
JOURNAL OF THORACIC IMAGING, 2013, 28 (01) :40-48
[7]   Automated tube potential selection for standard chest and abdominal CT in follow-up patients with testicular cancer: comparison with fixed tube potential [J].
Gnannt, Ralph ;
Winklehner, Anna ;
Eberli, Daniel ;
Knuth, Alexander ;
Frauenfelder, Thomas ;
Alkadhi, Hatem .
EUROPEAN RADIOLOGY, 2012, 22 (09) :1937-1945
[8]   Automated Attenuation-Based Kilovoltage Selection: Preliminary Observations in Patients After Endovascular Aneurysm Repair of the Abdominal Aorta [J].
Goetti, Robert ;
Winklehner, Anna ;
Gordic, Sonja ;
Baumueller, Stephan ;
Karlo, Christoph A. ;
Frauenfelder, Thomas ;
Alkadhi, Hatem .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2012, 199 (03) :W380-W385
[9]   Radiation Risks of Medical Imaging: Separating Fact from Fantasy [J].
Hendee, William R. ;
O'Connor, Michael K. .
RADIOLOGY, 2012, 264 (02) :312-321
[10]  
Hessmann MH, 2006, ACTA CHIR BELG, V106, P500