Lowering kilovoltage to reduce radiation dose in contrast-enhanced abdominal CT: Initial assessment of a prototype automated kilovoltage selection tool

David M. Hough, Joel Garland Fletcher, Katharine L. Grant, Jeff L. Fidler, Lifeng Yu, Jennifer R. Geske, Rickey E. Carter, Rainer Raupach, Bernhard Schmidt, Thomas Flohr, Cynthia H McCollough

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

OBJECTIVE: The purpose of this study was to determine whether the use of an automated CT kilovoltage (kV) selection tool (Auto kV) can result in lower radiation dose without sacrificing image quality in contrast-enhanced abdominopelvic CT. MATERIALS AND METHODS: Tube potential, radiation dose, and iodine contrasttonoise ratio (CNR) were retrospectively evaluated in 36 patients who underwent abdominopelvic CT with Auto kV, and compared with results from size-matched control patients using identical protocols. Two radiologists evaluated image quality (sharpness, noise, and diagnostic confidence) blinded to kV. Volume CT dose index (CTDIvol) was also compared with what each patient would have received from scanning at 120 kV. RESULTS: Mean (SD) CTDIvol was 16.0 (4.4) mGy after Auto kV versus 19.5 (4.0) mGy using standard 120-kV prescription and was 19.3 (6.0) mGy in control subjects (yielding dose reductions of 18.0% and 17.2%, respectively; p < 0.001 for both). Thirty of 36 patients were scanned at 100 kV (median dose reduction, 25%). Auto kV images were rated as very sharp in 33 (92%) and 36 (100%) cases versus 36 (100%) and 35 (97%) of the control cases, with all cases scored as having optimal noise. Readers had full diagnostic confidence in 34 (94%) and 36 (100%) of Auto kV cases; one reader scored "probably confident" in two cases (6%). Iodine CNRs for the aorta, liver, and portal vein were similar between Auto kV cases and control cases (p > 0.50, all comparisons). CONCLUSION: The use of an automated kV selection tool results in significant dose savings while maintaining diagnostic image quality and iodine CNR.

Original languageEnglish (US)
Pages (from-to)1070-1077
Number of pages8
JournalAmerican Journal of Roentgenology
Volume199
Issue number5
DOIs
StatePublished - Nov 2012

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Radiation
Iodine
Cone-Beam Computed Tomography
Prescriptions
Noise
Radiologists

Keywords

  • Automated kilovoltage selection
  • CT
  • Image quality
  • Radiation dose

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Lowering kilovoltage to reduce radiation dose in contrast-enhanced abdominal CT : Initial assessment of a prototype automated kilovoltage selection tool. / Hough, David M.; Fletcher, Joel Garland; Grant, Katharine L.; Fidler, Jeff L.; Yu, Lifeng; Geske, Jennifer R.; Carter, Rickey E.; Raupach, Rainer; Schmidt, Bernhard; Flohr, Thomas; McCollough, Cynthia H.

In: American Journal of Roentgenology, Vol. 199, No. 5, 11.2012, p. 1070-1077.

Research output: Contribution to journalArticle

Hough, David M. ; Fletcher, Joel Garland ; Grant, Katharine L. ; Fidler, Jeff L. ; Yu, Lifeng ; Geske, Jennifer R. ; Carter, Rickey E. ; Raupach, Rainer ; Schmidt, Bernhard ; Flohr, Thomas ; McCollough, Cynthia H. / Lowering kilovoltage to reduce radiation dose in contrast-enhanced abdominal CT : Initial assessment of a prototype automated kilovoltage selection tool. In: American Journal of Roentgenology. 2012 ; Vol. 199, No. 5. pp. 1070-1077.
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abstract = "OBJECTIVE: The purpose of this study was to determine whether the use of an automated CT kilovoltage (kV) selection tool (Auto kV) can result in lower radiation dose without sacrificing image quality in contrast-enhanced abdominopelvic CT. MATERIALS AND METHODS: Tube potential, radiation dose, and iodine contrasttonoise ratio (CNR) were retrospectively evaluated in 36 patients who underwent abdominopelvic CT with Auto kV, and compared with results from size-matched control patients using identical protocols. Two radiologists evaluated image quality (sharpness, noise, and diagnostic confidence) blinded to kV. Volume CT dose index (CTDIvol) was also compared with what each patient would have received from scanning at 120 kV. RESULTS: Mean (SD) CTDIvol was 16.0 (4.4) mGy after Auto kV versus 19.5 (4.0) mGy using standard 120-kV prescription and was 19.3 (6.0) mGy in control subjects (yielding dose reductions of 18.0{\%} and 17.2{\%}, respectively; p < 0.001 for both). Thirty of 36 patients were scanned at 100 kV (median dose reduction, 25{\%}). Auto kV images were rated as very sharp in 33 (92{\%}) and 36 (100{\%}) cases versus 36 (100{\%}) and 35 (97{\%}) of the control cases, with all cases scored as having optimal noise. Readers had full diagnostic confidence in 34 (94{\%}) and 36 (100{\%}) of Auto kV cases; one reader scored {"}probably confident{"} in two cases (6{\%}). Iodine CNRs for the aorta, liver, and portal vein were similar between Auto kV cases and control cases (p > 0.50, all comparisons). CONCLUSION: The use of an automated kV selection tool results in significant dose savings while maintaining diagnostic image quality and iodine CNR.",
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AU - Fletcher, Joel Garland

AU - Grant, Katharine L.

AU - Fidler, Jeff L.

AU - Yu, Lifeng

AU - Geske, Jennifer R.

AU - Carter, Rickey E.

AU - Raupach, Rainer

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AU - Flohr, Thomas

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