Background: In this study, the changes in the entrance surface dose (ESD) and image quality were examined when an air mattress was used to reduce the X-ray scattering caused by treatment tables commonly used for computed tomography (CT). Materials and Methods: Dual-energy CT (DECT) was used, with the ESD of Alderson Radiation Therapy (ART) phantom measured by scanning with different X-ray tube voltages and X -ray tube currents for three scenarios: when no air mattress was employed, and when a 5 cm or 10 cm thick air mattress was employed. The statistical significance of the changes in ESD and image quality were based on the presence and thickness of the air mattress. Additionally, the variations of the X-ray tube voltage and current for different air mattress thicknesses were investigated using paired t-test. Results: For all X-ray tube voltages and currents, applying an air mattress significantly improved both the ESD and image quality, with the 5 cm air mattress improving both the ESD and image quality. Conclusion: The 5 cm air mattress produced no artifacts in the diagnostic images, and demonstrated a statistically significant reduction in patient ESD during DECT imaging.

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