Balancing Radiation Dose and Image Quality: Clinical Applications of Neck Volume CT

Abstract

BACKGROUND AND PURPOSE:The advancement of multidetector CT technology has resulted in improved image quality as well as an increase in ionizing radiation dose to patient. The purpose of this study was to assess radiation dose and overall image quality of CT examination of the neck between fixed-tube current and automatic tube current modulation (ATCM) at 2 separate noise index levels.

Diagnostic Accuracy of 4D-CT for Parathyroid Adenomas and Hyperplasia

“…These parameters are comparable with recently reported CTDI vol values for neck CT ranging from 23.0 to 34.7 mGy. 15 We have chosen not to exclude the noncontrast examination, as we think it provides important diagnostic information, particularly in its ability to show attenuation differences in lesions contiguous with the thyroid gland. The risk-benefit discussion must weigh the cost, morbidity, and risk of formal neck exploration with the exposure from 4D-CT.…”

Image Quality and Radiation Dose of Dual-Energy CT of the Head and Neck Compared with a Standard 120-kVp Acquisition

“…The CTDI vol and DLP were significantly lower by 12% and 10% with DECT compared with SECT protocols; with no significant differences in noise level, attenuation measurements, or subjective image quality between the 2 protocols. The described SECT protocol is routine for H&N imaging used at our institution, with lower radiation doses than other reported protocols 16 and official dose limits. 17 The introduction of DE scanning and dual-source CT was accompanied by concerns about increased radiation dose, as was the case with the early years of multidetector CT, because of the focus on optimization of image quality, ignoring the effect on radiation dose.…”

“…Assessing image quality both objectively by noise and attenuation measurements 11,13,25 and subjectively by experienced radiologists blindly rating images with predefined scores is generally accepted. 11,13,16,18,25 The complex anatomy and wide variation of thickness and attenuation of the H&N region imply differences in noise levels and image quality; therefore, we chose representative anatomic levels similar to those described in a previous study, 18 instead of collectively judging all images. Objective noise was similar with DE and SECT protocols at the 5 anatomic levels.…”

“…17 The introduction of DE scanning and dual-source CT was accompanied by concerns about increased radiation dose, as was the case with the early years of multidetector CT, because of the focus on optimization of image quality, ignoring the effect on radiation dose. 16,18 Soon afterward, effort was di- rected toward decreasing radiation exposure, such as the installation of adaptive tube-current-modulation techniques in modern scanners. 15,16,18,19 Increased awareness of radiologists and familiarity with scanning parameters affecting radiation dose are at least of equal importance.…”

“…16,18 Soon afterward, effort was di- rected toward decreasing radiation exposure, such as the installation of adaptive tube-current-modulation techniques in modern scanners. 15,16,18,19 Increased awareness of radiologists and familiarity with scanning parameters affecting radiation dose are at least of equal importance. 15 A good practice that must be encouraged by all radiologists is the comparison of radiation doses before applying any change of the scanning parameters and especially before implementing new protocols or techniques.…”