Low-Tube-Voltage 80-kVp Neck CT: Evaluation of Diagnostic Accuracy and Interobserver Agreement

Abstract

BACKGROUND AND PURPOSE: Low-tube-voltage acquisition has been shown to facilitate substantial dose savings for neck CT with similar image contrast compared with standard 120-kVp acquisition. However, its potential for the detection of neck pathologies is uncertain. Our aim was to evaluate the effects of low-tube-voltage 80-kV(peak) acquisitions for neck CT on diagnostic accuracy and interobserver agreement.

Automated Tube Voltage Adaptation in Combination with Advanced Modeled Iterative Reconstruction in Thoracoabdominal Third-Generation 192-Slice Dual-Source Computed Tomography

“…The interobserver acceptance of subjective image analysis was expressed by the intraclass correlation coefficient (ICC) (20). ICC was calculated globally and for each value of the European guidelines on quality criteria and interpreted as fol- …”

“…Low-tube-voltage acquisition has been extensively investigated for different body regions to reduce radiation exposure (5,9,(20)(21)(22)(23)(24)(25). A potential drawback of this technique is an increase in image noise which may impair diagnostic acceptability (20,21,23).…”

Advanced Modeled Iterative Reconstruction in Low-Tube-Voltage Contrast-Enhanced Neck CT: Evaluation of Objective and Subjective Image Quality

“…11 In contrast and despite an increased image noise, prior studies investigating 80-kVp contrast-enhanced neck CT in combination with FBP on the same second-generation DSCT reported an increased tumor delineation and good diagnostic accuracy of benign and malignant pathologies. 4,5,24 The average size-specific dose estimate in our study was 13.59 Ϯ 1.23 mGy, which corresponds to a dose reduction of approximately 35.4% compared with standard 120 kVp. Iterative reconstruction has quickly become a standard feature on modern CT scanners, providing image noise reduction.…”

“…21,22 Tube-voltage reduction is one of several opportunities to reduce radiation exposure substantially in contrast-enhanced neck CT. 11,23 A potential drawback of a reduced tube voltage is an increase in image noise. 4,5,11,23,24 Due to increased image noise, 70 kV(peak) neck CT has compromised image quality in the lower part of the neck. 23 As a consequence of limited diagnostic acceptability, May et al 11 excluded 80-kVp acquisitions by using automated tube voltage adaptation in contrast-enhanced neck CT in combination with FBP on a second-generation 128-section DSCT.…”

“…These typically involve adjusting CT acquisition parameters such as tube voltage, tube current, tube rotation time, pitch, and collimation to the patient body and examined body region. [4][5][6] The interaction of these parameters is complex, and manual adjustments may result in nondiagnostic images. Thus, commercially available techniques, including tube current modulation, 7 automatic exposure control, 8,9 automated tube voltage adaptation, 10,11 iterative reconstruction, [12][13][14][15] and selective in-plane shielding (thyroid, eye lens, breast, and gonads), 16 have been introduced to support the radiologic technologist, physicist, and radiologist team in developing appropriate CT protocols.…”