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Automated tube voltage adaptation in head and neck computed tomography between 120 and 100 kV: effects on image quality and radiation dose

  • Head and Neck Radiology
  • Published:
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Abstract

Introduction

Low tube voltage allows for computed tomography (CT) imaging with increased iodine contrast at reduced radiation dose. We sought to evaluate the image quality and potential dose reduction using a combination of attenuation based tube current modulation (TCM) and automated tube voltage adaptation (TVA) between 100 and 120 kV in CT of the head and neck.

Methods

One hundred thirty consecutive patients with indication for head and neck CT were examined with a 128-slice system capable of TCM and TVA. Reference protocol was set at 120 kV. Tube voltage was reduced to 100 kV whenever proposed by automated analysis of the localizer. An additional small scan aligned to the jaw was performed at a fixed 120 kV setting. Image quality was assessed by two radiologists on a standardized Likert-scale and measurements of signal- (SNR) and contrast-to-noise ratio (CNR). Radiation dose was assessed as CTDIvol.

Results

Diagnostic image quality was excellent in both groups and did not differ significantly (p = 0.34). Image noise in the 100 kV data was increased and SNR decreased (17.8/9.6) in the jugular veins and the sternocleidomastoid muscle when compared to 120 kV (SNR 24.4/10.3), but not in fatty tissue and air. However, CNR did not differ statistically significant between 100 (23.5/14.4/9.4) and 120 kV data (24.2/15.3/8.6) while radiation dose was decreased by 7–8 %.

Conclusions

TVA between 100 and 120 kV in combination with TCM led to a radiation dose reduction compared to TCM alone, while keeping CNR constant though maintaining diagnostic image quality.

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Abbreviations

CT:

Computed tomography

TCM:

Tube current modulation

TVA:

Tube voltage adaptation

HU:

Hounsfield units

ROI:

Regions of interest

SNR:

Signal-to-noise ratio

CNR:

Contrast-to-noise ratio

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Ethical standards and patient consent

We declare that all human and animal studies have been approved by the Institutional Review Board and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Acknowledgments

We thank Petra Ruse, Elke Bedarf, and Andrea Brinkmann for excellent patient examination.

Conflict of interest

MM, WW, MS, MU, and ML are part of the Siemens AG Speaker’s Bureau. MU is part of the Bracco Imaging GmbH Speaker’s Bureau. ML is part of the Bayer AG Speaker’s Bureau. BS is an employee of Siemens AG.

Author information

Authors and Affiliations

  1. Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, 91054, Erlangen, Germany

    Matthias S. May, Manuel R. Kramer, Achim Eller, Wolfgang Wuest, Michael Scharf, Michael Brand, Marc Saake, Michael Uder & Michael M. Lell

  2. Siemens Healthcare, Erlangen, Germany

    Bernhard Schmidt

  3. Imaging Science Institute, University Erlangen, Erlangen, Germany

    Matthias S. May, Michael Uder & Michael M. Lell

Authors
  1. Matthias S. May
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  2. Manuel R. Kramer
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  3. Achim Eller
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  4. Wolfgang Wuest
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  5. Michael Scharf
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  6. Michael Brand
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  7. Marc Saake
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  8. Bernhard Schmidt
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  9. Michael Uder
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  10. Michael M. Lell
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Corresponding author

Correspondence to Matthias S. May.

Additional information

MM and MK contributed equally to this study.

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Cite this article

May, M.S., Kramer, M.R., Eller, A. et al. Automated tube voltage adaptation in head and neck computed tomography between 120 and 100 kV: effects on image quality and radiation dose. Neuroradiology 56, 797–803 (2014). https://doi.org/10.1007/s00234-014-1393-4

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  • DOI: https://doi.org/10.1007/s00234-014-1393-4

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