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Dual-energy compared to single-energy CT in pediatric imaging: a phantom study for DECT clinical guidance

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Abstract

Background

Dual-energy CT technology is available on scanners from several vendors and offers significant advantages over classic single-energy CT technology in multiple clinical applications. Many studies have detailed dual-energy CT applications in adults and several have evaluated the relative radiation dose performance of dual-energy CT in adult imaging. However, little has been published on dual-energy CT imaging in the pediatric population, and the relative dose performance of dual-energy CT imaging in the pediatric population is not well described.

Objective

When evaluating dual-energy CT technology for implementation into a routine clinical pediatric imaging practice, the radiation dose implications must be considered, and when comparing relative CT dose performance, image quality must also be evaluated. Therefore the purpose of this study is to develop dual-energy CT scan protocols based on our optimized single-energy scan protocols and compare the dose.

Materials and methods

We scanned the head, chest and abdomen regions of pediatric-size anthropomorphic phantoms with contrast inserts, using our optimized single-energy clinical imaging protocols on a Siemens Flash® CT scanner. We then scanned the phantoms in dual-energy mode using matching image-quality reference settings. The effective CT dose index volume (CTDIvol) of the scans was used as a surrogate for relative dose in comparing the single- and dual-energy scans. Additionally, we evaluated image quality using visual assessment and contrast-to-noise ratio.

Results

Dual-energy CT scans of the head and abdomen were dose-neutral for all three phantoms. Dual-energy CT scans of the chest showed a relative dose increase over the single-energy scan for 1- and 5-year-old child-based age-equivalent phantoms, ranging 11–20%. Quantitative analysis of image quality showed no statistically significant difference in image quality between the single-energy and dual-energy scans. There was no clinically significant difference in image quality by visual assessment.

Conclusion

Dual-energy CT is dose-neutral in imaging the head and abdomen in children. It is not dose-neutral in chest imaging of very small children. With a better understanding of the dose consequences of converting single-energy protocols to dual-energy protocols we can begin to implement clinical dual-energy CT and utilize its unique capabilities in pediatric imaging.

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References

  1. Johnson TRC (2012) Dual-energy CT: general principles. AJR Am J Roentgenol 199:3–8

    Article  Google Scholar 

  2. Freiherr G (2015) New offerings at RSNA 2014 echo increased efficiency. Imaging technology news. http://www.itnonline.com/article/new-offerings-rsna-2014-echo-increased-efficiency. Accessed 3 May 2016

  3. Mansouri M, Aran S, Singh A et al (2015) Dual-energy computed tomography characterization of urinary calculi: basic principles, applications and concerns. Curr Probl Diagn Radiol 44:496–500

    Article  PubMed  Google Scholar 

  4. Agrawal M, Pinho D, Kulkarni N et al (2014) Oncologic applications of dual energy CT in the abdomen. Radiograpics 34:589–611

    Article  Google Scholar 

  5. Coupal TM, Mallinson PI, McLaughlin P et al (2014) Peering through the glare: using dual-energy CT to overcome the problem of metal artefacts in bone radiology. Skelet Radiol 43:567–575

    Article  Google Scholar 

  6. Jiang XY, Zhang SH, Xie QZ et al (2015) Evaluation of virtual noncontrast images obtained from dual-energy CTA for diagnosing subarachnoid hemorrhage. AJNR Am J Neuroradiol 36:855–860

    Article  CAS  PubMed  Google Scholar 

  7. Schulz B, Kuehling K, Kromen W et al (2012) Automatic bone removal technique in whole-body dual-energy CT angiography: performance and image quality. AJR Am J Roentgenol 199:W646–W650

    Article  PubMed  Google Scholar 

  8. Goo HW (2010) Initial experience of dual-energy lung perfusion CT using a dual-source CT system in children. Pediatr Radiol 40:1536–1544

    Article  PubMed  Google Scholar 

  9. Zhu X, Mecca P, Servaes S et al (2014) Dual energy compared to single energy CT scans in pediatric patients: dose neutral or not? Abstract. Pediatr Radiol 44:S253

    Google Scholar 

  10. Schenzle JC, Sommer WH, Neumaier K et al (2010) Dual energy CT of the chest: how about the dose? Investig Radiol 45:347–353

    Google Scholar 

  11. Henzler T, Fink C, Schoenberg SO et al (2012) Dual-energy CT: radiation dose aspects. AJR Am J Roentgenol 199:16–25

    Article  Google Scholar 

  12. Takeuchi M, Kawai T, Ito M et al (2012) Split-bolus CT-urography using dual-energy CT: feasibility, image quality and dose reduction. Eur J Radiol 81:3160–3165

    Article  PubMed  Google Scholar 

  13. Goo HW (2013) Dual-energy lung perfusion and ventilation CT in children. Pediatr Radiol 43:298–307

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Xiaowei Zhu, Patricia Mecca, Sabah Servaes & Kassa Darge

  2. The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Xiaowei Zhu, Sabah Servaes & Kassa Darge

  3. Department of Radiology and Medical Imaging, University of Virginia Health System, P.O. Box 800170, Charlottesville, VA, 22908-0170, USA

    William P. McCullough

Authors
  1. Xiaowei Zhu
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  2. William P. McCullough
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  3. Patricia Mecca
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  4. Sabah Servaes
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  5. Kassa Darge
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Corresponding author

Correspondence to William P. McCullough.

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Zhu, X., McCullough, W.P., Mecca, P. et al. Dual-energy compared to single-energy CT in pediatric imaging: a phantom study for DECT clinical guidance. Pediatr Radiol 46, 1671–1679 (2016). https://doi.org/10.1007/s00247-016-3668-x

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  • DOI: https://doi.org/10.1007/s00247-016-3668-x

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