European Radiology

, Volume 23, Issue 10, pp 2643–2651 | Cite as

Clinical evaluation of automatic tube voltage selection in chest CT angiography

  • Tilo Niemann
  • Simon Henry
  • Jean-Baptiste Faivre
  • Kanna Yasunaga
  • Sofiane Bendaoud
  • Ariana Simeone
  • Jacques Remy
  • Alain Duhamel
  • Thomas Flohr
  • Martine Remy-JardinEmail author



To evaluate the clinical impact of automatic tube voltage selection on chest CT angiography (CTA).


Ninety-three patients were prospectively evaluated with a CT protocol aimed at comparing two successive CTAs acquired under similar technical conditions except for the kV selection: (1) the initial CTA was systematically obtained at 120 kVp and 90 ref mAs; (2) the follow-up CTA was obtained with an automatic selection of the kilovoltage (Care KV; Siemens Healthcare) for optimised CTA.


At follow-up, 90 patients (97 %) underwent CTA with reduced tube voltage, 100 kV (n = 26; 28 %) and 80 kV (n = 64; 69 %), resulting in a significant dose-length-product reduction (follow-up: 87.27; initial: 141.88; P < 0.0001; mean dose reduction: 38.5 %) and a significant increase in the CNR at follow-up (follow-up: 11.5 ± 3.5 HU; initial: 10.9 ± 3.7 HU; P = 0.03). The increase in objective image noise at follow-up (follow-up: 23.2 ± 6.7 HU vs. 17.8 ± 5.1 HU; P < 0.0001) did not alter the diagnostic value of images.


Automatic tube voltage selection reduced the radiation dose delivered during chest CT angiograms by 38.5 % while improving the contrast-to-noise ratio of the examinations.

Key Points

As low a dose as possible must be used for CT angiography.

Automatic tube voltage selection permits reduced patient exposure.

Lowering the kVp enables increased intravascular attenuation.

Automatic tube voltage selection does not compromise the overall image quality.


CT angiography Dose Image quality kV/kVp Tube voltage 



T. Niemann received grants from the Cancer League of Basel City and Basel Country and the Gottfried and Julia Bangerter-Rhyner Foundation.

T. Flohr is an employee of Siemens Medical Systems. J. Remy is consultant for Siemens Medical Systems.


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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Tilo Niemann
    • 1
  • Simon Henry
    • 1
  • Jean-Baptiste Faivre
    • 1
  • Kanna Yasunaga
    • 1
  • Sofiane Bendaoud
    • 1
  • Ariana Simeone
    • 1
  • Jacques Remy
    • 1
  • Alain Duhamel
    • 2
  • Thomas Flohr
    • 3
  • Martine Remy-Jardin
    • 4
    Email author
  1. 1.Department of Thoracic Imaging, Hospital Calmette (EA 2694)University Lille Nord de FranceLilleFrance
  2. 2.Department of Medical Statistics (EA 2694)University Lille Nord de FranceLilleFrance
  3. 3.Department of Research and DevelopmentSiemens Medical SystemsForchheimGermany
  4. 4.Department of Thoracic ImagingHospital CalmetteLille cedexFrance

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