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Strategien zur Reduktion der CT-Strahlendosis

Strategies for reducing the CT radiation dose

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Zusammenfassung

Die rasante technische Weiterentwicklung der CT hat in den letzten Jahren zu einer deutlichen Zunahme der diagnostischen Möglichkeiten geführt, mit dem Resultat, dass die CT-Untersuchungszahlen weltweit angestiegen sind. Dies hat ebenfalls Auswirkung auf die Strahlenexposition der Bevölkerung. Bis heute sind zahlreiche Publikationen erschienen, die gezeigt haben, dass eine Dosisreduktion erreicht werden kann, ohne dadurch die Bildqualität und Sensitivität der CT zu beeinträchtigen. Die Mehrzahl der Strategien zur Dosisoptimierung sind einfach anzuwenden und unabhängig von der Detektorkonfiguration des CT-Scanners. Im vorliegenden Übersichtsartikel werden die wichtigsten Methoden vorgestellt: indikationsabhängige Methoden (z. B. rechtfertigende Indikation, Reduktion der Röhrenspannung für die CT-Angiographie, Wahl von Kollimation und Pitchfaktor, Minimierung der Untersuchungsphasen, Senkung der Röhrenspannung und des -stroms für die Nativphase), herstellerabhängige Methoden (z. B. automatische Röhrenstrommodulation, adaptive Filter zur Reduktion des Bildrauschens, iterative Bildrekonstruktion) und allgemeine Methoden (z. B. Patientenzentrierung im Isozentrum der CT-Gantry, Reduktion der Scanlänge, Anwendung von Röntgenschutzmitteln, Reduktion der Röhrenspannung und/oder des -stroms für den CT-Planungsscan).

Abstract

The rapid technical advances in computed tomography have led to an increased number of clinical indications. Unfortunately, at the same time the radiation exposure to the population has also increased due to the increased total number of CT examinations. In the last few years various publications have demonstrated the feasibility of radiation dose reduction for CT examinations with no compromise in image quality and loss in interpretation accuracy. The majority of the proposed methods for dose optimization are easy to apply and are independent of the detector array configuration. This article reviews indication-dependent principles (e.g. application of reduced tube voltage for CT angiography, selection of the collimation and the pitch, reducing the total number of imaging series, lowering the tube voltage and tube current for non-contrast CT scans), manufacturer-dependent principles (e.g. accurate application of automatic modulation of tube current, use of adaptive image noise filter and use of iterative image reconstruction) and general principles (e.g. appropriate patient-centering in the gantry, avoiding over-ranging of the CT scan, lowering the tube voltage and tube current for survey CT scans) which lead to radiation dose reduction.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Dr. Schindera erhielt Drittmittel im Rahmen eines Kooperationsvertrags von Siemens Healthcare Sector.

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Authors and Affiliations

  1. Institut für Diagnostische, Interventionelle und Pädiatrische Radiologie, Universitätsspital Bern, Inselspital, Freiburgstraße, CH-3010, Bern, Schweiz

    S.T. Schindera, G. von Allmen, P. Vock & Z. Szucs-Farkas

  2. Institut für Diagnostische und Interventionelle Neuroradiologie, Universitätsspital Bern, Inselspital, Bern, Schweiz

    C. Nauer

  3. Abteilung Strahlenschutz, Bundesamt für Gesundheit, Bern, Schweiz

    R. Treier & P. Trueb

Authors
  1. S.T. Schindera
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  2. C. Nauer
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  3. R. Treier
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  4. P. Trueb
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  5. G. von Allmen
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  6. P. Vock
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  7. Z. Szucs-Farkas
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Correspondence to S.T. Schindera.

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Schindera, S., Nauer, C., Treier, R. et al. Strategien zur Reduktion der CT-Strahlendosis. Radiologe 50, 1120–1127 (2010). https://doi.org/10.1007/s00117-010-2053-2

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