Limiting CT radiation dose in children with craniosynostosis: phantom study using model-based iterative reconstruction
Medical professionals need to exercise particular caution when developing CT scanning protocols for children who require multiple CT studies, such as those with craniosynostosis.
To evaluate the utility of ultra-low-dose CT protocols with model-based iterative reconstruction techniques for craniosynostosis imaging.
Materials and methods
We scanned two pediatric anthropomorphic phantoms with a 64-slice CT scanner using different low-dose protocols for craniosynostosis. We measured organ doses in the head region with metal-oxide-semiconductor field-effect transistor (MOSFET) dosimeters. Numerical simulations served to estimate organ and effective doses. We objectively and subjectively evaluated the quality of images produced by adaptive statistical iterative reconstruction (ASiR) 30%, ASiR 50% and Veo (all by GE Healthcare, Waukesha, WI). Image noise and contrast were determined for different tissues.
Mean organ dose with the newborn phantom was decreased up to 83% compared to the routine protocol when using ultra-low-dose scanning settings. Similarly, for the 5-year phantom the greatest radiation dose reduction was 88%. The numerical simulations supported the findings with MOSFET measurements. The image quality remained adequate with Veo reconstruction, even at the lowest dose level.
Craniosynostosis CT with model-based iterative reconstruction could be performed with a 20-μSv effective dose, corresponding to the radiation exposure of plain skull radiography, without compromising required image quality.
KeywordsALARA Computed tomography optimization Craniosynostosis Iterative reconstruction Child Radiation protection
- 1.Brenner DJ, Hall EJ (2007) Computed tomography — an increasing source of radiation exposure. N Engl J Med 357:2277–2284Google Scholar
- 16.(2007) The 2007 recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann ICRP 37: 1–332Google Scholar
- 17.Drexler G, Panzer W, Petoussi N et al (1993) Effective dose — how effective for patients? Radiat Environ Biophys 32:209–219Google Scholar
- 18.Kaasalainen T, Palmu K, Lampinen A et al (2013) Effect of vertical positioning on organ dose, image noise and contrast in pediatric chest CT — phantom study. Pediatr Radiol 43:673–678Google Scholar
- 19.Likert R (1932) A technique for the measurement of attitudes. Arch Psychol 140:1–55Google Scholar