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Low-Dose CT of the Paranasal Sinuses: Minimizing X-Ray Exposure with Spectral Shaping

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Abstract

Objectives

Shaping the energy spectrum of the X-ray beam has been shown to be beneficial in low-dose CT. This study’s aim was to investigate dose and image quality of tin filtration at 100 kV for pre-operative planning in low-dose paranasal CT imaging in a large patient cohort.

Methods

In a prospective trial, 129 patients were included. 64 patients were randomly assigned to the study protocol (100 kV with additional tin filtration, 150mAs, 192x0.6-mm slice collimation) and 65 patients to the standard low-dose protocol (100 kV, 50mAs, 128 × 0.6-mm slice collimation). To assess the image quality, subjective parameters were evaluated using a five-point scale. This scale was applied on overall image quality and contour delineation of critical anatomical structures.

Results

All scans were of diagnostic image quality. Bony structures were of good diagnostic image quality in both groups, soft tissues were of sufficient diagnostic image quality in the study group because of a high level of noise. Radiation exposure was very low in both groups, but significantly lower in the study group (CTDIvol 1.2 mGy vs. 4.4 mGy, p < 0.001).

Conclusions

Spectral optimization (tin filtration at 100 kV) allows for visualization of the paranasal sinus with sufficient image quality at a very low radiation exposure.

Key Points

• Spectral optimization (tin filtration) is beneficial to low-dose parasinus CT

• Tin filtration at 100 kV yields sufficient image quality for pre-operative planning

• Diagnostic parasinus CT can be performed with an effective dose <0.05 mSv

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Acknowledgments

The scientific guarantor of this publication is Wolfgang Wuest. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, randomised controlled, performed at one institution.

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Authors and Affiliations

  1. Radiological Institute, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany

    Wolfgang Wuest, Matthias May, Marc Saake, Michael Brand, Michael Uder & Michael Lell

  2. Radiological Institute, Maximiliansplatz 1, 91054, Erlangen, Germany

    Wolfgang Wuest

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  1. Wolfgang Wuest
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  2. Matthias May
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  3. Marc Saake
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  4. Michael Brand
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  5. Michael Uder
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  6. Michael Lell
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Correspondence to Wolfgang Wuest.

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Wuest, W., May, M., Saake, M. et al. Low-Dose CT of the Paranasal Sinuses: Minimizing X-Ray Exposure with Spectral Shaping. Eur Radiol 26, 4155–4161 (2016). https://doi.org/10.1007/s00330-016-4263-0

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  • DOI: https://doi.org/10.1007/s00330-016-4263-0

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