DOI QR코드

DOI QR Code

Is Weight-Based Adjustment of Automatic Exposure Control Necessary for the Reduction of Chest CT Radiation Dose?

  • Prakash, Priyanka (Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School) ;
  • Kalra, Mannudeep K. (Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School) ;
  • Gilman, Matthew D. (Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School) ;
  • Shepard, Jo-Anne O. (Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School) ;
  • Digumarthy, Subba R. (Division of Thoracic Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School)
  • Received : 2009.07.10
  • Accepted : 2009.09.24
  • Published : 2010.02.01

Abstract

Objective: To assess the effects of radiation dose reduction in the chest CT using a weight-based adjustment of the automatic exposure control (AEC) technique. Materials and Methods: With Institutional Review Board Approval, 60 patients (mean age, 59.1 years; M:F = 35:25) and 57 weight-matched patients (mean age, 52.3 years, M:F = 25:32) were scanned using a weight-adjusted AEC and nonweight- adjusted AEC, respectively on a 64-slice multidetector CT with a 0.984:1 pitch, 0.5 second rotation time, 40 mm table feed/rotation, and 2.5 mm section thickness. Patients were categorized into 3 weight categories; < 60 kg (n = 17), 60-90 kg (n = 52), and > 90 kg (n = 48). Patient weights, scanning parameters, CT dose index volumes (CTDIvol) and dose length product (DLP) were recorded, while effective dose (ED) was estimated. Image noise was measured in the descending thoracic aorta. Data were analyzed using a standard statistical package (SAS/STAT) (Version 9.1, SAS institute Inc, Cary, NC). Results: Compared to the non-weight-adjusted AEC, the weight-adjusted AEC technique resulted in an average decrease of 29% in CTDIvol and a 27% effective dose reduction (p < 0.0001). With weight-adjusted AEC, the CTDIvol decreased to 15.8, 15.9, and 27.3 mGy for the < 60, 60-90 and > 91 kg weight groups, respectively, compared to 20.3, 27.9 and 32.8 mGy, with non-weightadjusted AEC. No significant difference was observed for objective image noise between the chest CT acquired with the non-weight-adjusted ($15.0{\pm}3.1$) and weight-adjusted ($16.1{\pm}5.6$) AEC techniques (p > 0.05). Conclusion: The results of this study suggest that AEC should be tailored according to patient weight. Without weight-based adjustment of AEC, patients are exposed to a 17 - 43% higher radiation-dose from a chest CT.

Keywords

References

  1. Mayo JR, Aldrich J, Muller NL; Fleischner Society. Radiation exposure at chest CT: a statement of the Fleischner Society. Radiology 2003;228:15-21 https://doi.org/10.1148/radiol.2281020874
  2. Mettler FA Jr, Wiest PW, Locken JA, Kelsey CA. CT scanning: patterns of use and dose. J Radiol Prot 2000;20:353-359 https://doi.org/10.1088/0952-4746/20/4/301
  3. McCollough CH, Bruesewitz MR, Kofler JM Jr. CT dose reduction and dose management tools: overview of available options. Radiographics 2006;26:503-512 https://doi.org/10.1148/rg.262055138
  4. Kalra MK, Maher MM, Toth TL, Hamberg LM, Blake MA, Shepard JA, et al. Strategies for CT radiation dose optimization. Radiology 2004;230:619-628 https://doi.org/10.1148/radiol.2303021726
  5. Kalra MK, Maher MM, Kamath RS, Horiuchi T, Toth TL, Halpern EF, et al. Sixteen-detector row CT of abdomen and pelvis: study for optimization of Z-axis modulation technique performed in 153 patients. Radiology 2004;233:241-249 https://doi.org/10.1148/radiol.2331031505
  6. EUR 16262. European guidelines on quality criteria for computed tomography. Available at: www.drs.dk/guidelines/ct/quality/download/eur16262.w51. (Accessed on January 13, 2009)
  7. Kalra MK, Rizzo S, Maher MM, Halpern EF, Toth TL, Shepard JA, et al. Chest CT performed with z-axis modulation: scanning protocol and radiation dose. Radiology 2005;237:303-308 https://doi.org/10.1148/radiol.2371041227
  8. Kubo T, Lin PJ, Stiller W, Takahashi M, Kauczor HU, Ohno Y, et al. Radiation dose reduction in chest CT: a review. AJR Am J Roentgenol 2008;190:335-343 https://doi.org/10.2214/AJR.07.2556
  9. Prasad SR, Wittram C, Shepard JA, McLoud T, Rhea J. Standard-dose and 50%-reduced-dose chest CT: comparing the effect on image quality. AJR Am J Roentgenol 2002;179:461-465 https://doi.org/10.2214/ajr.179.2.1790461
  10. Karabulut N, Ariyurek M. Low dose CT: practices and strategies of radiologists in university hospitals. Diagn Interv Radiol 2006;12:3-8
  11. Mulkens TH, Bellinck P, Baeyaert M, Ghysen D, Van Dijck X, Mussen E, et al. Use of an automatic exposure control mechanism for dose optimization in multi-detector row CT examinations: clinical evaluation. Radiology 2005;237:213-223 https://doi.org/10.1148/radiol.2363041220
  12. Zhu X, Yu J, Huang Z. Low-dose chest CT: optimizing radiation protection for patients. AJR Am J Roentgenol 2004;183:809-816 https://doi.org/10.2214/ajr.183.3.1830809
  13. Mayo JR, Kim KI, MacDonald SL, Johkoh T, Kavanagh P, Coxson HO, et al. Reduced radiation dose helical chest CT: effect on reader evaluation of structures and lung findings. Radiology 2004;232:749-756 https://doi.org/10.1148/radiol.2323030899

Cited by

  1. Diffuse lung disease: CT of the chest with adaptive statistical iterative reconstruction technique. vol.256, pp.1, 2010, https://doi.org/10.1148/radiol.10091487
  2. Estimation of Radiation Exposure of 128-Slice 4D-Perfusion CT for the Assessment of Tumor Vascularity vol.11, pp.5, 2010, https://doi.org/10.3348/kjr.2010.11.5.547
  3. Individualized volume CT dose index determined by cross-sectional area and mean density of the body to achieve uniform image noise of contrast-enhanced pediatric chest CT obtained at variable kV level vol.41, pp.7, 2010, https://doi.org/10.1007/s00247-011-2121-4
  4. CT Radiation Dose Optimization and Estimation: an Update for Radiologists vol.13, pp.1, 2010, https://doi.org/10.3348/kjr.2012.13.1.1
  5. 80-kVp CT Using Iterative Reconstruction in Image Space Algorithm for the Detection of Hypervascular Hepatocellular Carcinoma: Phantom and Initial Clinical Experience vol.13, pp.2, 2010, https://doi.org/10.3348/kjr.2012.13.2.152
  6. 흉부 CT촬영에서 저선량 프로토콜의 선량과 화질: 표준선량 프로토콜과 비교 vol.37, pp.2, 2010, https://doi.org/10.14407/jrp.2012.37.2.084
  7. Combining Automatic Tube Current Modulation with Adaptive Statistical Iterative Reconstruction for Low-Dose Chest CT Screening vol.9, pp.4, 2010, https://doi.org/10.1371/journal.pone.0092414
  8. Performance Evaluation of CT Automatic Exposure Control on Fast Dual Spiral Scan vol.70, pp.11, 2010, https://doi.org/10.6009/jjrt.2014_jsrt_70.11.1273
  9. Dose reduction in chest CT examination vol.165, pp.1, 2015, https://doi.org/10.1093/rpd/ncv123