Program Information
Optimizing Dose Reduction in Pediatric Head CT Protocols While Maintaining Image Quality in Postmortem Head Scans
I Lipnharski*, N Quails , C Carranza , N Correa , D Rajderkar , L Rill , M Arreola , University of Florida, Gainesville, FL
Presentations
SA-B-BRA|B-2 (Saturday, March 18, 2017) 10:30 AM - 12:30 PM Room: Ballroom A|B
Purpose: Efforts to optimize scan protocol should consider both dose and clinical image quality. This is made possible with postmortem subjects, whose brains are similar to patients, allowing for an investigation of ideal scan parameters. The purpose of this work is to reduce dose for head CT protocols for 3 indications commonly examined in children.
Methods: One small cadaver, estimated to be the size of a 10 year old, was scanned using a routine head CT protocol used for children older than 8 years old (120 kVp, 270 mA, 0.75 s, 70.8 mGy CTDIvol) followed by 10 reduced-dose protocols with varying combinations of reduced tube current using fixed, modulating (TCM), and iterative methods (AIDR-3D). Two neuro-radiologists assessed 17 image quality features for diagnosing hydrocephalus, trauma follow-up, and craniosynostosis on a three-point scale.
Results: Scan protocols that produced image quality features with an image quality score of 2 or 1 were considered unacceptable for clinical use. Each indication required a different level of dose to produce acceptable image quality. Tube current modulation was useful for producing acceptable image quality with CTDIvol values of 44 mGy, 32.3 mGy, and 11.8 mGy for trauma follow-up, hydrocephalus, and craniosynostosis exams, respectively.
Conclusion: When the clinical indication for the exam does not require detailed image quality, it is possible to reduce dose to minimize radiation risks to a sensitive population. Radiologists at our institution accepted scan protocols acquired with lower scan parameters, with CTDIvol values decreasing up to 83%. These low-dose protocols are useful for children examined for hydrocephalus, trauma follow-up, and craniosynostosis, especially considering they will likely receive repeat head CT exams in the future.
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