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Estimation of the minimum dose required to measure ventricular width in follow-up cranial computed tomography (CCT)
K Kirchhof1, W A Wohlgemuth, A Berlis
1Institut und Poliklinik für Radiologische Diagnostik, Universitätsklinikum Carl Gustav Carus, Dresden, Germany. Klaus.Kirchhof@uniklinikumdresden.de
Insights
Radiation dose for pediatric hydrocephalus imaging can be reduced significantly using cranial computed tomography (CCT) without compromising ventricular width measurements. Standard protocols with reduced tube current (100 kV) are generally safe.
Area of Science:
- Pediatric Radiology
- Medical Imaging Physics
Background:
- Hydrocephalus in children often requires serial cranial computed tomography (CCT) scans to monitor ventricular width.
- Optimizing radiation dose during CCT is crucial to minimize cumulative exposure in pediatric patients.
Purpose of the Study:
- To determine the minimum radiation dose for CCT that reliably measures ventricular width in pediatric hydrocephalus.
- To assess the impact of varying tube current and voltage on measurement accuracy.
Main Methods:
- A phantom simulating infant calvarium and lateral ventricles was scanned using two multi-slice CT scanners.
- Scans were performed with varied tube current (100-400 mA) and voltage (80-140 kV).
- Ventricular width was measured and compared to reference values obtained at higher doses.
Main Results:
- Significant radiation dose reduction (up to 85%) was achieved with both scanners without affecting measurement reliability.
- Specific combinations of tube voltage and current led to less reliable measurements despite higher doses.
Conclusions:
- No single dose or setting guarantees optimal reliability and minimal exposure for all scanners.
- Reducing tube current to 100 kV within standard protocols is a safe guideline for reliable ventricular width assessment.
Purpose:
To estimate the minimum dose needed at follow-up cranial computed tomography (CCT) to reliably determine ventricular width in children with hydrocephalus.
Materials And Methods:
For the study, a phantom was created using the calvarium of an infant which was filled with gelatin and the shaped inner cones of two carrots serving as lateral ventricles. The phantom was scanned ten times with two multi-slice CTs (LightSpeed Ultra, GE, and Somatom Sensation, Siemens), using a tube current of 400, 350, 300, 250, 200, 150, and 100 mA, and a tube voltage of 140, 120, 100, and 80 kV. The width of both lateral ventricles was measured at 4 sites. The values derived from scans performed at 380/400 mA and 140 kV (LightSpeed/Somatom) served as a reference. Measurements scored 1 point if they did not differ by more than 0.5 mm from the reference values.
Results:
The radiation dose can be reduced from 61.0 mGy to 9.2 mGy (15.1%) with LightSpeed and from 55.0 mGy to 8.0 mGy (14.6%) with Somatom without impairing the reliability of ventricular width measurements. However, in the case of both scanners, certain combinations of tube voltage and current yielded less reliable measurements although the dose was higher and the pixel noise was lower.
Conclusion:
There is no single cut-off dose or setting for tube voltage and current which guarantees reliable ventricular width measurements with the least radiation exposure for both scanners. As a guideline, it is safe to use the standard protocols with a reduced tube current of 100 kV.
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