Comparison of different phantom designs for CT scanner automatic tube current modulation system tests

Modern CT scanners modulate tube current during scans according to patient size, shape and attenuation. However, the ATCM (automatic tube current modulation) systems for different CT manufacturers work on different principles. Although the systems are used for the majority of patients and examinations, there is no standard phantom for routine quality control of CT scanner ATCM operation. The ideal phantom for testing these systems should be capable of evaluating how tube current and image quality as well as dose vary according to changes in patient size and shape. For this study, a conical phantom designed by ImPACT has been compared with two phantoms made from elliptical sections with varying dimensions. The concept of the designs is to reflect the ATCM performance for the varying shapes and dimensions along the length of the human body. The first phantom comprises five elliptical sections with a wide range of different dimensions and the second has three sections that are more similar in size. The phantoms have been used to test ATCM systems for Philips, Siemens, GE and Toshiba scanners. Although the results of the tube current modulation patterns were similar for all CT scanners, the abrupt changes in attenuation for the first sectional phantom provoked an abnormal ATCM response for the GE and Toshiba scanners. The second sectional phantom was developed from the results of the first, and was more effective for ATCM system testing and could be used for dose and image quality assessment in standard positions. However, the ImPACT conical phantom provided the best overall assessment of performance in terms of tube current modulations and noise pattern.