Head CT dose reduction with organ-based tube current modulation

A helical head CT examination uses a pitch factor (PF) of <1.0, resulting in a part of the slice being directly irradiated twice. This raises the possibility of double irradiation, which may increase the amount of radiation to the lens. Organ-based tube current modulation (OBTCM) is an effective method for reducing lens exposure because it reduces the dose to the anterior aspect of the patient. However, it is challenging to visualize the complex dose distribution when factoring in double irradiation.

To visualize twice-irradiated areas in helical head CT in three dimensions and to clarify the exposure reduction effect of OBTCM.

A leuco crystal violet (LCV) dosimeter was placed into an empty polyethylene terephthalate bottle 16.5 cm in diameter. Helical scans were performed without and with OBTCM using the following parameters: tube voltage 120 kV, tube current 600 mA, pitch factor 0.637, rotation time 0.5 s, 80 (detector rows) × 0.5 mm (detector collimation), and ten scans. Exposed areas were visualized using an optical computed tomography (OCT) system designed by our group. The dose reduction rate of OBTCM was defined as the ratio of the average values of the histogram with the dose value on the x-axis and the frequency on the y-axis without and with OBTCM at 90° to the anterior midline.

The LCV dosimeter visualized the spiral-shaped twice-irradiated areas. Double irradiation resulted in a dose of 2.19/1.90 and 1.38/1.19 Gy (15.0% and 15.9% increase) without and with OBTCM, respectively. The dose reduction using OBTCM was 29.6% at 90° anterolateral.

The LCV dosimeter visualized the complex three-dimensional irradiated areas and enabled dose measurement in twice-irradiated areas. Increased exposure from double irradiation was attenuated by OBTCM.