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Tin filter compared to low kV protocols - optimizing sinonasal imaging in computed tomography.

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Optimized low-dose CT protocols for paranasal sinus imaging were identified. Protocols using 100 kV with spectral shaping or 70 kV offer the best balance of image quality and radiation dose for diagnosing sinusitis.

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Area of Science:

  • Radiology
  • Medical Imaging
  • Head and Neck Imaging

Background:

  • Paranasal sinus imaging is common in head and neck radiology for chronic inflammatory disease.
  • Computed tomography (CT) is the gold standard for these examinations.
  • Optimizing CT protocols is crucial for balancing image quality and radiation exposure.

Purpose of the Study:

  • To analyze different low-dose CT protocols for paranasal sinus imaging.
  • To evaluate image quality, radiation exposure, and subjective reader perception.
  • To establish an optimized scanning protocol for diagnosing sinusitis and preoperative planning.

Main Methods:

  • A phantom study using an Alderson phantom with 12 CT protocols (70-120 kV, 25-200 mAs, with/without tin filtration).
  • Iterative reconstruction was used for all datasets.
  • Objective evaluation (noise, contrast-to-noise ratio) and subjective evaluation by 62 experienced readers using a Likert scale.

Main Results:

  • Moderate agreement among readers for the 12 protocols.
  • 100 kV with spectral shaping and 50-100 mAs yielded the best results for diagnosing sinusitis (FOM 1st-2nd place).
  • For preoperative planning, 100 kV with spectral shaping and 100 mAs showed the best results (FOM 1st place).

Conclusions:

  • 100-kV protocols with spectral shaping or low kV (70 kV) protocols with low dose demonstrate the best figure of merit for sinonasal imaging.
  • Modern scanner technology should utilize spectral shaping or low kV protocols for sinusitis imaging.