As low as diagnostically acceptable dose imaging in maxillofacial trauma: a reference quality approach

Area of Science:

• Medical Imaging
• Radiology
• Radiation Dose Management

Background:

• Current diagnostic reference levels for CT scans are often higher than As-low-as-diagnostically-acceptable (ALADA) doses.
• Improving dose management in CT imaging is crucial for patient safety.

Purpose of the Study:

• To test a reference quality approach for selecting potential ALADA dose protocols for various CT scanner models.
• To benchmark new ALADA protocols against established ones using phantom and cadaver studies.

Main Methods:

• Phantom studies evaluated spatial resolution, contrast resolution, CNR, noise, and sharpness for a reference ALADA protocol and various test protocols across different CT scanners and parameters.
• Test protocols were selected based on non-inferior quality metrics compared to the reference protocol.
• Selected low-dose protocols were verified in a cadaver study for diagnostic accuracy in detecting maxillofacial fractures and CNR of orbital structures.

Main Results:

• Phantom quality metrics identified potential ALADA dose protocols with doses as low as 1.73-1.92 mGy.
• Cadaver studies confirmed non-inferiority of selected low-dose protocols in detecting maxillofacial fractures and achieving adequate CNR for orbital soft tissues compared to reference images.

Conclusions:

• Reference quality metrics derived from clinical ALADA dose protocols are a viable method for selecting potential ALADA protocols.
• This approach can guide the development of lower-dose CT protocols across different scanner models while maintaining diagnostic image quality.