Image quality and radiation doses in abdominal CT: A multicenter study

To benchmark image quality and corresponding radiation doses for acute abdominal CT examination across different laboratories and CT manufacturers.

An anthropomorphic phantom was scanned once with local abdominal CT protocols at 40 CT scanners, from four vendors, in thirty-three sites. Quantitative image quality was evaluated by CNR and SNR in the liver and kidney parenchyma. Qualitative image quality was assessed by visual grading analysis performed by three experienced radiologists using a five-point Likert scale to score thirteen image quality criteria. The CTDI_vol was recorded for each scan. Pearson's correlation coefficient was calculated for the continuous variables, and the intraclass correlation coefficient was used to investigate interrater reliability between the radiologists.

CTDI_vol ranged from 3.5 to 12 mGy (median 5.3 mGy, third quartile 6.7 mGy). SNR in liver parenchyma ranged from 4.4 to 14.4 (median 8.5), and CNR ranged from 2.7 to 11.2 (median 6.1). A weak correlation was found between CTDI_vol and CNR (r = 0.270, p = 0.092). Variations in CNR across scanners at the same dose level CTDI_vol were observed. No significant difference in CTDI_vol or CNR was found based on scanner installation year. The oldest scanners had a 15 % higher median CTDI_vol and a 12 % lower median CNR. The ICC showed acceptable agreement for all dose groups: low (ICC=0.889), medium (ICC=0.767), high (ICC=0.847), and in low (ICC=0.803) and medium (ICC=0.811) CNR groups.

There was large variation in radiation dose and image quality across the different CT scanners. Interestingly, the weak correlation between CTDI_vol and CNR indicates that higher doses do not consistently improve CNR, indicating a need for systematic assessment and optimization of image quality and radiation doses for the abdominal CT examination.