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Related Experiment Video

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Ultra-low dose CT for suspected physical abuse.

Ahmed Mohammed1, Eimear Mahon2, Niamh Moore2

  • 1Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Cork, Ireland; Radiological Sciences Department, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia.

Journal of Medical Imaging and Radiation Sciences
|November 22, 2025
PubMed
Summary

Ultra-low dose CT (ULDCT) significantly reduces radiation exposure for suspected physical abuse (SPA) diagnosis compared to standard dose CT. While image quality was lower with ULDCT, it shows promise as a replacement for radiography in SPA imaging.

Keywords:
Non-accidental injuryPaediatricSkeletal surveyVisual grading analysisWhole-body CT

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Area of Science:

  • Medical Imaging
  • Radiology
  • Pediatric Imaging

Background:

  • Ultra-low dose CT (ULDCT) is a potential alternative to radiography for diagnosing suspected physical abuse (SPA).
  • This study compares the image quality and radiation dose of ULDCT versus standard dose CT (STDCT) in SPA cases using a phantom model.

Purpose of the Study:

  • To compare image quality and radiation dose between ULDCT and STDCT for suspected physical abuse (SPA) diagnosis.
  • To evaluate observer confidence and diagnostic accuracy using both CT protocols.

Main Methods:

  • Acquisition of whole-body phantom images using STDCT and ULDCT protocols with Deep Learning Iterative Reconstruction (DLIR).
  • Calculation of effective dose (ED) via Monte Carlo simulation.
  • Observer assessment of image quality (IQ) and diagnostic confidence using Visual Grading Analysis (VGA).

Main Results:

  • ULDCT achieved a 93.5% reduction in effective dose compared to STDCT (0.04mSv vs 0.56mSv).
  • STDCT demonstrated significantly higher image quality than ULDCT (AUCVGA=0.75).
  • Only 41% of observers were confident using ULDCT for SPA diagnosis, despite its substantial dose reduction.

Conclusions:

  • ULDCT offers a substantial radiation dose reduction with acceptable image quality in a phantom setting for SPA.
  • ULDCT shows potential as a complementary tool for SPA imaging, possibly replacing radiography.
  • Further optimization of ULDCT protocols is necessary to improve image quality and observer confidence for clinical use.