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PT  - JOURNAL ARTICLE
AU  - Tan, Zhengwu
AU  - Zhang, Lan
AU  - Sun, Xiaojie
AU  - Yang, Ming
AU  - Makamure, Joyman
AU  - Wu, Hongying
AU  - Wang, Jing
TI  - Dual-Layer Detector Head CT to Maintain Image Quality While Reducing the Radiation Dose in Pediatric Patients
AID  - 10.3174/ajnr.A7999
DP  - 2023 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1212--1218
VI  - 44
IP  - 10
4099  - http://www.ajnr.org/content/44/10/1212.short
4100  - http://www.ajnr.org/content/44/10/1212.full
SO  - Am. J. Neuroradiol.2023 Oct 01; 44
AB  - BACKGROUND AND PURPOSE: Radiation exposure in the CT diagnostic imaging process is a conspicuous concern in pediatric patients. This study aimed to evaluate whether 60-keV virtual monoenergetic images of the pediatric cranium in dual-layer CT can reduce the radiation dose while maintaining image quality compared with conventional images.MATERIALS AND METHODS: One hundred six unenhanced pediatric head scans acquired by dual-layer CT were retrospectively assessed. The patients were assigned to 2 groups of 53 and scanned with 250 and 180 mAs, respectively. Dose-length product values were retrieved, and noise, SNR, and contrast-to-noise ratio were calculated for each case. Two radiologists blinded to the reconstruction technique used evaluated image quality on a 5-point Likert scale. Statistical assessment was performed with ANOVA and the Wilcoxon test, adjusted for multiple comparisons.RESULTS: Mean dose-length product values were 717.47 (SD, 41.52) mGy×cm and 520.74 (SD, 42) mGy×cm for the 250- and 180-mAs groups, respectively. Irrespective of the radiation dose, noise was significantly lower, SNR and contrast-to-noise ratio were significantly higher, and subjective analysis revealed significant superiority of 60-keV virtual monoenergetic images compared with conventional images (all P &amp;lt; .001). SNR, contrast-to-noise ratio, and subjective evaluation in 60-keV virtual monoenergetic images were not significantly different between the 2 scan groups (P &amp;gt; .05). Radiation dose parameters were significantly lower in the 180-mAs group compared with the 250-mAs group (P &amp;lt; .001).CONCLUSIONS: Dual-layer CT 60-keV virtual monoenergetic images allowed a radiation dose reduction of 28% without image-quality loss in pediatric cranial CT.CNRcontrast-to-noise ratioCTDIvolvolume CT dose indexDECTdual-energy CTDLCTdual-layer CTDLPdose-length productGWMAassessment of GM-WM differentiationPFAAassessment of artifacts in posterior fossaSSAassessment of the subcalvarial spaceSAIsubcalvarial artifact indexVMIvirtual monoenergetic image