Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 7/2014

01-07-2014 | Emergency Radiology

Topogram-based automated selection of the tube potential and current in thoraco-abdominal trauma CT – a comparison to fixed kV with mAs modulation alone

Authors: Claudia Frellesen, Wenzel Stock, J. Matthias Kerl, Thomas Lehnert, Julian L. Wichmann, Christoph Nau, Emanuel Geiger, Sebastian Wutzler, Martin Beeres, Boris Schulz, Boris Bodelle, Hanns Ackermann, Thomas J. Vogl, Ralf W. Bauer

Published in: European Radiology | Issue 7/2014

Login to get access

Abstract

Objective

To investigate the impact of automated attenuation-based tube potential selection on image quality and exposure parameters in polytrauma patients undergoing contrast-enhanced thoraco-abdominal CT.

Methods

One hundred patients were examined on a 16-slice device at 120 kV with 190 ref.mAs and automated mA modulation only. Another 100 patients underwent 128-slice CT with automated mA modulation and topogram-based automated tube potential selection (autokV) at 100, 120 or 140 kV. Volume CT dose index (CTDIvol), dose–length product (DLP), body diameters, noise, signal-to-noise ratio (SNR) and subjective image quality were compared.

Results

In the autokV group, 100 kV was automatically selected in 82 patients, 120 kV in 12 patients and 140 kV in 6 patients. Patient diameters increased with higher kV settings. The median CTDIvol (8.3 vs. 12.4 mGy; −33 %) and DLP (594 vs. 909 mGy cm; −35 %) in the entire autokV group were significantly lower than in the group with fixed 120 kV (p < 0.05 for both). Image quality remained at a constantly high level at any selected kV level.

Conclusion

Topogram-based automated selection of the tube potential allows for significant dose savings in thoraco-abdominal trauma CT while image quality remains at a constantly high level.

Key Points

• Automated kV selection in thoraco-abdominal trauma CT results in significant dose savings
• Most patients benefit from a 100-kV protocol with relevant DLP reduction
• Constantly good image quality is ensured
• Image quality benefits from higher kV when arms are positioned downward
Literature
1.
Boehm T, Alkadhi H, Schertler T et al (2004) Application of multislice spiral CT (MSCT) in multiple injured patients and its effect on diagnostic and therapeutic algorithms. Röfo 176(12):1734–1742PubMed
2.
Hessmann MH, Hofmann A, Kreitner KF, Lott C, Rommens PM (2006) The benefit of multislice CT in the emergency room management of polytraumatized patients. Acta Chir Belg 106(5):500–507PubMed
3.
Huber-Wagner S, Lefering R, Qvick LM et al (2009) Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study. Lancet 373(9673):1455–1461PubMedCrossRef
4.
Wurmb TE, Fruhwald P, Hopfner W et al (2009) Whole-body multislice computed tomography as the first line diagnostic tool in patients with multiple injuries: the focus on time. J Trauma 66(3):658–665PubMedCrossRef
5.
Wurmb TE, Quaisser C, Balling H et al (2011) Whole-body multislice computed tomography (MSCT) improves trauma care in patients requiring surgery after multiple trauma. Emerg Med J 28(4):300–304PubMedCrossRef
6.
Pfeifer R, Tarkin IS, Rocos B, Pape HC (2009) Patterns of mortality and causes of death in polytrauma patients-has anything changed? Injury 40(9):907–911PubMedCrossRef
7.
Wada D, Nakamori Y, Yamakawa K et al (2013) Impact on survival of whole-body computed tomography before emergency bleeding control in patients with severe blunt trauma. Crit Care 17(4):R178PubMedCrossRef
8.
Yeguiayan JM, Yap A, Freysz M et al (2012) Impact of whole-body computed tomography on mortality and surgical management of severe blunt trauma. Crit Care 16(3):R101PubMedCentralPubMedCrossRef
9.
Brenner DJ, Hall EJ (2007) Computed tomography-an increasing source of radiation exposure. N Engl J Med 357(22):2277–2284PubMedCrossRef
10.
11.
12.
Brenner D, Elliston C, Hall E, Berdon W (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol 176(2):289–296PubMedCrossRef
13.
Kepros JP, Opreanu RC, Samaraweera R et al (2013) Whole body imaging in the diagnosis of blunt trauma, ionizing radiation hazards and residual risk. Eur J Trauma Emerg Surg 39:15–24CrossRef
14.
Kalra MK, Maher MM, Toth TL et al (2004) Techniques and applications of automatic tube current modulation for CT. Radiology 233(3):649–657PubMedCrossRef
15.
McCollough CH, Bruesewitz MR, Kofler JM Jr (2006) CT dose reduction and dose management tools: overview of available options. Radiographics 26(2):503–512PubMedCrossRef
16.
Raman SP, Johnson PT, Deshmukh S, Mahesh M, Grant KL, Fishman EK (2013) CT dose reduction applications: available tools on the latest generation of CT scanners. J Am Coll Radiol 10(1):37–41PubMedCrossRef
17.
Soderberg M, Gunnarsson M (2010) The effect of different adaptation strengths on image quality and radiation dose using Siemens Care Dose 4D. Radiat Prot Dosim 139(1–3):173–179CrossRef
18.
Hough DM, Fletcher JG, Grant KL et al (2012) Lowering kilovoltage to reduce radiation dose in contrast-enhanced abdominal CT: initial assessment of a prototype automated kilovoltage selection tool. AJR Am J Roentgenol 199(5):1070–1077PubMedCrossRef
19.
Marin D, Nelson RC, Barnhart H et al (2010) Detection of pancreatic tumors, image quality, and radiation dose during the pancreatic parenchymal phase: effect of a low-tube-voltage, high-tube-current CT technique - preliminary results. Radiology 256(2):450–459PubMedCrossRef
20.
Hendee WR, O'Connor MK (2012) Radiation risks of medical imaging: separating fact from fantasy. Radiology 264(2):312–321PubMedCrossRef
21.
Bayer J, Pache G, Strohm PC et al (2011) Influence of arm positioning on radiation dose for whole body computed tomography in trauma patients. J Trauma 70(4):900–905PubMedCrossRef
22.
Brink M, de Lange F, Oostveen LJ et al (2008) Arm raising at exposure-controlled multidetector trauma CT of thoracoabdominal region: higher image quality, lower radiation dose. Radiology 249(2):661–670PubMedCrossRef
23.
Loewenhardt B, Buhl M, Gries A et al (2012) Radiation exposure in whole-body computed tomography of multiple trauma patients: bearing devices and patient positioning. Injury 43(1):67–72PubMedCrossRef
24.
Gnannt R, Winklehner A, Eberli D, Knuth A, Frauenfelder T, Alkadhi H (2012) Automated tube potential selection for standard chest and abdominal CT in follow-up patients with testicular cancer: comparison with fixed tube potential. Eur Radiol 22(9):1937–1945PubMedCrossRef
25.
Goetti R, Winklehner A, Gordic S et al (2012) Automated attenuation-based kilovoltage selection: preliminary observations in patients after endovascular aneurysm repair of the abdominal aorta. AJR Am J Roentgenol 199(3):W380–W385PubMedCrossRef
26.
Ghoshhajra BB, Engel LC, Karolyi M et al (2013) Cardiac computed tomography angiography with automatic tube potential selection: effects on radiation dose and image quality. J Thorac Imaging 28(1):40–48PubMedCrossRef
27.
Karlo C, Gnannt R, Frauenfelder T et al (2011) Whole-body CT in polytrauma patients: effect of arm positioning on thoracic and abdominal image quality. Emerg Radiol 18(4):285–293PubMedCrossRef
Metadata
Title
Topogram-based automated selection of the tube potential and current in thoraco-abdominal trauma CT – a comparison to fixed kV with mAs modulation alone
Authors
Claudia Frellesen
Wenzel Stock
J. Matthias Kerl
Thomas Lehnert
Julian L. Wichmann
Christoph Nau
Emanuel Geiger
Sebastian Wutzler
Martin Beeres
Boris Schulz
Boris Bodelle
Hanns Ackermann
Thomas J. Vogl
Ralf W. Bauer
Publication date
01-07-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3197-7

Other articles of this Issue 7/2014

European Radiology 7/2014 Go to the issue

Pediatric

Pixel-by-pixel analysis of DCE-MRI curve shape patterns in knees of active and inactive juvenile idiopathic arthritis patients

Urogenital

Perfusion and diffusion characteristics of cervical cancer based on intraxovel incoherent motion MR imaging-a pilot study

Obituary

Obituary for Prof. Roberto Passariello

Interventional

Chronic obstructive pulmonary disease (COPD) patients with osteoporotic vertebral compression fractures (OVCFs): improvement of pulmonary function after percutaneous vertebroplasty (VTP)

Interventional

Combined radiofrequency ablation and ethanol injection with a multipronged needle for the treatment of medium and large hepatocellular carcinoma

Breast

Stiffness of the surrounding tissue of breast lesions evaluated by ultrasound elastography