New Approaches to Reduce Radiation While Maintaining Image Quality in Multi-Detector-Computed Tomography

Abstract

This review discusses new technological approaches to reduce radiation dose while maintaining image quality in multi-detector-computed tomography (CT) for both adult and pediatric applications. First, the review focuses on the principles of automatic exposure control (AEC) systems for modulation of the tube current according to patient’s size; as well as special AEC adaptations for cardiac CT and organ-based tube current modulation. The selection of the tube potential (kV) is also discussed, with particular emphasis in a new technology which allows an automatic selection of the tube potential with a corresponding adjustment in the tube current, according to patient’s size and diagnostic task. The principles of iterative reconstruction, which is quickly becoming a standard feature in CT scanners, are also presented with particular emphasis on dose reduction and image quality. A full section is devoted to two latest state-of-the-art applications which can be used for radiation dose reduction: virtual non-contrast imaging with dual-energy CT and ultra-low dose CT with added spectral filtration. In the final section, innovations in CT hardware are presented ranging from the X-ray tube to CT detectors, which enable data acquisition at faster speeds and better efficiency to improve the balance between radiation dose and image quality.