The Taguchi-based optimization of head and neck CT angiography (CTA) using in-vivo enhanced triggered timing for 600 patients was accomplished in this study. A total of 600 patients were categorized into three (test, verification, and implementation groups with 360, 120, and 120 patients, respectively). The patients in the test group were randomly assigned into 18 sub-groups according to Taguchi L[Formula: see text](2[Formula: see text]) orthogonal array for optimizing factor combinations of head and neck CTA. The signal-to-noise ratio was defined as a high LRA/US ratio (both left and right arterial pressure divided by upper sinuses’ one) and low stdev. The seven factors of CTA were: (A) left- or right-hand injection; (B) tube current, mA; (C) kilovoltage peak, kVp; (D) contrast media concentration; (E) FOV; (F) flow rate of contrast media; and (G) rotation time for one CTA loop. With the Taguchi unique organization, 18 sub-groups (each containing 20 patients’ real LRA/US ratios) could cover 1458 cases and provide the appropriate reliability. The optimal factor combination was identified as follows: (A) left-hand injection, (B) tube current of 280[Formula: see text]mA, (C) 100[Formula: see text]kVp, (D) contrast media concentration of 60%, (E) FOV of 250[Formula: see text]mm, (F) contrast media flow rate of 4.0[Formula: see text]ml/s, and (G) rotation time for one CTA loop of 0.9[Formula: see text]s. The optimal suggestion was validated in the verification group with 120 patients and applied to the implementation group with 120 patients. The successful factor combination is instrumental in defining a standard protocol for medical staff in deriving the maximal LRA/US value ([Formula: see text]) of head and neck CTA.
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