Z-axis Automatic Tube Current Modulation Research Articles

Automatic tube current modulation for volume scan in a 320-detector row CT scanner

The x-y plane combined with z-axis automatic tube current modulation (ATCM) technique is one of the most comprehensive approaches to CT dose reduction because the radiation dose is adjusted according to patient attenuation in three dimensions. The 320-detector row CT scanner has the widest scan range (16 cm) within one axial rotation and equips with volume scan ATCM (VS-ATCM) mode. Special attention is needed while utilizing VS-ATCM mode in CT acquisitions especially scanning different anatomical regions, such as neck and shoulder in a single volume. However, the mechanism of VS-ATCM of the 320-detector row CT scanner remains unclear. This study aims to evaluate the performance of VS-ATCM mode in a 320-detector row CT scanner. A phantom set consists of three simple-shaped phantoms was scanned with the VS-ATCM mode. A solid-state detector was inserted into the central position of the phantom set to measure the real-time dose profiles at seven positions within five scan volumes. The effective tube-current time product of each slice was recorded. The standard deviation of the CT numbers measured at each image slice was used as a noise measurement. The performance of helical scan ATCM (HS-ATCM) mode was in comparison of VS-ATCM mode. The results indicated that VS-ATCM mode can provide a less dose CT scanning to a patient but resulted in a higher image noise in comparison with those of HS-ATCM mode. In clinical practice, radiologists or radiological technologists should pay more attention on the volume position when using VS-ATCM mode for patient imaging. Our experience can be a reference to others for implementation of clinical practices.

Low-dose Unenhanced CT for IV Contrast Bolus Timing:: Is It Reliable to Assess Hepatic Steatosis?

To determine whether an unenhanced low-dose image acquired during automated contrast bolus timing can be used to assess hepatic steatosis. Fifty subjects (29 male, 21 female; 26-92 years; mean body mass index (BMI; 26.9) with abdominal multiphasic computed tomography were included. Abdominal diameters and circumferences were derived from anteroposterior and lateral scout radiographs. Hepatic attenuation (HA) was measured on unenhanced low-dose images (120 kV; 40 mA; 0.5 seconds' rotation time) and corresponding unenhanced standard-dose images (120 kV, z-axis automatic tube current modulation, noise index 11.5). Noise estimates were measured in surrounding air. Pearson correlation was calculated between abdominal circumference and BMI. Mean HA assessed on low-dose images and standard-dose images was compared using a paired Student's t-test and Bland Altman plots. Abdominal circumference (mean, 142.8cm) correlated well with BMI (r = 0.83). No significant difference was found for HA on low-dose images (mean +57.7 HU) compared to HA on standard-dose images (+56.0 HU) (P = .077). Image noise (+11.5 HU) was significantly higher on low-dose images compared to image noise (+8.1 HU) on standard-dose images (P < .05). For HA mean difference comparing low- and standard-dose images was -1.7 HU (limits of agreement: -14.6, 11.2). In all subjects, hepatic attenuation can be correctly assessed on unenhanced low-dose images.

CT Dose Index and Patient Dose: They AreNotthe Same Thing

Estimates of individual patient risk, and epidemiologic studies assessing potential late effects, must use patient size–specific dose estimates—they cannot use only scanner output (volume CT dose index or dose-length product).

Use of automatic tube current modulation with a standardized noise index in young children undergoing chest computed tomography scans with 64-slice multidetector computed tomography

The automatic tube current modulation (ATCM) technique is available on multidetector computed tomography (MDCT) scanners, and its dose reduction benefits in clinical applications have been documented primarily in adult patients. To evaluate the use of ATCM to reduce radiation dose while maintaining consistent image quality for young children undergoing 64-slice MDCT chest scans. Chest scans (120 kV, small-scan field of view, 5-mm image slice thickness) were performed for 50 consecutive young children (0.2-3 years) using 64-slice volume computed tomography (VCT) with ATCM method and a noise index (NI) of either 8 or 9, depending on the patient's age. The scanner automatically selected the actual tube current based on NI values and patient attenuation as determined by scout scans for the study group. Image quality and volume-weighted CT dose index (CTDI(vol)) values (measured with small-scan field of view and 16-cm diameter CTDI phantom) were compared with images from a control group of 50 children acquired earlier using a standard protocol with fixed tube current. Two experienced pediatric radiologists assessed image quality, including resolution, noise, and artifacts, on a five-point scale. Scores greater than or equal to 3 were considered to be clinically acceptable. The mean image quality score and CTDI(vol) for the study and control groups were 3.46 and 2.34+/-0.71 mGy, and 4.65 and 6.68+/-0.62 mGy, respectively. While there was a statistically significant decrease in image quality in the study group, all studies had acceptable image quality, and CTDI(vol) with ATCM was about 65% lower than that with fixed tube current. The average image noise for the control group was 4.78+/-0.58, versus 7.53+/-0.42 and 8.28+/-0.40 for children under and above 1 year of age, respectively, in the study group. Despite a higher average noise level, the study group with ATCM demonstrated a lower standard deviation of image noise. The z-axis ATCM method produces consistent image quality for young children undergoing 64-slice MDCT chest scans. With noise levels of NI=8 and 9 at 5-mm image slice thickness, one may obtain clinically acceptable images with significantly reduced radiation dose.

Quantitative assessment of image noise and streak artifact on CT image: Comparison of z-axis automatic tube current modulation technique with fixed tube current technique

The purpose of our study is to quantitatively assess the effects of z-axis automatic tube current modulation technique on image noise and streak artifact, by comparing with fixed tube current technique. Standard deviation of CT-values was employed as a physical index for evaluating image noise, and streak artifact was quantitatively evaluated using our devised Gumbel evaluation method. z-Axis automatic tube current modulation technique will improve image noise and streak artifact, compared with fixed tube current technique, and will make it possible to significantly reduce radiation doses at lung levels while maintaining the same image quality as fixed tube current technique.

Chest CT Performed with 3D and z-Axis Automatic Tube Current Modulation Technique : Breast and Effective Doses

Chest computed tomographic (CT) scans are the most effective examinations for detecting lung cancer at an early stage. In chest CT examinations, it is important to consider the reduction of radiation dose, particularly to the mammary gland. The objective of this study was to assess breast doses and effective doses on chest CT examinations between three-dimensional and z-axis automatic tube current modulation (ATCM) techniques. Absorbed dose to the breast, lung, mediastinum, and skin was evaluated with an anthropomorphic phantom and radiophotoluminescence glass dosimeters using two different CT scanners. The dosimeters were placed inside and outside the phantom. The phantom was scanned using three-dimensional and z-axis ATCM techniques after scanning localizer radiographs from the horizontal and vertical directions. After scanning, each organ dose was calculated. Moreover, the dose-length product recorded in the dose reports was examined, and each effective dose was calculated. Compared with z-axis ATCM, three-dimensional ATCM reduced breast dose by 0.7% to 18.6% and effective dose by 4.9% to 10.2%. In particular, three-dimensional ATCM reduced frontal breast dose. For other organs, three-dimensional ATCM reduced absorbed doses by 3.4% to 13.6% compared to z-axis ATCM. Three-dimensional ATCM can reduce absorbed doses to the breast and other organs, in addition to reducing effective dose, compared to z-axis ATCM.

Thyroid Shields versus z-Axis Automatic Tube Current Modulation for Dose Reduction at Neck CT

To assess the effectiveness of in-plane bismuth thyroid shields and a z-axis automatic tube current modulation (ATCM) technique with respect to dose reduction and image noise in the thyroid and other regional tissues during neck computed tomography (CT). Because this was a phantom study, neither institutional review board approval nor HIPAA compliance was required. A female phantom, thyroid shields, and an eight-section CT scanner were used. Radiation dose was measured by using thermoluminescent dosimetry (TLD) chips placed in the phantom's thyroid, cervical bone marrow, and soft tissues. Scans were performed by using fixed tube current and a z-axis ATCM technique with and without shields. Image noise was quantified as the standard deviation of the attenuation value (in Hounsfield units) on CT images. Thyroid dose was 76.9 mGy with an unshielded fixed tube current technique. Use of shields and ATCM reduced this dose to 44.7 mGy (42% reduction, P < .001) and 17.0 mGy (78% reduction, P < .001), respectively. The combination of shields and ATCM further reduced this dose to between 11.9 and 12.9 mGy (83%-85% reduction, P < .001), depending on the shield's presence in the scout scan. ATCM resulted in minimized tube current throughout the neck, which reduced dose-length product across the entire scan volume by 60% (926 vs 368 mGy . cm). Thyroid bed noise was lowest (3.9 HU) during the fixed tube current technique without shields, with noise slightly higher (6.9 HU) with the unshielded ATCM technique (P < .001). Thyroid image noise was markedly higher when using shields (P < .001), with noise measuring between 74 and 113 HU for fixed tube current and ATCM scans. z-Axis ATCM is more effective than shields at reducing thyroid radiation dose during neck CT. Shields combined with ATCM slightly further reduces dose; however, this is associated with higher image noise.

Comparison between 3-D and z-axis automatic tube current modulation technique in multidetector-row CT

In this study, the 3-D automatic tube current modulation (3-D ATCM) technique was compared with the z-axis ATCM technique on multidetector-row CT. Absorbed dose measurements were performed by inserting an ion chamber into the phantoms, and objective image noise shown as the standard deviation of CT value in Hounsfield units was measured on the obtained images. The ratio of absorbed doses with 3-D ATCM technique to z-axis ATCM technique was 94.7% using an elliptical cylinder phantom with an inner cylinder phantom and 96.3% using an elliptical cylinder phantom without an inner cylinder phantom. Differences in objective noise between the 3-D ATCM technique and z-axis ATCM technique were within a tolerable range compared with the setting noise index. Therefore, the 3-D ATCM technique effectively optimises the radiation dose, while maintaining an appropriate image quality compared with z-axis ATCM technique.

Chest CT Performed with Z-Axis Modulation: Scanning Protocol and Radiation Dose

Institutional review board approval of the study protocol and waiver of informed consent were obtained. This study was compliant with the Health Insurance Portability and Accountability Act. The purpose of this study was to retrospectively assess the scanning protocol and radiation dose associated with z-axis automatic tube current modulation in multi-detector row CT scanning of the chest. Fifty-three patients (mean age, 54 years; age range, 26-77 years; 25 men, 28 women) underwent 16-detector row chest CT with z-axis modulation and noise indexes of 10.0, 12.5, and 15.0 HU. Two radiologists independently compared images acquired with z-axis modulation and fixed tube current (180-300 mA) techniques for image noise, diagnostic acceptability, and depiction of peripheral bronchovascular markings. Tube current-time product was calculated for each study. There was good interobserver agreement between the two readers (kappa = 0.72). Compared with the fixed tube current technique, z-axis modulation provides acceptable image noise for chest CT, with an 18% and 26% reduction in tube current-time product at 10.0- and 12.5-HU noise indexes, respectively.

16-MDCT of the Posttraumatic Pediatric Elbow: Optimum Parameters and Associated Radiation Dose

Our objective was to investigate a low-radiation-dose protocol for 16-MDCT of the posttraumatic pediatric elbow using z-axis automatic tube-current modulation, based on optimum scanning parameters determined in a porcine fracture model, and to report the radiation dose from this technique in nine children with acute elbow trauma. For the posttraumatic pediatric elbow, 16-MDCT using z-axis automatic tube-current modulation was optimal at 100 kVp with a noise index of 20 and a minimum amperage of 25 mA.

Detection of Urinary Tract Stones at Low-Radiation-Dose CT with Z-Axis Automatic Tube Current Modulation: Phantom and Clinical Studies

To evaluate depiction of urinary tract calculi at computed tomography (CT) with a z-axis modulation technique at various noise indexes to reduce radiation dose and preserve image quality. Sixteen radiopaque kidney stones (2.5-19.2 mm in diameter) were embedded in the collecting systems of two bovine kidneys immersed in a water bath. A kidney phantom was made by placing the kidneys in an elliptical Plexiglas phantom (32 x 20 x 20 cm) filled with physiologic saline. The phantom was scanned at 16-detector row CT with a fixed tube current (300 mA) and z-axis modulation at noise indexes of 14, 20, 25, 35, and 50; remaining imaging parameters were held constant. Two abdominal radiologists reviewed images from most to least noisy. Images were evaluated for presence of stones and size, site, and attenuation value of each stone. Readers also graded conspicuity and margins of each stone on a five-point scale. In addition, follow-up studies of 22 patients (mean age, 46 years; range, 26-57 years; male-female ratio, 14:8) with kidney and ureteral stones who underwent CT with z-axis modulation (noise index, 14 and 20) were evaluated in the same manner. Statistical analysis was performed with the Student t test, Wilcoxon signed rank test, and kappa test of interobserver agreement. Institutional review board approval was obtained, and informed consent was not needed. In the phantom study, all 16 stones were identified on images obtained with a fixed tube current and z-axis modulation at noise indexes of 14, 20, and 25 (with a reduction in radiation dose of up to 77% compared with that of fixed tube current scanning). Three stones (<5 mm) were not visualized with z-axis modulation at noise indexes of 35 and 50. No significant difference was shown for conspicuity of kidney stones in 22 patients who underwent CT with z-axis modulation (with a 43%-66% reduction in radiation dose) when compared with results of previous fixed tube current studies (P > .05). Kidney stones (< or =2.5 mm) can be adequately depicted with the z-axis modulation technique, with a 56%-77% reduction in radiation dose. In patients with urinary tract stones, the technique results in a 43%-66% reduction in radiation dose at noise indexes of 14 and 20 without compromising stone depiction.