Contrast Administration in CT: A Patient-Centric Approach.

Patient-centric care has garnered the attention of the radiology community. The authors describe a patient-centric approach to iodinated contrast administration designed to optimize the diagnostic yield of contrast-enhanced CT while minimizing patient iodine load and exposure to ionizing radiation, thereby enhancing patient safety while providing reasonable diagnostic efficacy. Patient-centric CT hardware settings and contrast media administration are important considerations for clinical CT quality and safety.

Pediatric cardiac-gated CT angiography: assessment of radiation dose.

OBJECTIVE: The purpose of our study was to determine a dose range for cardiac-gated CT angiography (CTA) in children. MATERIALS AND METHODS: ECG-gated cardiac CTA simulating scanning of the heart was performed on an anthropomorphic phantom of a 5-year-old child on a 16-MDCT scanner using variable parameters (small field of view; 16 x 0.625 mm configuration; 0.5-second gantry cycle time; 0.275 pitch; 120 kVp at 110, 220, and 330 mA; and 80 kVp at 385 mA). Metal oxide semiconductor field effect transistor (MOSFET) technology measured 20 organ doses. Effective dose calculated using the dose-length product (DLP) was compared with effective dose determined from measured absorbed organ doses. RESULTS: Highest organ doses included breast (3.5-12.6 cGy), lung (3.3-12.1 cGy), and bone marrow (1.7-7.6 cGy). The 80 kVp/385 mA examination produced lower radiation doses to all organs than the 120 kVp/220 mA examination. MOSFET effective doses (+/- SD) were as follows: 110 mA: 7.4 mSv (+/- 0.6 mSv), 220 mA: 17.2 mSv (+/- 0.3 mSv), 330 mA: 25.7 mSv (+/- 0.3 mSv), 80 kVp/385 mA: 10.6 mSv (+/- 0.2 mSv). DLP effective doses for diagnostic runs were as follows: 110 mA: 8.7 mSv, 220 mA: 19 mSv, 330 mA: 28 mSv, 80 kVp/385 mA: 12 mSv. DLP effective doses exceeded MOSFET effective doses by 9.7-17.2%. CONCLUSION: Radiation doses for a 5-year-old during cardiac-gated CTA vary greatly depending on parameters. Organ doses can be high; the effective dose may reach 28.4 mSv. Further work, including determination of size-appropriate mA and image quality, is important before routine use of this technique in children.

Optimization of multiplanar reformations from isotropic data sets acquired with 16-detector row helical CT scanner.

Institutional review board approval and waiver of consent were obtained for the patient component of this retrospective HIPAA-compliant study. By using an anthropomorphic phantom and metal oxide semiconductor field effect transistor detectors, radiation dose was determined for one eight-detector row and two 16-detector row computed tomographic (CT) protocols. A custom phantom was scanned by using the three protocols to identify isotropy. Contrast-to-noise ratios (CNRs) were determined for the same protocols by using a third phantom. Seven patients had undergone isotropic 16-detector row CT of the abdomen and pelvis. Anonymized coronal reformations at various thicknesses were ranked qualitatively by three radiologists. Effective dose equivalents were similar for the eight- and 16-detector row protocols. When transverse and coronal reformations of data acquired in the custom phantom were compared, coronal reformations obtained with the 16-detector row and 0.625-mm section thickness protocol were found to be nearly identical to the transverse image for all sets of line pairs. CNRs were consistently highest on 5-mm-thick coronal reformations (CNR range, 1.2-3.3). For qualitative assessment, 2- and 3-mm-thick coronal reformations were consistently preferred.

Liver: single breath-hold dynamic subtraction CT with multi-detector row helical technology feasibility study.

Fifty-two patients with known or suspected hypervascular malignancy were examined to determine the technical feasibility of performing single-breath-hold dynamic subtraction computed tomography (CT) of the liver with multi-detector row helical CT. The precontrast and hepatic arterial CT scans, which were acquired during the same breath hold, were subtracted. The mean liver-to-muscle contrast ratio on the precontrast, hepatic arterial, and subtracted images was 1.3, 1.4, and 2.3, respectively. In 13 patients with lesions, the subtracted images showed a 2.5-fold increase in mean lesion contrast compared with the hepatic arterial CT scans.