title: Individually adapted examination protocols for reduction of radiation exposure for 16-MDCT chest examinations.
abstract: OBJECTIVE
  The purpose of our study was to develop a simple protocol for reduction of radiation exposure without loss of diagnostic information in chest 16-MDCT.
  
  
  METHODS
  Two hundred and four patients underwent MDCT of the thorax (Somatom Sensation 16, Siemens). Group 1 was scanned using a standard protocol with 100 mAs(effective) (mAs(eff)). Group 2 was scanned using a dose modulation template (CareDose). Group 3 was scanned with mAs(eff) = body weight (kg). Group 4 was scanned with a combination of weight-adapted mAs(eff) and dose modulation. All other parameters were kept constant. Signal-to-noise ratio was assessed as an objective measurement for image quality, and subjective image quality was rated by three experienced radiologists on a 4-point scale. Effective dose was calculated using dedicated software.
  
  
  RESULTS
  The mean noise measurement values were 8.31 H for the 100 mAs(eff) protocol for the regression between weight and signal-to-noise (p < 0.0001), 9.08 H for group 2 (p < 0.0001), 9.0 H for group 3 (p = 0.5051), and 9.98 H for group 4 (p = 0.0152). The median image quality was 1 (1 = highest quality) in all subgroups. The mean effective dose was 6.83 mSv, 5.92 mSv, 4.73 mSv, and 3.97 mSv, respectively. The least correlation between weight and image noise was achieved for the individually weight-adapted protocol and in the weight-adapted with CareDose combination.
  
  
  CONCLUSIONS
  By tube current time product adaptation (kg = mAs(eff)) combined with an online tube current modulation template, a well-balanced examination without significant loss of information was achieved for this specific scanner. Thus, individually adapted protocols for chest 16-MDCT can be recommended.
authors.affiliation: Department of Diagnostic Radiology, University Hospital, University of Technology (RWTH), Pauwelsstrasse 30, D-52074 Aachen, Germany. das@rad.rwth-aachen.de
authors.forename: Marco
authors.initials: M
authors.lastname: Das
authors.forename: Andreas Horst
authors.initials: AH
authors.lastname: Mahnken
authors.forename: Georg
authors.initials: G
authors.lastname: Mühlenbruch
authors.forename: Achim
authors.initials: A
authors.lastname: Stargardt
authors.forename: Claudia
authors.initials: C
authors.lastname: Weiss
authors.forename: Dirk-Alexander
authors.initials: DA
authors.lastname: Sennst
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Flohr
authors.forename: Rolf W
authors.initials: RW
authors.lastname: Günther
authors.forename: Joachim Ernst
authors.initials: JE
authors.lastname: Wildberger
mesh_terms: D000465:Algorithms; D000704:Analysis of Variance; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D013902:Radiography, Thoracic; D012044:Regression Analysis; D014057:Tomography, X-Ray Computed