title: Dose reduction and image quality in MDCT colonography using tube current modulation.
abstract: OBJECTIVE
  The purpose of our study was to evaluate the dose reduction potential of combined online (x- and y-axes) and topogram-based (l) X-ray tube current modulation in CT colonography in a screening population.
  
  
  METHODS
  Eighty asymptomatic individuals underwent CT colonography screening for colon polyps. A 16-MDCT scanner (Somatom Sensation 16) was used. Forty patients were examined at 120 kVp and 120 effective mAs (supine) and 40 effective mAs (prone) using online x- and y-axis tube current modulation. Another 40 patients were scanned using combined x-, y-, and z-axis tube current modulation. Individual patient radiation exposure was determined using the dose-length product. Image noise was determined by Hounsfield unit measurements in the colonic lumen at four anatomic levels. Image quality was rated on a 5-point confidence scale by two independent reviewers. The unpaired Student's t test (for radiation dose, image noise) and Wilcoxon's test (for image quality) were used to test for statistically significant differences between these values.
  
  
  RESULTS
  Radiation dose was significantly lower in the patient group scanned with x-, y-, and z-axis tube current modulation than in the group scanned with x- and y-axis tube current modulation (supine: 4.24 vs 6.50 mSv, p < 0.0001; prone: 1.61 vs 2.38 mSv, p < 0.0001). Radiation dose was reduced by 35% (supine) and 33% (prone). No statistically significant difference was seen in overall image noise (supine: 15.9 vs 16.3 H, p = 0.13; prone: 23.5 vs 24.8 H, p = 0.44) or image quality (supine: 4.6 vs 4.5, p = 0.62; prone: 3.5 vs 3.6, p = 0.54).
  
  
  CONCLUSIONS
  Combined x-, y-, and z-axis tube current modulation leads to a significant reduction of radiation exposure in CT colonography without loss of image quality.
authors.affiliation: Department of Clinical Radiology, University of Munich, Grosshadern Campus, Marchioninistr. 15, Munich 81377, Germany. anno.graser@med.uni-muenchen.de
authors.forename: A
authors.initials: A
authors.lastname: Graser
authors.forename: B J
authors.initials: BJ
authors.lastname: Wintersperger
authors.forename: C
authors.initials: C
authors.lastname: Suess
authors.forename: M F
authors.initials: MF
authors.lastname: Reiser
authors.forename: C R
authors.initials: CR
authors.lastname: Becker
mesh_terms: D000368:Aged; D003111:Colonic Polyps / Q000000981:diagnostic imaging*; D023881:Colonography, Computed Tomographic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011874:Radiometry; D012680:Sensitivity and Specificity; D012984:Software