title: Prospective evaluation of image quality with use of a patient image gallery for dose reduction in pediatric 16-MDCT.
abstract: OBJECTIVE
  The purposes of this study were to evaluate prospective adjustment of dose settings in pediatric 16-MDCT by use of computer-simulated images in a patient image gallery and to compare the dose reduction achieved with that of standard pediatric protocols.
  
  
  METHODS
  The image gallery consisted of images from weight-dependent sample examinations performed with varied simulated tube current-exposure time settings. The scanning parameters prospectively chosen on the basis of the image quality of the image gallery were used for 30 16-MDCT examinations (chest, n = 15; abdomen, n = 8; pelvis, n = 7) of 22 children (14 boys, eight girls; mean age, 6.8 +/- 5.8 years; mean body weight, 26.7 +/- 19.6 kg). Three blinded radiologists used a 4-point grading scale to rate the overall image quality of the image gallery and the 16-MDCT scans. Objective and subjective image quality was assessed for the simulated and actual CT scans. The concordance correlation coefficient (K) was determined.
  
  
  RESULTS
  There was mainly moderate concordance with regard to objective (chest, K = 0.69; abdomen, K = 0.33; pelvis, K = 0.55) and subjective (chest soft-tissue window, kappa coefficient [kappa] = 0.00; chest lung window, kappa = 0.53; abdomen, kappa = 1.00; pelvis, kappa = 0.48) analysis of image gallery compared with actual 16-MDCT examinations. Compared with use of previous weight-adapted pediatric standard protocols, use of an image gallery resulted in further dose reduction for abdominal and pelvic CT but not for thoracic CT.
  
  
  CONCLUSIONS
  A patient image gallery can be used as a basis for pediatric 16-MDCT examinations. The gallery provides a preexamination overview of expected image quality. Radiation exposure can be optimized with regard to patient weight and the image quality needed to answer the clinical question.
authors.affiliation: Department of Diagnostic Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, D-52074 Aachen, Germany. honnef@rad.rwth-aachen.de
authors.forename: Dagmar
authors.initials: D
authors.lastname: Honnef
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.forename: Gabriel
authors.initials: G
authors.lastname: Haras
authors.forename: Christian
authors.initials: C
authors.lastname: Hohl
authors.forename: Gundula
authors.initials: G
authors.lastname: Staatz
authors.forename: Rolf W
authors.initials: RW
authors.lastname: Günther
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Mahnken
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000517:prevention & control*; D011856:Radiographic Image Enhancement / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed / Q000379:methods*