title: Cranial CT with 64-, 16-, 4- and single-slice CT systems-comparison of image quality and posterior fossa artifacts in routine brain imaging with standard protocols.
abstract: Posterior fossa artifacts constitute a characteristic limitation of cranial CT. To identify practical benefits and drawbacks of newer CT systems with reduced collimation in routine cranial imaging, we aimed to investigate image quality, posterior fossa artifacts and parenchymal delineation in non-enhanced CT (NECT) with 1-, 4-, 16- and 64-slice scanners using standard scan protocols. We prospectively enrolled 25 consecutive patients undergoing NECT on a 64-slice CT. Three groups with 25 patients having undergone NECT on 1-, 4- and 16-slice CT machines were matched regarding age and sex. Standard routine CT parameters were used on each CT system with helical acquisition in the posterior fossa; the parameters varied regarding collimation and radiation dose. Three blinded readers independently assessed the cases regarding image quality, infra- and supratentorial artifacts and delineation of brain parenchymal structures on a five-point ordinal scale. Reading orders were randomized. A proportional odds model that accounted for the correlated nature of the data was fit using generalized estimating equations. Posterior fossa artifacts were significantly reduced, and the delineation of infratentorial brain structures was significantly improved with the thinner collimation used for the newer CT systems (p<0.001). No significant differences were observed for midbrain structures (p>0.5). The thinner collimation available on modern CT systems leads to reduced posterior fossa artifacts and to a better delineation of brain parenchyma in the posterior fossa.
authors.affiliation: Institute of Clinical Radiology, University of Munich-Campus Grosshadern, Marchioninistr. 15, 81377, Munich, Germany. B.Ertl-Wagner@t-online.de
authors.forename: Birgit
authors.initials: B
authors.lastname: Ertl-Wagner
authors.forename: Lara
authors.initials: L
authors.lastname: Eftimov
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Blume
authors.forename: Roland
authors.initials: R
authors.lastname: Bruening
authors.forename: Christoph
authors.initials: C
authors.lastname: Becker
authors.forename: Jean
authors.initials: J
authors.lastname: Cormack
authors.forename: Hartmut
authors.initials: H
authors.lastname: Brueckmann
authors.forename: Maximilian
authors.initials: M
authors.lastname: Reiser
mesh_terms: D000368:Aged; D016477:Artifacts; D001921:Brain / Q000000981:diagnostic imaging*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods