title: Pediatric multidetector computed tomography using tube current modulation and a patient image gallery.
abstract: BACKGROUND
  Dose reduction is crucial in pediatric multidetector computed tomography (MDCT).
  
  
  OBJECTIVE
  To perform pediatric 16-slice MDCT using tube current modulations and to adjust prospectively the tube current using a patient image gallery (IG) providing simulated dose-reduced protocols; and to evaluate and compare the image quality of the IG and the clinical MDCT.
  
  
  METHODS
  30 examinations (thorax, n = 15; abdomen, n = 8; pelvis, n = 7) in 20 patients (nine male, age 8.05 +/- 7.33 years, weight 29.8 +/- 24.02 kg) were performed according to an IG on a 16-slice MDCT with additional use of online tube current modulation (CARE Dose). Three radiologists visually assessed image quality from the IG and actual 16-slice MDCT scans. For objective analysis, image noise was determined.
  
  
  RESULTS
  Statistical analysis showed moderate concordance in objective (K = 0.68-0.78) and subjective (K = 0.33-0.64) image assessment between the IG and clinical 16-slice MDCT scans. Depending on the weight group and clinical question, no or only minor dose reductions in the chest, but moderate to considerable reductions in the abdominal/pelvic 16-slice MDCT scans compared to previously used pediatric protocols were achieved. Extra dose reduction was achieved due to additional use of CARE Dose depending on age group and scan region (mean 8.6-23.9%).
  
  
  CONCLUSIONS
  The IG enabled us to prospectively reduce the tube current and adapt the required image quality to the clinical question. Additional dose reduction was achieved with application of CARE Dose; nevertheless, the images are comparable to the simulated images of the IG.
authors.affiliation: Department of Diagnostic Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, D-52074 Aachen, Germany. honnef@rad.rwth-aachen.de
authors.forename: D
authors.initials: D
authors.lastname: Honnef
authors.forename: A H
authors.initials: AH
authors.lastname: Mahnken
authors.forename: G
authors.initials: G
authors.lastname: Haras
authors.forename: J E
authors.initials: JE
authors.lastname: Wildberger
authors.forename: G
authors.initials: G
authors.lastname: Staatz
authors.forename: M
authors.initials: M
authors.lastname: Das
authors.forename: M
authors.initials: M
authors.lastname: Barker
authors.forename: S
authors.initials: S
authors.lastname: Stanzel
authors.forename: R W
authors.initials: RW
authors.lastname: Günther
authors.forename: C
authors.initials: C
authors.lastname: Hohl
mesh_terms: D016477:Artifacts; D002648:Child; D003198:Computer Simulation; D005260:Female; D006801:Humans; D008297:Male; D016012:Poisson Distribution; D011446:Prospective Studies; D011832:Radiation Injuries / Q000517:prevention & control; D014057:Tomography, X-Ray Computed / Q000379:methods*