title: Automated Tube Potential Selection as a Method of Dose Reduction for CT of the Neck: First Clinical Results.
abstract: OBJECTIVE
  The objective of our study was to investigate whether the use of a software-based automated tube potential selection (ATPS) CT neck protocol can result in radiation dose reduction as compared with a set 120-kV protocol without a statistically significant reduction in image quality.
  
  
  METHODS
  Three hundred sixty-four patients (median age, 52 years) underwent CT of the neck. Group 1 (n = 320) underwent CT with ATPS with 80, 100, or 120 kV. Group 2 (n = 44) was examined with the standard CT protocol at 120 kV. Attenuation, image background noise, signal-to-noise ratio (SNR), dose-length product (DLP), volume CT dose index (CTDIvol), body mass index (BMI [weight in kilograms divided by the square of height in meters]), and subjective image quality (5-point Likert scale, two readers in consensus) were analyzed.
  
  
  RESULTS
  A tube potential of 100 kV was selected in 279 patients, 120 kV in 40 patients, and 80 kV in one patient of the ATPS group. A significant correlation was found for selected tube potential and BMI (80 kV, BMI = 20.4; 100 kV, mean BMI = 24.2; 120 kV, BMI = 28.6; r = 0.28, p < 0.01). The average radiation dose was significantly lower with ATPS activated than with the standard protocol (mean DLP, 259 vs 350 mGy × cm, respectively). Background noise did not differ between groups 1 and 2 at the levels of the mandibular angle and the upper mediastinum; however, attenuation and SNR increased significantly with lower tube potential settings. Subjective image quality did not suffer (mean image quality score: ATPS protocol vs standard protocol, 4.56 vs 4.61, respectively; p > 0.05) with good interobserver agreement (κ > 0.56).
  
  
  CONCLUSIONS
  ATPS allows significant dose savings for CT of the neck compared with a standard protocol that uses a fixed 120-kV setting without a statistically significant reduction in image quality.
authors.affiliation: 1 Department of Diagnostic and Interventional Radiology, Goethe University of Frankfurt and Johann Wolfgang Goethe University Hospital, Theodor-Stern-Kai 7, Frankfurt, Hessen 60590, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Bodelle
authors.forename: Martin
authors.initials: M
authors.lastname: Beeres
authors.forename: Sebastian
authors.initials: S
authors.lastname: Scheithauer
authors.forename: Julian L
authors.initials: JL
authors.lastname: Wichmann
authors.forename: Nour-Eldin Abdelrehim
authors.initials: NE
authors.lastname: Nour-Eldin
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.forename: Boris
authors.initials: B
authors.lastname: Schulz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001331:Automation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D059629:Signal-To-Noise Ratio; D012984:Software; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*
keywords: CT; attenuation-based automated tube potential selection; automated tube potential selection (ATPS); dose reduction; neck CT; radiation exposure