title: Effects of automatic tube potential selection on radiation dose index, image quality, and lesion detectability in pediatric abdominopelvic CT and CTA: a phantom study.
abstract: OBJECTIVE
  To assess the effect of automatic tube potential selection (ATPS) on radiation dose, image quality, and lesion detectability in paediatric abdominopelvic CT and CT angiography (CTA).
  
  
  METHODS
  A paediatric modular phantom with contrast inserts was examined with routine pitch (1.4) and high pitch (3.0) using a standard abdominopelvic protocol with fixed 120 kVp, and ATPS with variable kVp in non-contrast, contrast-enhanced, and CTA mode. The volume CT dose index (CTDIvol), contrast-to-noise ratio (CNR) and lesion detectability index (d') were compared between the standard protocol and ATPS examinations.
  
  
  RESULTS
  CTDIvol was reduced in all routine pitch ATPS examinations, with dose reductions of 27-52 % in CTA mode (P < 0.0001), 15-33 % in contrast-enhanced mode (P = 0.0003) and 8-14 % in non-contrast mode (P = 0.03). Iodine and soft tissue insert CNR and d' were improved or maintained in all ATPS examinations. kVp and dose were reduced in 25 % of high pitch ATPS examinations and in none of the full phantom examinations obtained after a single full phantom localizer.
  
  
  CONCLUSIONS
  ATPS reduces radiation dose while maintaining image quality and lesion detectability in routine pitch paediatric abdominopelvic CT and CTA, but technical factors such as pitch and imaging range must be considered to optimize ATPS benefits.
  
  
  CONCLUSIONS
  ATPS automatically individualizes CT scan technique for each patient. ATPS lowers radiation dose in routine pitch pediatric abdominopelvic CT and CTA. There is no loss of image quality or lesion detectability with ATPS. Pitch and scan range impact the effectiveness of ATPS dose reduction.
authors.affiliation: Department of Radiology, Duke University School of Medicine, DUMC Box 3808, Durham, NC, 27710, USA. michael.brinkley@dm.duke.edu.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Brinkley
authors.affiliation: Siemens Healthcare, Malvern, USA.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Ramirez-Giraldo
authors.affiliation: Clinical Imaging Physics Group, Department of Radiology, Duke University School of Medicine, Durham, NC, 27710, USA.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Samei
authors.affiliation: Medical Physics, Duke University School of Medicine, Durham, NC, 27710, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Frush
authors.affiliation: Department of Radiology, Duke University School of Medicine, DUMC Box 3808, Durham, NC, 27710, USA.
authors.forename: Kingshuk Roy
authors.initials: KR
authors.lastname: Choudhury
authors.affiliation: Clinical Imaging Physics Group, Department of Radiology, Duke University School of Medicine, Durham, NC, 27710, USA.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Wilson
authors.affiliation: Clinical Imaging Physics Group, Department of Radiology, Duke University School of Medicine, Durham, NC, 27710, USA.
authors.forename: Olav I
authors.initials: OI
authors.lastname: Christianson
authors.affiliation: Department of Radiology, Duke University School of Medicine, DUMC Box 3808, Durham, NC, 27710, USA.
authors.forename: Donald P
authors.initials: DP
authors.lastname: Frush
mesh_terms: D000005:Abdomen; D000792:Angiography / Q000295:instrumentation*; D002648:Child; D004867:Equipment Design; D006801:Humans; D010388:Pelvis / Q000000981:diagnostic imaging*; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011860:Radiography, Abdominal / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*
keywords: Computed tomography; Pediatrics; Radiation dosage; Radiocontrast agent; Radiologic phantom