title: The impact of pediatric-specific dose modulation curves on radiation dose and image quality in head computed tomography.
abstract: BACKGROUND
  The volume of CT examinations has increased with resultant increases in collective dose values over the last decade.
  
  
  OBJECTIVE
  To analyze the impact of the tube current and voltage modulation for dose values and image quality of pediatric head CT examinations.
  
  
  METHODS
  Head CT examinations were performed on anthropomorphic phantoms and four pediatric age categories before and after the introduction of dedicated pediatric curves for tube voltage and current modulation. Local diagnostic reference levels were calculated. Visual grading characteristic image quality evaluation was performed by four pediatric neuroradiologists and image noise comparisons were performed.
  
  
  RESULTS
  Pediatric-specific modulation curves demonstrated a 49% decrease in mean radiation dose for phantom examinations. The local diagnostic reference levels (CTDIvol) for clinical examinations decreased by 52%, 41%, 46% and 40% for newborn, 5-, 10- and 15-year-old patients, respectively. Visual grading characteristic image quality was maintained for the majority of age categorizations (area under the curve = 0.5) and image noise measurements did not change (P = 0.693).
  
  
  CONCLUSIONS
  Pediatric-specific dose modulation curves resulted in an overall mean dose reduction of 45% with no significant differences in subjective or objective image quality findings.
authors.affiliation: Instituto Politécnico de Coimbra, ESTESC, DMIR, Rua 5 de Outubro, S. Martinho do Bispo, 3046-854, Coimbra, Portugal. joanasantos@estescoimbra.pt.
authors.forename: Joana
authors.initials: J
authors.lastname: Santos
authors.affiliation: School of Medicine & Medical Science, Health Science Centre, University College Dublin, Belfield, Dublin 4, Ireland.
authors.forename: Shane
authors.initials: S
authors.lastname: Foley
authors.affiliation: Instituto Politécnico de Coimbra, ESTESC, DMIR, Rua 5 de Outubro, S. Martinho do Bispo, 3046-854, Coimbra, Portugal.
authors.forename: Graciano
authors.initials: G
authors.lastname: Paulo
authors.affiliation: Faculty of Health Sciences, Cumberland Campus, The University of Sydney, Sydney, Australia.
authors.forename: Mark F
authors.initials: MF
authors.lastname: McEntee
authors.affiliation: School of Medicine & Medical Science, Health Science Centre, University College Dublin, Belfield, Dublin 4, Ireland.
authors.forename: Louise
authors.initials: L
authors.lastname: Rainford
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006257:Head / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Child; Computed tomography; Head; Radiation dose reduction