title: Third-generation dual-source 70-kVp chest CT angiography with advanced iterative reconstruction in young children: image quality and radiation dose reduction.
abstract: BACKGROUND
  Many technical updates have been made in multi-detector CT.
  
  
  OBJECTIVE
  To evaluate image quality and radiation dose of high-pitch second- and third-generation dual-source chest CT angiography and to assess the effects of different levels of advanced modeled iterative reconstruction (ADMIRE) in newborns and children.
  
  
  METHODS
  Chest CT angiography (70 kVp) was performed in 42 children (age 158 ± 267 days, range 1-1,194 days). We evaluated subjective and objective image quality, and radiation dose with filtered back projection (FBP) and different strength levels of ADMIRE. For comparison were 42 matched controls examined with a second-generation 128-slice dual-source CT-scanner (80 kVp).
  
  
  RESULTS
  ADMIRE demonstrated improved objective and subjective image quality (P < .01). Mean signal/noise, contrast/noise and subjective image quality were 11.9, 10.0 and 1.9, respectively, for the 80 kVp mode and 11.2, 10.0 and 1.9 for the 70 kVp mode. With ADMIRE, the corresponding values for the 70 kVp mode were 13.7, 12.1 and 1.4 at strength level 2 and 17.6, 15.6 and 1.2 at strength level 4. Mean CTDIvol, DLP and effective dose were significantly lower with the 70-kVp mode (0.31 mGy, 5.33 mGy*cm, 0.36 mSv) compared to the 80-kVp mode (0.46 mGy, 9.17 mGy*cm, 0.62 mSv; P < .01).
  
  
  CONCLUSIONS
  The third-generation dual-source CT at 70 kVp provided good objective and subjective image quality at lower radiation exposure. ADMIRE improved objective and subjective image quality.
authors.affiliation: Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, 91054, Erlangen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Rompel
authors.affiliation: Department of Pediatric Cardiology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Glöckler
authors.affiliation: Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, 91054, Erlangen, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Janka
authors.affiliation: Department of Pediatric Cardiology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Dittrich
authors.affiliation: Department of Pediatric Cardiac Surgery, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Cesnjevar
authors.affiliation: Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, 91054, Erlangen, Germany.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Lell
authors.affiliation: Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, 91054, Erlangen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Uder
authors.affiliation: Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, 91054, Erlangen, Germany. matthias.hammon@uk-erlangen.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hammon
mesh_terms: D002648:Child; D002675:Child, Preschool; D000072226:Computed Tomography Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000032:analysis / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Chest; Child; Computed tomography; Image quality; Iterative reconstruction; Radiation dose