title: Dose reduction in 64-row whole-body CT in multiple trauma: an optimized CT protocol with iterative image reconstruction on a gemstone-based scintillator.
abstract: OBJECTIVE
  Evaluation of potential dose savings by implementing adaptive statistical iterative reconstruction (ASiR) on a gemstone-based scintillator in a clinical 64-row whole-body CT (WBCT) protocol after multiple trauma.
  
  
  METHODS
  Dose reports of 152 WBCT scans were analysed for two 64-row multidetector CT scanners (Scanners A and B); the main scanning parameters were kept constant. ASiR and a gemstone-based scintillator were used in Scanner B, and the noise index was adjusted (head: 5.2 vs 6.0; thorax/abdomen: 29.0 vs 46.0). The scan length, CT dose index (CTDI) and dose-length product (DLP) were analysed. The estimated mean effective dose was calculated using normalized conversion factors. Student's t-test was used for statistics.
  
  
  RESULTS
  Both the mean CTDI (mGy) (Scanner A: 53.8 ± 2.0, 10.3 ± 2.5, 14.4 ± 3.7; Scanner B: 48.7 ± 2.2, 7.1 ± 2.3, 9.1 ± 3.6; p < 0.001, respectively) and the mean DLP (mGy cm) (Scanner A: 1318.9 ± 167.8, 509.3 ± 134.7, 848.8 ± 254.0; Scanner B: 1190.6 ± 172.6, 354.6 ± 128.3, 561.0 ± 246.7; p < 0.001, respectively) for the head, thorax and abdomen were significantly reduced with Scanner B. There was no relevant difference in scan length. The total mean effective dose (mSv) was significantly decreased with Scanner B (24.4 ± 6.0, 17.2 ± 5.8; p < 0.001).
  
  
  CONCLUSIONS
  The implementation of ASiR and a gemstone-based scintillator allows for significant dose savings in a clinical WBCT protocol.
  
  
  CONCLUSIONS
  Recent technical developments can significantly reduce radiation dose of WBCT in multiple trauma. Dose reductions of 10-34% can be achieved.
authors: 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors: Lucas L
authors: LL
authors: Geyer
authors: 2 Radiologie Muehleninsel, Landshut, Germany.
authors: Markus
authors: M
authors: Körner
authors: 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors: Andreas
authors: A
authors: Harrieder
authors: 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors: Fabian G
authors: FG
authors: Mueck
authors: 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors: Zsuzsanna
authors: Z
authors: Deak
authors: 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors: Stefan
authors: S
authors: Wirth
authors: 3 Institute for Diagnostic and Interventional Radiology, HELIOS Klinikum Munich West and Munich Perlach, Munich, Germany.
authors: Ulrich
authors: U
authors: Linsenmaier
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D016037:Single-Blind Method; D015898:Tomography Scanners, X-Ray Computed; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D051598:Whole Body Imaging / Q000295:instrumentation / Q000379:methods*