title: Evaluation of a Net Dose-Reducing Organ-Based Tube Current Modulation Technique: Comparison With Standard Dose and Bismuth-Shielded Acquisitions.
abstract: OBJECTIVE
  The purpose of this study was to compare the dose and image noise associated with two methods of radiation dose reduction to the superficial anterior organs: bismuth shielding and a net dose-reducing organ-based tube current modulation TCM technique.
  
  
  METHODS
  Three scanning modes-the reference dose, bismuth-shielded, and organ dose-modulated modes-were evaluated. With the use of an anthropomorphic phantom, surface doses to the eye, thyroid, and female breast were measured using optically stimulated luminescence detectors. A CT dose index (CTDI) phantom was used to compare doses with the overall phantom volume in the different modes.
  
  
  RESULTS
  The dose to the anterior surface was reduced by 35%, 42%, and 37% in the head, neck, and chest regions, respectively, when the bismuth-shielded scanning mode was used, whereas surface dose reductions of 20%, 34%, and 38%, respectively, were noted for the organ-based TCM scanning mode. The CTDI-type dose was reduced by 13%, 14%, and 17% in the head, neck, and chest regions, respectively, when the bismuth-shielded mode was used, whereas dose reductions of 9%, 18%, and 20%, respectively, were observed for the organ-based TCM mode. Anterior image noise increased by 0.1, 9.5, and 0.7 HU in the head, neck, and chest regions, respectively, when the bismuth-shielded mode was used. These findings compared with increases in image noise of 0.1, 0.5, and 0.6 HU, respectively, for the organ-based TCM mode.
  
  
  CONCLUSIONS
  The implementation of organ-based TCM reduces the net tube current per rotation, so no body region receives increased radiation exposure. The use of this method allows the dose to the anterior surface to be reduced to an extent similar to that observed with the use of the bismuth shield, yet it does not produce the image quality degradation associated with bismuth shielding.
authors.affiliation: 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, 500 Parnassus Ave, San Francisco, CA 94143.
authors.forename: Jack W
authors.initials: JW
authors.lastname: Lambert
authors.affiliation: 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, 500 Parnassus Ave, San Francisco, CA 94143.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Gould
mesh_terms: D001729:Bismuth; D001940:Breast; D005260:Female; D006257:Head; D006801:Humans; D009333:Neck; D019047:Phantoms, Imaging; D011482:Protective Devices; D011829:Radiation Dosage; D011835:Radiation Protection / Q000295:instrumentation*; D013909:Thorax; D014057:Tomography, X-Ray Computed
chemical_list: D001729:Bismuth
keywords: CT; bismuth shield; dose reduction; organ-based tube current modulation; tube current modulation