title: Advanced abdominal imaging with dual energy CT is feasible without increasing radiation dose.
abstract: BACKGROUND
  Dual energy CT (DECT) has proven its potential in oncological imaging. Considering the repeated follow-up examinations, radiation dose should not exceed conventional single energy CT (SECT). Comparison studies on the same scanner with a large number of patients, considering patient geometries and image quality, and exploiting full potential of SECT dose reduction are rare. Purpose of this retrospective study was to compare dose of dual source DECT versus dose-optimized SECT abdominal imaging in clinical routine.
  
  
  METHODS
  One hundred patients (62y (±14)) had either contrast-enhanced SECT including automatic voltage control (44) or DECT (56). CT dose index (CTDIvol), size-specific dose-estimate (SSDE) and dose-length product (DLP) were reported. Image noise (SD) was recorded as mean of three ROIs placed in subcutaneous fat and normalized to dose by [Formula: see text] . For dose-normalized contrast-to-noise ratio (CNRD), mean attenuation of psoas muscle (CTmuscle) and subcutaneous fat (CTfat) were compared by CNRD = (CTmuscle - CTfat)/SDn. Statistical significance was tested with two-sided t-test (α = 0.05).
  
  
  RESULTS
  There was no significant difference (p < 0.05) between DECT and SECT: Mean CTDIvol was 14.2 mGy (±3.9) (DECT) and 14.3 mGy (±4.5) (SECT). Mean DLP was 680 mGy*cm (±220) (DECT) and 665 mGy*cm (±231) (SECT). Mean SSDE was 15.7 mGy (±1.9) (DECT) and 16.1 mGy (±2.5) (SECT). Mean SDn was 42.2 (±13.9) HU [Formula: see text] (DECT) and 47.8 (±14.9) HU [Formula: see text] (SECT). Mean CNRD was 3.9 (±1.3) [Formula: see text]. (DECT) and 4.0 (±1.3) [Formula: see text] (SECT).
  
  
  CONCLUSIONS
  Abdominal DECT is feasible without increasing radiation dose or deteriorating image quality, even compared to dose-optimized SECT including automatic voltage control. Thus DECT can contribute to sophisticated oncological imaging without dose penalty.
authors.affiliation: Department of Radiology, German Cancer Research Center (DKFZ) Heidelberg, Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany. m.uhrig@dkfz.de.
authors.forename: Monika
authors.initials: M
authors.lastname: Uhrig
authors.affiliation: Department of Radiology, German Cancer Research Center (DKFZ) Heidelberg, Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Simons
authors.affiliation: Department of Medical Physics in Oncology, Division of X-Ray Imaging and Computed Tomography, German Cancer Research Center (DKFZ) Heidelberg, Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Kachelrieß
authors.affiliation: Department of Medical Physics in Oncology, Division of X-Ray Imaging and Computed Tomography, German Cancer Research Center (DKFZ) Heidelberg, Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pisana
authors.affiliation: Department of Medical Physics in Oncology, Division of X-Ray Imaging and Computed Tomography, German Cancer Research Center (DKFZ) Heidelberg, Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kuchenbecker
authors.affiliation: Department of Radiology, German Cancer Research Center (DKFZ) Heidelberg, Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany.
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Schlemmer
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging*; D000008:Abdominal Neoplasms / Q000175:diagnosis*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Abdominal imaging; Dual energy CT; Oncological imaging; Radiation dose