A CONSORT-compliant prospective randomized controlled trial: radiation dose reducing in computed tomography using an additional lateral scout view combined with automatic tube current modulation Phantom and patient study
A CONSORT-compliant prospective randomized controlled trial: radiation dose reducing in computed tomography using an additional lateral scout view combined with automatic tube current modulation Phantom and patient study
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DOI：
10.1097/md.0000000000007324
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发表时间：
2017-07-01
期刊：
影响因子：
1.6
通讯作者：
Zhao, Fei
中科院分区：
文献类型：
--
作者：
Peng, Wanlin;Li, Zhenlin;Zhao, Fei
背景：辐射暴露一直是计算机断层成像(CT)领域的研究热点。近年来，自动管电流调制(ATCM)已成为减少辐射照射的一项重要技术。许多研究表明，童子军观点的不同会影响调制。这项前瞻性随机对照研究的目的是探讨增加侧位扫描对多层螺旋CT的辐射剂量和图像质量的影响。方法：结合多层螺旋CT上的ATCM(关爱剂量4D)，获得2个胸部体模CT图像序列，分别采用正位扫描和侧位扫描。此外，410名患者接受了使用CARE剂量4D调制的胸部CT检查，并被随机分成两组，一组是计划由AP侧方侦察员进行的扫描，另一组是单独的AP侦察员。分析不同侦察观点对有效毫安秒(MAs)、体积CT剂量指数(CTDIvolv)和剂量长度乘积(DLP)的影响。对患者的CT图像质量也进行了评估。结果：与AP组比较，AP组CTDIVOL(模体，0.890.08 vs1.36+/-0.26mGyP<；.001；患者组，1.12[0.96，1.34]vs2.16[1.66，2.64]mGyP<；.001)和DLP(模模组，26[23.25，28]vs40[34.25，48]mGyx cm，P<；.001；在患者中，AP-侧方侦察组41[33，41]比77[60.5，99.5]mGyx cm，P<；.001)显著减少约50%。不同偏心部位的照射剂量基本相同(CTDIvol0.76~0.99mGy.DLP：22~28mGyx cm有效剂量：0.31~0。39 mSv)。在图像质量方面，AP组的对比度噪声比和信噪比与AP侧视面组相似。结论：AP联合ACTM附加侧视面能在不影响图像质量的情况下显著降低胸部CT的辐射剂量。
Background: Radiation exposure has been a hot point in research field of computed tomography (CT). Recently, automated tube current modulation (ATCM) has emerged as an important technique to reduce radiation exposure. Many studies have shown that the difference in scout view would affect modulation. This prospective randomized controlled study is aimed to investigate the impact of an additional lateral scout view on radiation dose and image quality in CT using ACTM.Methods: Combined with ATCM (Care Dose 4D) on multidetector CT, 2 thoracic phantom CT image series were acquired in which planning was conducted with either an anteroposterior (AP) or an AP-lateral scout view. Also, 410 patients underwent thoracic CT examinations using Care Dose 4D modulation and were randomized to either a scan planned with an AP-lateral scout or a single AP scout. Effects of the different scout views on applied effective milliampere seconds (mAs), volume CT dose index (CTDIvol) and dose-length-product (DLP) were analyzed. The quality of patient CT images was also assessed. Data were analyzed using independent t tests and linear correlation analysis.Results: Compared with AP groups, the mean CTDIvol (phantom, 0.890.08 vs 1.36 +/- 0.26mGy, P < .001; in patients, 1.12 [0.96, 1.34] vs 2.16 [1.66, 2.64] mGy, P < .001) and DLP (in phantom, 26 [23.25, 28] vs 40 [34.25, 48] mGy x cm, P < .001; in patients, 41 [33, 41] vs 77 [60.5, 99.5]mGy x cm, P < .001) were significantly reduced by approximately 50% in AP-lateral scout view group. With the AP-lateral to pogram, the radiation dose on different off-center positions was essentially equal (CTDIvol: 0.76-0.99 mGy; DLP: 22-28 mGy x cm effective dose: 0.31-0. 39 mSv). For image quality, contrast-to-noise ratio and signal-to-noise ratio values in the AP group were similar to those of AP-lateral scout view group.Conclusion: AP combined with an additional lateral scout view using ACTM can significantly reduce the radiation dose without compromising image quality in chest screening CT.