Dual-energy computed tomography of the neck-optimizing tube current settings and radiation dose using a 3D-printed patient phantom

Background: Dual-energy computed tomography (DECT) is increasingly used in studies and clinical practice. However, the best protocol is controversially discussed and whether it exhibits more radiation exposure compared to conventional protocols. Thus, the purpose of the study was to determine optimal tube current settings for DECT in a 3D-printed anthropomorphic phantom of the neck. Methods: A 3D-printed iodinated ink based phantom of a contrast enhanced CT of the neck was imaged. Six dual-energy multi-detector computed tomography scans were performed with six different tube currents (80 kVp: 30-400 mAs; 135 kVp: 5-160 mAs). 120 virtual blended images (VBIs) and 66 virtual monochromatic images (VMIs) were reconstructed and 12 regions of interest (bilaterally: common carotid arteries, subcutaneous soft tissue, mandibular bone, sternocleidomastoid muscle, submandibular gland, and mid-image: vertebral body of C2 and pharyngeal space) in six consecutive slices resulting in 96 measurements per scan were performed. Hounsfield units and signaland contrast-to-noise ratio were compared to single energy computed tomography as standard of reference. Results: VBIs overestimated the Hounsfield units (P<0.0001). Optimal dual-energy scanning parameters resulted in 120% (100 kVe: 51.2 vs. 61.7 and 65.2, for signal and contrast-to-noise ratio, respectively; 120 kVe: 60.8 vs. 72.1 vs. 128.3) of the radiation exposure with about 80% of the signal/contrast-to-noise ratio of the corresponding single-energy images. However, optimal weighting of tube currents for both voltages depended on the desired reconstruction. Conclusions: Dual-energy protocols apply an estimated 120% of the single-energy radiation exposure and result in approximately 80% of the image quality. Tube current settings should be adapted to the desired information.

Automated summary

This study aimed to determine optimal tube current settings for dual-energy computed tomography (DECT) imaging of the neck. Results showed that optimal DECT scanning parameters can achieve 120% of the radiation exposure with around 80% of the image quality, but optimal tube current settings depend on the desired reconstruction.