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  • Title: Individualized kV selection and tube current reduction in excretory phase computed tomography urography: potential for radiation dose reduction and the contribution of iterative reconstruction to image quality.
    Author: Froemming AT, Kawashima A, Takahashi N, Hartman RP, Nathan MA, Carter RE, Yu L, Leng S, Kagoshima H, McCollough CH, Fletcher JG.
    Journal: J Comput Assist Tomogr; 2013; 37(4):551-9. PubMed ID: 23863531.
    Abstract:
    OBJECTIVE: The objective of this study was to analyze radiation dose reduction and image quality by combining automated kV selection, tube current reduction, and iterative reconstruction. METHODS: This was a retrospective analysis of the excretory phase of 55 patients with 2 computed tomography urography examinations: automated kV selection with tube current reduction ("low-dose protocol": with filtered back projection vs iterative reconstruction) and routine dose examinations. Image quality was analyzed blindly and in side-by-side analyses, in addition to quantitative measurements. RESULTS: Low-dose protocol median dose change was -40% (-10.7 to +12.9 mGy); 100 kV was autoselected in 44 (80%) of 55 patients (body mass index range, 19-36 kg/m) with mean dose reduction of 42.5%. Whereas up to 19% of low-dose images with filtered back projection were inferior by blinded review (P < 0.001), low-dose iterative reconstruction images were not rated inferior (P = 1.0). CONCLUSIONS: The combination of iterative reconstruction, automated kV selection, and tube current reduction results in radiation dose reduction with preserved image quality and diagnostic confidence.
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