A Preliminary Study of Personalized Head CT Scan in Pediatric Patients

Bian Bingyang; Wang Gang; Shao Zhiqing; Nan Li; BoXu Zhou; ShuJia Xu; Dan Li

doi:10.1177/1559325820985660

A Preliminary Study of Personalized Head CT Scan in Pediatric Patients

Dose Response. 2021 Mar 4;19(1):1559325820985660. doi: 10.1177/1559325820985660. eCollection 2021 Jan-Mar.

Authors

Bian Bingyang¹, Wang Gang², Shao Zhiqing¹, Nan Li¹, BoXu Zhou¹, ShuJia Xu¹, Dan Li¹

Affiliations

¹ Jilin University First Hospital, Changchun, China.
² Third Hospital of Jilin University, Changchun, China.

Abstract

Objectives: In the present study, we introduced a practical approach to quantify organ-specific radiation doses and investigated whether low-dose head circumference (HC)-based protocols for non-enhanced head computed tomography (CT) could reduce organs-specific radiation dose in pediatric patients while maintaining high image quality.

Methods: A total of 83 pediatric patients were prospectively recruited. Without limits to the HC, 15 patients were selected as a convention group (CON group) and underwent non-enhanced head CT scan with standard-dose protocols (tube current-time products of 250mAs). Low-dose group (LD group), including remaining 68 pediatrics were divided into 3 subgroups based on the HC: 54.1-57.0 cm for LD_200mAs group (HC-based protocols of 200mAs), 51.1-54.0 cm for LD_150mAs group (HC-based protocols of 150mAs), 48.1-51.0 cm for LD_100mAs group (HC-based protocols of 100mAs). Subjective and objective image quality was evaluated and measured by 2 experienced radiologists. Radimetrics was used to calculate organs-specific radiation dose, including the brain, eye lenses, and salivary glands.

Results: In CON_250mAs group, radiation doses in the brain and salivary glands were conversely correlated with HC, and pediatric patients with smaller HC received higher organs-specific radiation dose. Reducing tube current-time product from 250 to 100mAs could significantly reduce the organ-specific radiation dose. The subjective image quality score ≥ 3.0 is acceptable for diagnosis purposes. The signal to noise ratio (SNR) and the contrast to noise ratio (CNR) of bilateral thalamus and centrum semiovale in 3 LD subgroups were not statistically different compared with the CON group.

Conclusion: Our research indicated that low-dose HC-based protocols of non-enhanced head CT scan can evidently reduce the organ-specific radiation doses, while maintaining high image quality. HC can serve as a vital tool to guide personalized low-dose head CT scan for pediatric patients.

Keywords: Monte Carlo simulation; head circumference; low-dose; non-enhanced head computed tomography; pediatric; radiation dose of organs-specific; standard-dose.