PT - JOURNAL ARTICLE AU - Tan, Zhengwu AU - Zhang, Lan AU - Sun, Xiaojie AU - Yang, Ming AU - Makamure, Joyman AU - Wu, Hongying AU - Wang, Jing TI - Dual-Layer Detector Head CT to Maintain Image Quality While Reducing the Radiation Dose in Pediatric Patients AID - 10.3174/ajnr.A7999 DP - 2023 Oct 01 TA - American Journal of Neuroradiology PG - 1212--1218 VI - 44 IP - 10 4099 - http://www.ajnr.org/content/44/10/1212.short 4100 - http://www.ajnr.org/content/44/10/1212.full SO - Am. J. Neuroradiol.2023 Oct 01; 44 AB - BACKGROUND AND PURPOSE: Radiation exposure in the CT diagnostic imaging process is a conspicuous concern in pediatric patients. This study aimed to evaluate whether 60-keV virtual monoenergetic images of the pediatric cranium in dual-layer CT can reduce the radiation dose while maintaining image quality compared with conventional images.MATERIALS AND METHODS: One hundred six unenhanced pediatric head scans acquired by dual-layer CT were retrospectively assessed. The patients were assigned to 2 groups of 53 and scanned with 250 and 180 mAs, respectively. Dose-length product values were retrieved, and noise, SNR, and contrast-to-noise ratio were calculated for each case. Two radiologists blinded to the reconstruction technique used evaluated image quality on a 5-point Likert scale. Statistical assessment was performed with ANOVA and the Wilcoxon test, adjusted for multiple comparisons.RESULTS: Mean dose-length product values were 717.47 (SD, 41.52) mGy×cm and 520.74 (SD, 42) mGy×cm for the 250- and 180-mAs groups, respectively. Irrespective of the radiation dose, noise was significantly lower, SNR and contrast-to-noise ratio were significantly higher, and subjective analysis revealed significant superiority of 60-keV virtual monoenergetic images compared with conventional images (all P < .001). SNR, contrast-to-noise ratio, and subjective evaluation in 60-keV virtual monoenergetic images were not significantly different between the 2 scan groups (P > .05). Radiation dose parameters were significantly lower in the 180-mAs group compared with the 250-mAs group (P < .001).CONCLUSIONS: Dual-layer CT 60-keV virtual monoenergetic images allowed a radiation dose reduction of 28% without image-quality loss in pediatric cranial CT.CNRcontrast-to-noise ratioCTDIvolvolume CT dose indexDECTdual-energy CTDLCTdual-layer CTDLPdose-length productGWMAassessment of GM-WM differentiationPFAAassessment of artifacts in posterior fossaSSAassessment of the subcalvarial spaceSAIsubcalvarial artifact indexVMIvirtual monoenergetic image