SU-F-I-47: Optimizing Protocols for Image Quality and Dose in Abdominal CT of Large Patients




Newer CT scanners are able to use scout views to adjust mA throughout the scan in order to achieve a given noise level. However, given constraints of radiologist preferences for kVp and rotation time, it may not be possible to achieve an acceptable noise level for large patients. A study was initiated to determine for which patients kVp and/or rotation time should be changed in order to achieve acceptable image quality.


Patient scans were reviewed on two new Emergency Department scanners (Philips iCT) to identify patients over a large range of sizes. These iCTs were set with a limit of 500 mA to safeguard against a failure that might cause a CT scan to be (incorrectly) obtained at too-high mA. Scout views of these scans were assessed for both AP and LAT patient width and AP and LAT standard deviation in an ROI over the liver. Effective diameter and product of the scout standard deviations over the liver were both studied as possible metrics for identifying patients who would need kVp and/or rotation time changed. The mA used for the liver in the CT was compared to these metrics for those patients whose CT scans showed acceptable image quality.


Both effective diameter and product of the scout standard deviations over the liver result in similar predictions for which patients will require the kVp and/or rotation time to be changed to achieve an optimal combination of image quality and dose.


Two mechanisms for CT technologists to determine based on scout characteristics what kVp, mA limit, and rotation time to use when DoseRight with our physicians’ preferred kVp and rotation time will not yield adequate image quality are described.