Optimization of recommendations for abdomen computerized tomography based on reconstruction filters, voltage and tube current

The use of computed tomography has increased significantly over the past decades. In Brazil the use increased more than twofold from 2008 to 2014, in the meantime the abdomen procedures have tripled. The high frequency of this procedure combined by the increasing collective radiation dose in medical exposures, has resulted development tools to maximize the benefit in CT images. This work aimed to establish protocols optimized in abdominal CT through acquisitions parameters and reconstructions techniques based on filters kernels. A sample of patients undergoing abdominal CT in a diagnostic center of Rio de Janeiro was assessed. Had been collected patients information and acquisitions parameters. The phantoms CT image acquisitions were performed by using different voltage values by adjusting the tube current (mAs) to obtain the same value from CTDI_vol patients with normal BMI. Afterwards, the CTDIvol values were reduced by 30%, 50% and 60%. All images were reconstructed with low-contrast filters (A) and standard filters (B). The CTDIvol values for patients with normal BMI were 7% higher than in patients with underweight BMI and 30%, 50% and 60% lower than the overweight, obese I and III patients, respectively. The evaluations of image quality showed that variation of the current (mA) and the reconstruction filters did not affect the Hounsfield values. When the contrast-to-noise ratio (CNR) was normalized to CTDIvol, the protocols acquired with 60% reduction of CTDIvol with 140 kV and 80 kV showed CNR 6% lower than the routine. Modifications of the acquisition parameters did not affect spatial resolution, but the post-processing with B filters reduced the spatial frequency by 16%. With reduced the dose of 30%, lesions in the spleen had the CNR higher than 10% routine protocols with 140 kV acquired and post-processed to filter A. The image post-processing with a filter A with a 80kV voltage provided CNR values equal to the routine for the liver lesions with a 30% reduction in dose. This study demonstrated that the reduction in tube voltage and the image post-processing filter to enable a reduction in the radiation dose by 30%. (author)