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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticlePediatric Neuroimaging

Radiation Dose and Image Quality in Pediatric Neck CT

S.V. Tipnis, W.J. Rieter, D. Patel, S.T. Stalcup, M.G. Matheus and M.V. Spampinato
American Journal of Neuroradiology May 2019, DOI: https://doi.org/10.3174/ajnr.A6073
S.V. Tipnis
aFrom the Department of Radiology and Radiological Science (S.V.T., W.J.R., D.P., S.T.S., M.G.M., M.V.S.)
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  • ORCID record for S.V. Tipnis
W.J. Rieter
aFrom the Department of Radiology and Radiological Science (S.V.T., W.J.R., D.P., S.T.S., M.G.M., M.V.S.)
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D. Patel
aFrom the Department of Radiology and Radiological Science (S.V.T., W.J.R., D.P., S.T.S., M.G.M., M.V.S.)
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S.T. Stalcup
aFrom the Department of Radiology and Radiological Science (S.V.T., W.J.R., D.P., S.T.S., M.G.M., M.V.S.)
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M.G. Matheus
aFrom the Department of Radiology and Radiological Science (S.V.T., W.J.R., D.P., S.T.S., M.G.M., M.V.S.)
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M.V. Spampinato
aFrom the Department of Radiology and Radiological Science (S.V.T., W.J.R., D.P., S.T.S., M.G.M., M.V.S.)
bCenter for Biomedical Imaging (M.V.S.), Medical University of South Carolina, Charleston, South Carolina.
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    Fig 1.

    Representative CT image of a 6-year-old boy at the level of the vocal cords for assessment of the signal-to-noise ratio. Background noise was estimated as the average SD in Hounsfield units of 2 ROIs drawn over the air anterior to the patient (large circles). Signal was estimated as the average attenuation in Hounsfield units of 2 ROIs drawn over the paraspinal musculature (small circles).

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    Fig 2.
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    Fig 2.

    Comparison of the median values of tube current (milliampere-seconds) (A), radiation output of scanner (CTDIvol) (B), and scan length between the 2 cohorts (C). Also shown are P values from an unpaired t test.

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    Fig 3.

    Comparison of the median values of the dose-length product (A) and estimated effective dose (B) between the 2 cohorts. Also shown are the P values from an unpaired t test.

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    Fig 4.

    Comparison of the median values of the signal-to-noise ratio (A) and image-quality score (B) between the 2 cohorts. Also shown are the P values from an unpaired t test.

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    Table 1:

    Total number of patients and distribution of patient age and sex in the 3 age groups of the study

    Group0–4 yr5–9 yr10–16 yr0–16 yr
    Baseline cohort
        ♂10112041
        ♀772034
        Total (No.)17184075
    Follow-up cohort
        ♂17172155
        ♀893249
        Total (No.)252653104
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    Table 2:

    Interpretation of the subjective image-quality scores for the individual, prelabeled CT image slices at the level of the vocal cords

    ScoreComment
    1Image quality very poor (significant noise and/or artifacts, study uninterpretable)
    2Image quality poor (noise and/or artifacts, can only answer broad clinical questions)
    3Image quality adequate (some noise and/or artifacts, but study interpretable)
    4Above-average image quality (minimal noise and/or artifacts)
    5Excellent image quality (imperceptible noise and free of artifacts)
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    Table 3:

    Median values of the scan parameters, signal-to-noise ratio, image-quality scores, estimated effective dose, and the percentage difference for the 2 cohorts

    Parameter0–4 yr5–9 yr10–16 yr
    III% DiffIII% DiffIII% Diff
    Tube current (mAs)150128−15182162−11266165−38
    CTDIvol (mGy)7.44.4−418.65.5−36207−67
    Scan length (cm)17.617.8120.321526271
    DLP (mGy-cm)12577−38175132−24522240−54
    ED (mSv)2.11.2−402.21.7−219.74.4−55
    SNR16.413.4−1813.416.32220.216.2−20
    IQ3.674.0094.004.0004.334.00−8
    • Note:—IQ indicates image quality; ED, effective dose; Diff, difference; I, baseline; II, follow-up.

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Cite this article
S.V. Tipnis, W.J. Rieter, D. Patel, S.T. Stalcup, M.G. Matheus, M.V. Spampinato
Radiation Dose and Image Quality in Pediatric Neck CT
American Journal of Neuroradiology May 2019, DOI: 10.3174/ajnr.A6073

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Radiation Dose and Image Quality in Pediatric Neck CT
S.V. Tipnis, W.J. Rieter, D. Patel, S.T. Stalcup, M.G. Matheus, M.V. Spampinato
American Journal of Neuroradiology May 2019, DOI: 10.3174/ajnr.A6073
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