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Radiation Exposure and Image Quality in Chest CT Examinations

¹ All authors: Department of Radiology, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210.

View larger version (82K): [in a new window]   Fig. 1A. —Representative images of chest of 48-year-old woman printed using lung and mediastinum window and level settings. Images were obtained with patient in supine position at level of aortic arch. A-C, CT scans of chest obtained at 280 (A), 160 (B), and 40 (C) mAs.

View larger version (78K): [in a new window]   Fig. 1B. —Representative images of chest of 48-year-old woman printed using lung and mediastinum window and level settings. Images were obtained with patient in supine position at level of aortic arch. A-C, CT scans of chest obtained at 280 (A), 160 (B), and 40 (C) mAs.

View larger version (84K): [in a new window]   Fig. 1C. —Representative images of chest of 48-year-old woman printed using lung and mediastinum window and level settings. Images were obtained with patient in supine position at level of aortic arch. A-C, CT scans of chest obtained at 280 (A), 160 (B), and 40 (C) mAs.

View larger version (9K): [in a new window]   Fig. 2. —Average rank plotted as function of radiographic tube current (solid line) compared with theoretic expectation for ideal observer (dashed line). Error bars correspond to standard error at each value for five interpreters. For values equal to or greater than 160 mAs, observers have difficulty correlating image quality with milliampere-second setting, whereas for values of less than 160 mAs, observers can accurately correlate image quality with tube current.

View larger version (10K): [in a new window]   Fig. 3. —Average error rate plotted as function of radiographic tube current. Error bars correspond to standard error at each setting for five interpreters. For technique factors equal to or greater than 160 mAs, mean error is relatively constant, suggesting little difference in CT image quality. As technique is reduced below 160 mAs, mean error is monotonically reduced, indicating that interpreters see inferior images with increasing levels of mottle.

View larger version (9K): [in a new window]   Fig. 4. —Average score for image quality of specified image against quality of reference image obtained at 160 mAs. Error bars correspond to standard error at each setting for five interpreters. These data clearly show that increasing radiographic tube output (and patient dose) beyond 120 mAs is not justified by any corresponding benefit in terms of CT image quality.

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