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Do Metallic Endoprostheses Increase Radiation Dose Associated with Automatic Tube-Current Modulation in Abdominal–Pelvic MDCT? A Phantom and Patient Study

Stefania M. R. Rizzo1, Mannudeep K. Kalra1, Michael M. Maher1, Michael A. Blake1, Thomas L. Toth2 and Sanjay Saini1

1 Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, White 270-E, 55 Fruit St., Boston, MA 02114.
2 GE Healthcare, Waukesha, WI.



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  		Fig. 1A. —Z-modulation technique caused an increase in tube current for CT of phantom with metallic prosthesis, compared with scanning of phantom without prosthesis, with no reduction in artifacts compared with fixed-tube-current scanning. Transverse CT image, acquired with z-modulation (113 mA, 0.5-sec rotation time), of water phantom shows no streak artifacts.

 


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  		Fig. 1B. —Z-modulation technique caused an increase in tube current for CT of phantom with metallic prosthesis, compared with scanning of phantom without prosthesis, with no reduction in artifacts compared with fixed-tube-current scanning. Transverse CT image, acquired with fixed-tube-current scanning (240 mAs, 0.5-sec rotation time), of phantom with metallic prosthesis shows streak artifacts.

 


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  		Fig. 1C. —Z-modulation technique caused an increase in tube current for CT of phantom with metallic prosthesis, compared with scanning of phantom without prosthesis, with no reduction in artifacts compared with fixed-tube-current scanning. Transverse CT image of phantom, acquired with z-modulation (274 mAs, 0.5-sec rotation time), with metallic prosthesis shows streak artifacts.

 


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  		Fig. 2. —Line graph diagram shows tube current used for scanning phantom with and without prosthesis using z-modulation (• [solid dot] and {square} [open box], respectively), compared with fixed-tube-current scanning (x). Tube current is increased when phantom with prosthesis is scanned using z-modulation technique.

 


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  		Fig. 3A. —Z-modulation technique caused an increase in tube current for CT of patient with metallic endoprosthesis, compared with fixed-tube-current scanning of same patient and z-modulation technique in a different patient without metallic prostheses. Transverse CT image, acquired with z-modulation (299 mA, 0.5-sec rotation time), of 64-year-old woman with pancreatic cancer shows streak artifacts due to left hip endoprosthesis.

 


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  		Fig. 3B. —Z-modulation technique caused an increase in tube current for CT of patient with metallic endoprosthesis, compared with fixed-tube-current scanning of same patient and z-modulation technique in a different patient without metallic prostheses. Transverse CT image, acquired with fixed-tube-current scanning (240 mA, 0.5-sec rotation time), of same patient as in A shows similar streak artifacts.

 


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  		Fig. 3C. —Z-modulation technique caused an increase in tube current for CT of patient with metallic endoprosthesis, compared with fixed-tube-current scanning of same patient and z-modulation technique in a different patient without metallic prostheses. Transverse CT image, acquired with z-modulation (93 mA, 0.5-sec rotation time), of 60-year-old woman with gastric cancer and no metallic prosthesis shows no streak artifacts.

 

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