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Current Directions in Biomedical Engineering

Joint Journal of the German Society for Biomedical Engineering in VDE and the Austrian and Swiss Societies for Biomedical Engineering

Editor-in-Chief: Dössel, Olaf

Editorial Board: Augat, Peter / Buzug, Thorsten M. / Haueisen, Jens / Jockenhoevel, Stefan / Knaup-Gregori, Petra / Kraft, Marc / Lenarz, Thomas / Leonhardt, Steffen / Malberg, Hagen / Penzel, Thomas / Plank, Gernot / Radermacher, Klaus M. / Schkommodau, Erik / Stieglitz, Thomas / Urban, Gerald A.


CiteScore 2018: 0.47

Source Normalized Impact per Paper (SNIP) 2018: 0.377

Open Access
Online
ISSN
2364-5504
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Optimizing a perfusion CT protocol for head and neck cancer

Anja Stüssi
  • Corresponding author
  • Department of Radiation Oncology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
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/ Marta Bogowicz
  • Department of Radiation Oncology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
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/ Verena Weichselbaumer
  • Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
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/ Patrick Veit-Haibach
  • Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
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/ Oliver Riesterer
  • Department of Radiation Oncology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
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/ Matthias Guckenberger
  • Department of Radiation Oncology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
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/ Stephanie Tanadini-Lang
  • Department of Radiation Oncology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
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Published Online: 2017-09-07 | DOI: https://doi.org/10.1515/cdbme-2017-0123

Abstract

Perfusion computed tomography (CTP) images tumor angiogenesis and can assess tumor aggressiveness. However, the CTP examinations are dose intensive. This study aimed to optimize a routinely used CTP protocol for the head and neck region in oncology in order to reduce the effective dose to the patient and simultaneously achieve the same image quality.

The Alderson phantom was scanned on a GE Revolution CT scanner. A scan with our standard protocol for head and neck cancer patients was used (100kV, 80mAs, 5mm slice thickness and backprojection algorithm) and in seven predefined regions (ROI) the signal to noise ratio (SNR) was measured. For the dose optimized protocol, the tube voltage was lowered and the mAs adaptation protocol was used. To improve image quality different percentage of an adaptive statistical iterative reconstruction (ASiR) was applied. For a better resolution we set the slice thickness to 2.5 mm. The mAs adaption range and the percentage of the ASiR reconstruction were varied until we found a combination with the same median SNR in the seven defined ROIs as for our old protocol. For the old and the optimized protocol dose measurements were performed using 25 LiF-TLDs. Organ doses were calculated and the effective dose was determined based on the weighting factors of ICRP103.

The optimized scanning protocol used a voltage of 80kV, a mAs range between 15 and 80, a noise level of 10%, and 50% ASiR reconstruction. The median SNR ratio was slightly better (14% better SNR) with the new protocol. An effective dose of 8 mSv was measured with the original protocol and 4 mSv with the optimized scanning protocol. For organs in the scanning field the dose was reduced by a factor of 2 and outside the field by a factor of 2.2.

Advanced reconstruction algorithms allow a significant dose reduction and an improvement of image resolution, while maintaining the image quality.

Keywords: Perfusion CT imaging; head and neck cancer; effective dose

About the article

#AS and MB contributed equally


Published Online: 2017-09-07


Citation Information: Current Directions in Biomedical Engineering, Volume 3, Issue 2, Pages 591–594, ISSN (Online) 2364-5504, DOI: https://doi.org/10.1515/cdbme-2017-0123.

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©2017 Anja Stüssi et al., published by De Gruyter. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License. BY-NC-ND 4.0

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