AJDRAJNR - American Journal of Neuroradiology

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BRAIN

Comparison of Image Quality Between Conventional and Low-Dose Nonenhanced Head CT

Mark E. Mullinsa, Michael H. Leva, Peter Bovee, Cara E. O’Reillya, Sanjay Sainib, James T. Rhead, James H. Thralla, George J. Huntera, Leena M. Hamberga and R. Gilberto Gonzaleza

a Neuroradiology Division, Massachusetts General Hospital and the Harvard Medical School, Boston, MA
b Abdominal Imaging Division, Massachusetts General Hospital and the Harvard Medical School, Boston, MA
c Emergency Radiology Division, Massachusetts General Hospital and the Harvard Medical School, Boston, MA
d Office of the Chairman, Massachusetts General Hospital and the Harvard Medical School, Boston, MA
e Center for Diagnostic Imaging, Orlando, FL

Address reprint requests to Dr Lev, Neuroradiology Division GRB285, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114

BACKGROUND AND PURPOSE: Increasing use of CT for evaluating neurologic disease may expose patients to considerable levels of ionizing radiation. We compared the image quality of low-mAs head CT scans with that of conventional nonenhanced scans.

METHODS: Conventional head CT scans were obtained in 20 patients (all >65 years with history of non-CNS malignancy) by using a multidetector technique: 170 mA and 1-second scanning time (ie, 170 mAs), 140 kVp, table speed of 7.5 mm per rotation, pitch of 0.75, section thickness of 5 mm, and field of view of 25 mm. A limited volume helical data acquisition covering four 5-mm-thick images was obtained by using 90 mAs but otherwise the same parameters. Three neuroradiologists visually rated the resulting images for quality in a blinded comparison. Representative 1- to 4-mm2 regions of interest were chosen in gray matter and white matter locations. Conspicuity and the contrast-to-noise ratio were analyzed. Statistical comparisons were done by using the Student t test.

RESULTS: Mean gray matter conspicuity was not significantly different between the 170- and 90-mAs groups (0.39 ± 0.19 vs 0.41 ± 0.03, P = .32). Mean gray matter contrast-to-noise ratio was approximately 22% higher with 170 mAs than with 90 mAs (1.77 ± 0.52 vs 1.39 ± 0.38, P = .005). All 90-mAs images were rated as having slightly greater image noise than the 170-mAs scans but with sufficient perceived resolution.

CONCLUSION: Although 90-mAs head CT images were moderately noisier than 170-mAs images, they were rated as having acceptable diagnostic quality.