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AJNR - American Journal of Neuroradiology

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Low-Dose Nonenhanced Head CT Protocol for Follow-Up Evaluation of Children with Ventriculoperitoneal Shunt: Reduction of Radiation and Effect on Image Quality

U.K. Udayasankar^a, K. Braithwaite^b, M. Arvaniti^b, D. Tudorascu^a, W.C. Small^a, S. Little^b and S. Palasis^b

^a Emory University Hospital, Atlanta, Ga
^b Children's Healthcare of Atlanta at Scottish Rite, Atlanta, Ga

View larger version (77K): [in this window] [in a new window]   Fig 1. Diagnostic acceptability of low-dose CT studies. Standard-dose (A) and low-dose (B) head CT studies were obtained in a 16-year-old male adolescent at an interval of 8 months and were rated as good (grade 4) by both readers.

View larger version (75K): [in this window] [in a new window]   Fig 2. A,B, Attenuation characteristics of standard-dose and low-dose head CT studies in a 7-year-old girl with a shunt for hydrocephalus. (A) Transverse standard-dose supraventricular CT image with sample ROIs (white circles) showed GM and WM attenuations of 31.6 HU and 25.6 HU, respectively, with noise (SD, HU within ROI) levels of 1.6 HU and 1.8 HU. Low-dose image (B) showed no significant change in attenuation (30.6 HU and 26.8 HU) despite increased noise levels (4.3 HU and 2.8 HU). CNR of standard-dose CT (1.88) was significantly higher (P < .01) than that of low-dose CT (0.47). However, both readers ranked standard-dose (grade 4) and low-dose (grade 3) studies as diagnostically acceptable.