Optimal tube potential for radiation dose reduction in pediatric CT: principles, clinical implementations, and pitfalls

In addition to existing strategies for reducing radiation dose in computed tomographic (CT) examinations, such as the use of automatic exposure control, use of the optimal tube potential also may help improve image quality or reduce radiation dose in pediatric CT examinations. The main benefit of the use of a lower tube potential is that it provides improved contrast enhancement, a characteristic that may compensate for the increase in noise that often occurs at lower tube potentials and that may allow radiation dose to be substantially reduced. However, selecting an appropriate tube potential and determining how much to reduce radiation dose depend on the patient's size and the diagnostic task being performed. The power limits of the CT scanner and the desired scanning speed also must be considered. The use of a lower tube potential and the amount by which to reduce radiation dose must be carefully evaluated for each type of examination to achieve an optimal tradeoff between contrast, noise, artifacts, and scanning speed.