Design and use of a phantom for testing and comparing the performance of computed tomography automatic tube current modulation systems.

Automatic tube current modulation (ATCM) is now available on all computed tomography (CT) scanners, but there is no standard phantom for testing its operation. For this study, a phantom comprising five elliptical sections of varying diameters in the shape of a pagoda has been made to represent the range of sizes for patients in Thailand and the Far East. ATCM performance can be evaluated in terms of how tube current and image noise vary with changes in the sizes of the sections. Additional rods of different materials with similar properties to human tissues have been inserted to allow the measurement of contrast-to-noise ratios (CNRs) for assessment of image quality. The phantom has been used to test and compare the performance of CT ATCM systems for the major four CT scanner vendors. The results showed that the ATCM systems of Toshiba and GE CT scanners maintained image noise and CNR within narrower ranges by varying tube current aggressively along the scan length, and commencing modulation before the high attenuation sections are reached. In contrast, the ATCM systems of Philips and Siemens scanners adjusted the tube current within narrower ranges, allowed larger variations in image noise and CNR, and commenced modulation at the start of sections with higher attenuation. The phantom can be used to confirm functionality of the system for acceptance testing, as well as providing information on the tradeoff between radiation dose and image quality when setting up clinical protocols during commissioning of new CT scanners. The phantom can also be used on a routine basis to check that performance is maintained, and could be used in the future for selecting protocol settings to give required values of CNR or adjusting protocol settings on different CT scanners to provide similar levels of clinical performance.