Ntoufas Nikos, Raissaki Maria, Damilakis John, Perisinakis Kostas
University of Crete, Medical School, Department of Medical Physics, 71003, Heraklion, Crete, Greece.
University of Crete, Medical School, Department of Radiology, 71003, Heraklion, Crete, Greece.
Eur Radiol. 2025 Jun;35(6):3528-3537. doi: 10.1007/s00330-024-11273-7. Epub 2024 Dec 18.
To compare the radiation exposure from single-energy CT (SECT) against rapid kV-switching dual-energy CT (DECT) imaging in both adults and children when resulting image data offer equivalent lesion identification power.
Lesions in an adult and a 10-year-old-child body phantom were imitated using iodine solutions of different concentrations. Phantoms were subjected to several SECT and DECT thoracic and abdominal scans using a rapid kV-switching DECT scanner. The contrast-to-noise ratio (CNR) of each lesion was measured on resulting SECT images and virtual monoenergetic images (VMI) available from DECT. The SECT scans that resulted in CNR values similar to the maximum CNR observed in VMIs derived from corresponding DECT scans were identified. SECT and DECT scans with equivalent lesion-discriminating power were compared regarding the associated radiation dose burden. Doses to the lung, breast, and esophagus from thoracic imaging and doses to the liver, kidneys, and stomach from abdominal imaging were determined through Monte Carlo simulations of SECT and DECT exposures.
Compared to SECT imaging of the adult body phantom, organ doses from DECT were found to be 5-11% lower in thoracic imaging and 44-45% lower in abdominal imaging. Compared to SECT imaging of the 10-year-old body phantom, organ doses from DECT were found to be 2.8-3.4 times higher in thoracic imaging and 1.5-1.6 times higher in abdominal imaging.
The use of rapid kV-switching DECT instead of SECT imaging may be associated with a similar or lower dose burden in adults but a noticeably higher dose burden in children.
Question How does the radiation exposure from single-energy and dual-energy CT imaging compare when both techniques provide equivalent lesion identification power? Findings Rapid kV-switching dual-energy CT compared to single-energy CT may result in a similar or lower radiation dose in adults, but higher radiation dose in children. Clinical relevance Rapid kV-switching dual-energy CT imaging in children should be preferred over single-energy CT imaging only in cases where the additional information provided is crucial for an effective diagnosis.
比较单能量CT（SECT）与快速千伏切换双能量CT（DECT）成像在成人和儿童中的辐射暴露情况，前提是所得图像数据具有同等的病变识别能力。
使用不同浓度的碘溶液模拟成人和10岁儿童体模中的病变。使用快速千伏切换DECT扫描仪对体模进行多次SECT以及DECT胸部和腹部扫描。在所得的SECT图像和DECT提供的虚拟单能量图像（VMI）上测量每个病变的对比噪声比（CNR）。识别出导致CNR值与相应DECT扫描的VMI中观察到的最大CNR相似的SECT扫描。比较具有同等病变鉴别能力的SECT和DECT扫描的相关辐射剂量负担。通过对SECT和DECT曝光的蒙特卡罗模拟确定胸部成像对肺、乳腺和食管的剂量以及腹部成像对肝脏、肾脏和胃的剂量。
与成人身体体模的SECT成像相比，发现DECT的胸部成像器官剂量低5 - 11%，腹部成像低44 - 45%。与10岁身体体模的SECT成像相比，发现DECT的胸部成像器官剂量高2.8 - 3.4倍，腹部成像高1.5 - 1.6倍。
使用快速千伏切换DECT而非SECT成像在成人中可能具有相似或更低的剂量负担，但在儿童中剂量负担明显更高。
问题 当两种技术提供同等的病变识别能力时，单能量和双能量CT成像产生的辐射暴露情况如何比较？ 发现 与单能量CT相比，快速千伏切换双能量CT在成人中可能导致相似或更低的辐射剂量，但在儿童中辐射剂量更高。 临床意义 仅在提供的额外信息对有效诊断至关重要的情况下，儿童才应优先选择快速千伏切换双能量CT成像而非单能量CT成像。
