Comparison of radiation exposure from dual- and single-energy CT imaging protocols resulting in equivalent contrast-to-noise ratio of lesions for adults and children: a phantom study.

Objectives: 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.

Materials And Methods: 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.

Results: 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.

Conclusion: 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.

Key Points: 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.