Semin Musculoskelet Radiol 2018; 22(S 01): S1-S5
DOI: 10.1055/s-0038-1639517
Scientific Presentations and Posters
Georg Thieme Verlag KG Stuttgart · New York

Iterative Reconstructions and Tube Voltage Variation to Reduce Radiation Dose in CT Imaging of Spine Fractures

M.P. Brönnimann
1   Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
,
J.T. Heverhagen
1   Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
,
A. Huppertz
1   Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
,
F. Streitparth
3   Clinic and Policlinic for Radiology, University Hospitals Munich, Munich, Germany
,
C. Jackowski
2   Radiology Practice, Poliklinik Ernst von Bergmann GmbH, Potsdam, Germany
,
M.H. Maurer
1   Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
26 March 2018 (online)

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Purpose: To assess the possible extent of tube voltage reductions and the use of iterative reconstruction (IR) techniques with the aim of reducing the radiation dose in computed tomography (CT) imaging of the spine.

Methods and Materials: Nine human cadavers were repeatedly examined with a CT scan of the whole spine with stepwise tube voltage reductions from 140 kV to 70 kV and a constant tube current of 250 mA. For each different tube voltage, five IR levels (IR 1–5) were applied. Two blinded readers independently evaluated the CT data sets starting with the lowest tube voltage category and the highest level of IR. The tube voltage and the IR level at which spine factures could be detected were noted. The detected spine fractures were assigned according to Davis’s three-column model into stable and unstable fractures. The highest required level of kV and IR where both readers detected the different fractures was documented.

Results: In all nine cadavers, there were 37 fractures, 18 stable and 19 unstable. Overall, 100% of all fractures were detected at 80 kV and the highest IR level (IR-5). For a successful differentiation of all fractures (100%) between stable and unstable, 100 kV was needed and the lowest IR level (IR-1). An average dose reduction for detection of all fractures from 80% (80 kV and IR-5) and for differentiation of all fractures from 57% (100 kV and IR-1) is possible.

Conclusion: Significant tube voltage reductions in combination with IR methods still allow a sensitive detection of spine fractures and might be a possible way to reduce the radiation dose significantly in CT scans of the spine even in clinical practice.