Reducing Radiation Exposure from Survey CT Scans

Abstract

OBJECTIVE. The purpose of this study was to focus attention on the technique factors commonly used in survey CT scans (e.g., scout, topogram, or pilot scans) to measure the radiation exposure from typical survey CT scans, to compare their exposure to that of typical chest radiographs, and to explore methods for radiation exposure reduction. MATERIALS AND METHODS. The default survey CT scans on 21 CT scanners, representing three different vendors and 11 different models, were investigated. Exposure measurements were obtained with an ion chamber at isocenter and adjusted to be consistent with standard chest radiographic exposure measurement methods (single posterior–anterior projection). These entrance exposures were compared with those of typical chest radiographs, for which the mean for average-sized adults is 16 mR (4.1 × 10^–6 C/kg). RESULTS. The entrance exposures of the default survey CT scans ranged from 3.2 to 74.7 mR (0.8 to 19.3 × 10^–6 C/kg), which is equivalent to approximately 0.2 to 4.7 chest radiographs. By changing the default scan parameters from 120 kVp to 80 kVp and the tube position from 0° (tube above table) to 180° (tube below table), the entrance exposure for the survey CT scan was reduced to less than that of one chest radiograph for all CT scanners. CONCLUSION. For institutions at which the interpreting radiologists do not rely heavily on the appearance of the survey CT image, we recommend adjusting the technique parameters (kilovoltage and X-ray tube position) to decrease radiation exposure, especially for vulnerable patient populations such as children and young women.