Comparison of 100-Kilovoltage Tin Filtration with Advanced Modeled Iterative Reconstruction Protocol to an Automated Kilovoltage Selection with Filtered Back Projection Protocol on Radiation Dose and Image Quality in Pediatric Noncontrast-Enhanced Chest Computed Tomography

Objective The aim of the study was to compare effects of a 100-kilovoltage (kVp) tin filtration (Sn100kVp) with Advanced Modeled Iterative Reconstruction (ADMIRE) protocol to an automated kVp selection and filtered back projection (FBP) protocol on radiation dose and image quality of in noncontrast-enhanced pediatric chest computed tomography (CT). Methods This retrospective study included 55 children (12 ± 6 years) undergoing baseline imaging using automated kVp selection with FBP on a second-generation dual-source CT scanner and follow-up CT using Sn100kVp with ADMIRE on a third-generation dual-source CT scanner. The volume CT dose index, dose length product, size-specific dose estimate, and milliamperage were compared. Image quality was calculated using signal-to-noise ratio and subjectively evaluated by 2 radiologists. Results Mean volume CT dose index, dose length product, and size-specific dose estimate were lower for the Sn100kVp protocol with ADMIRE (0.83 ± 0.18 mGy, 21.9 ± 7.5 mGy × cm, 1.28 ± 0.24 mGy) compared with the automated kVp protocol with FBP (2.17 ± 1.10 mGy, 65.1 ± 41.1 mGy × cm, 3.25 ± 1.44 mGy, P < 0.001), whereas milliamperage was and subjective image quality were higher for Sn100kVp (P < 0.001). Conclusions A Sn100kVp protocol with ADMIRE lowers dose while maintaining image quality in noncontrast-enhanced pediatric chest CT.