Chest-abdomen-pelvis CT for staging in cancer patients : dose effectiveness and image quality using automated attenuation-based tube potential selection

  • Background: Evaluation of automated attenuation-based tube potential selection and its impact on image quality and radiation dose in CT (computed tomography) examinations for cancer staging. Methods: A total of 110 (59 men, 51 women) patients underwent chest-abdomen-pelvis CT examinations; 55 using a fixed tube potential of 120 kV/current of 210 Reference mAs (using CareDose4D), and 55 using automated attenuation-based tube potential selection (CAREkV) also using a current of 210 Reference mAs. This evaluation was performed as a single-centre, observer-blinded retrospective analysis. Image quality was assessed by two readers in consensus. Attenuation, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured or calculated for objective image evaluation. For the evaluation of radiation exposure, dose-length-product (DLP) values were compared and Size-specific dose estimates (SSDE) values were calculated. Results: Diagnostic image quality was obtained from all patients. The median DLP (703.5 mGy · cm, range 390–2203 mGy · cm) was 7.9% lower when using the algorithm compared with the standard 120 kV protocol (median 756 mGy · cm, range 345–2267 mGy · cm). A reduction in potential to 100 kV occurred in 32 cases; therefore, these patients received significantly lower radiation exposure compared with the 120 kV protocol. Conclusion: Automated attenuation-based tube potential selection produces good diagnostic image quality in chest-abdomen-pelvis CT and reduces the patient’s overall radiation dose by 7.9% compared to the standard 120 kV protocol.

Download full text files

Export metadata

Additional Services

Share in Twitter Search Google Scholar
Author:Martin BeeresGND, Marcus Römer, Boris BodelleORCiDGND, Clara Lee, Tatjana Gruber-RouhORCiDGND, Emmanuel Mbalisike, Josef M. Kerl, Julian WichmannORCiDGND, Boris Schulz, Thomas J. VoglORCiDGND, Ralf W. Bauer
Parent Title (English):Cancer imaging
Publisher:BioMed Central
Place of publication:London
Document Type:Article
Date of Publication (online):2014/09/02
Date of first Publication:2014/09/02
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2014/11/04
Tag:Cancer; Cancer staging; Multidetector computed tomography; Neoplasms
Page Number:8
© 2014 Beeres et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0