Reduced Kilovoltage in Computed Tomography–Guided Intervention in a Community Hospital: Effect on the Radiation Dose

• Published in: Canadian Association of Radiologists journal 2014-11, Vol.65 (4), p.345-351
• Main Authors: Rezazadeh, Saman, MD, PhD, Co, Steven J., MD, Bicknell, Simon, MD, FRCPC
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Comparative analysis; Computed tomography; Computed tomography technique; Female; Hospitals; Humans; Intervention; Interventional Radiology; Male; Middle Aged; Radiation; Radiation Dosage; Radiation dose reduction; Radiation Protection - methods; Radiography, Interventional - instrumentation; Radiography, Interventional - methods; Radiology; Retrospective Studies; Tomography; Tomography, X-Ray Computed - instrumentation; Tomography, X-Ray Computed - methods
• ISSN: 0846-5371; 1488-2361
• DOI: 10.1016/j.carj.2014.04.002

Abstract Purpose The purpose of this study was to determine whether low-kilovoltage (80 or 100 kV) computed tomography (CT)-guided interventions performed in a community-based hospital are feasible and to compare radiation exposure incurred with conventional 120 kV potential. Materials and Methods Effective doses (ED) received by patients who underwent CT-guided intervention were analysed before and after a low-dose kilovoltage protocol was instituted in our department. We performed CT-guided procedures of 93 consecutive patients by using conventional 120-kV tube voltage (50 patients) and a low voltage of 80 or 100 kV for the remainder of this cohort. Automatic tube current modulation was enabled to obtain the best image quality. Procedure details were prospectively recorded and included examination site and type, slice width, tube voltage and current, dose length product, volume CT dose index, and size-specific dose estimate. Dose length product was converted to ED to account for radiosensitivity of specific organs. Statistical comparisons with test differences in the ED, volume CT dose index, size-specific dose estimate, and effective diameter (patient size) were made by using the Student t test. Results All but 6 of the procedures performed at 80 kV were successful, for a success rate of 86%. At lower voltages, the ED was significantly ( P < .01) reduced, on average, by 57%, 73%, and 65% for the pelvic, chest, and abdomen procedures, respectively. Conclusion A low-dose radiation technique by using 80 or 100 kV results in a high technical success rate for pelvic, chest, and abdomen CT-guided interventional procedures, although dramatically decreasing radiation exposure. There was no significant difference in effective diameter (patient size) between the conventional and the low-dose groups, which would suggest that dose reduction was indeed a result of kVp change and not patient size.