Tube current modulation allows (i) a mAs setting to automatically adapt to patient size (adult vs pediatric), (ii) full mAs variation over the patient’s long axis, and (iii) real-time modulation during tube rotation. This allows several benefits, including same scan protocols for slim/obese patients, optimal diagnostic image quality in every slice, and images achieved at the lowest dose levels. Optimization of x-ray spectra automatically adjusts for the tube voltage to be tailored to the individual patient size (as low as 70kv for children), the system capabilities, and the clinical task desired. X-ray beam collimation is a technology based on precise, fast and independent movement of both collimator blades, which limits over-ranging and only irradiates the targeted tissues of clinical interest. The most recent improvements in iterative reconstruction include the advanced modeled iterative reconstruction (ADMIRE). The benefits of ADMIRE are (i) exceptionally low radiation levels, providing enhanced image quality with a natural image impression at doses that weren’t possible in the past, (ii) excellent image quality, offering great delineation and sharpness of the organs and structures of interest, and (iii) everyday suitability, allowing image availability immediately after the examination is complete.
Dr. Fung concludes with hypothesizing that the dose reduction seen in 2007 (mean 7.4 mSv/scan) should continue to drop precipitously, with an estimated 40% further dose reduction based on the aforementioned technological advances.
Speaker(s): George Fung, Siemens AG, Pittsburgh, PA, USA
Written by: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre, Twitter: @zklaassen_md, at the AUA Quality Improvement Summit - October 21, 2017- Linthicum, Maryland