Limiting CT radiation dose in children with craniosynostosis: phantom study using model-based iterative reconstruction

Pediatr Radiol. 2015 Sep;45(10):1544-53. doi: 10.1007/s00247-015-3348-2. Epub 2015 May 5.


Background: Medical professionals need to exercise particular caution when developing CT scanning protocols for children who require multiple CT studies, such as those with craniosynostosis.

Objective: To evaluate the utility of ultra-low-dose CT protocols with model-based iterative reconstruction techniques for craniosynostosis imaging.

Materials and methods: We scanned two pediatric anthropomorphic phantoms with a 64-slice CT scanner using different low-dose protocols for craniosynostosis. We measured organ doses in the head region with metal-oxide-semiconductor field-effect transistor (MOSFET) dosimeters. Numerical simulations served to estimate organ and effective doses. We objectively and subjectively evaluated the quality of images produced by adaptive statistical iterative reconstruction (ASiR) 30%, ASiR 50% and Veo (all by GE Healthcare, Waukesha, WI). Image noise and contrast were determined for different tissues.

Results: Mean organ dose with the newborn phantom was decreased up to 83% compared to the routine protocol when using ultra-low-dose scanning settings. Similarly, for the 5-year phantom the greatest radiation dose reduction was 88%. The numerical simulations supported the findings with MOSFET measurements. The image quality remained adequate with Veo reconstruction, even at the lowest dose level.

Conclusion: Craniosynostosis CT with model-based iterative reconstruction could be performed with a 20-μSv effective dose, corresponding to the radiation exposure of plain skull radiography, without compromising required image quality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Artifacts
  • Child, Preschool
  • Craniosynostoses / diagnostic imaging*
  • Humans
  • Infant, Newborn
  • Phantoms, Imaging*
  • Radiation Dosage*
  • Radiographic Image Interpretation, Computer-Assisted / methods*
  • Signal-To-Noise Ratio
  • Tomography, X-Ray Computed / methods*