Low-Dose CT of the Paranasal Sinuses: Minimizing X-Ray Exposure with Spectral Shaping

Eur Radiol. 2016 Nov;26(11):4155-4161. doi: 10.1007/s00330-016-4263-0. Epub 2016 Feb 24.


Objectives: Shaping the energy spectrum of the X-ray beam has been shown to be beneficial in low-dose CT. This study's aim was to investigate dose and image quality of tin filtration at 100 kV for pre-operative planning in low-dose paranasal CT imaging in a large patient cohort.

Methods: In a prospective trial, 129 patients were included. 64 patients were randomly assigned to the study protocol (100 kV with additional tin filtration, 150mAs, 192x0.6-mm slice collimation) and 65 patients to the standard low-dose protocol (100 kV, 50mAs, 128 × 0.6-mm slice collimation). To assess the image quality, subjective parameters were evaluated using a five-point scale. This scale was applied on overall image quality and contour delineation of critical anatomical structures.

Results: All scans were of diagnostic image quality. Bony structures were of good diagnostic image quality in both groups, soft tissues were of sufficient diagnostic image quality in the study group because of a high level of noise. Radiation exposure was very low in both groups, but significantly lower in the study group (CTDIvol 1.2 mGy vs. 4.4 mGy, p < 0.001).

Conclusions: Spectral optimization (tin filtration at 100 kV) allows for visualization of the paranasal sinus with sufficient image quality at a very low radiation exposure.

Key points: • Spectral optimization (tin filtration) is beneficial to low-dose parasinus CT • Tin filtration at 100 kV yields sufficient image quality for pre-operative planning • Diagnostic parasinus CT can be performed with an effective dose <0.05 mSv.

Keywords: CT; Low dose; Parasinus CT; Spectral shaping; Tin filtration.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / methods
  • Paranasal Sinuses / diagnostic imaging*
  • Phantoms, Imaging
  • Prospective Studies
  • Radiation Dosage
  • Radiation Protection / instrumentation
  • Sinusitis / diagnostic imaging*
  • X-Rays
  • Young Adult