%0 Journal Article
%A Baader, Edith
%A Kachelriess, Marc
%T Risk-minimizing tube current and tube voltage modulation for CT: A simulation study.
%J Medical physics
%V 52
%N 8
%@ 0094-2405
%C Hoboken, NJ
%I Wiley
%M DKFZ-2025-01850
%P e18047
%D 2025
%Z #EA:E025#LA:E025#
%X The optimal tube voltage in clinical CT depends on the patient's attenuation and the imaging task. Although the patient's attenuation changes with view angle and longitudinal position of the X-ray tube, the tube voltage remains constant throughout the scan in current clinical practice. In general, the optimum tube voltage increases with patient diameter. For iodine-enhanced scans, the tube voltage is ideally low to increase contrast. However, 70 kV, the lowest clinically available tube voltage today, can not always be used due to tube current restrictions.To determine the additional relative reduction in effective dose of a tube voltage modulation in addition to a tube current modulation for unenhanced and iodine-enhanced CT scans.For patient models based on CT scans, the effective dose was simulated per projection for different voltages using Monte Carlo simulations. Using these dose data and analytical estimations of noise and iodine contrast, tube voltage and tube current curves were optimized for circular scans. For unenhanced scans, the dose-weighted noise was minimized, and for iodine-enhanced scans, the dose-weighted contrast-to-noise ratio (CNRD) was maximized. The effective dose values of the optimized tube voltage and tube current curves (riskTCTVM) were compared at the same noise or same contrast-to-noise ratio (CNR) to a pure tube current modulation minimizing the effective dose (riskTCM) and to conventional mAs-minimizing tube current modulation (mAsTCM).For unenhanced scans, riskTCTVM reduces the effective dose by less than 1 
%K Tomography, X-Ray Computed: instrumentation
%K Tomography, X-Ray Computed: methods
%K Tomography, X-Ray Computed: adverse effects
%K Radiation Dosage
%K Humans
%K Monte Carlo Method
%K Signal-To-Noise Ratio
%K Risk
%K computed tomography (Other)
%K radiation risk (Other)
%K tube current modulation (Other)
%K tube voltage modulation (Other)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:40903921
%R 10.1002/mp.18047
%U https://inrepo02.dkfz.de/record/304437