TY  - JOUR
AU  - Baader, Edith
AU  - Kachelriess, Marc
TI  - Risk-minimizing tube current and tube voltage modulation for CT: A simulation study.
JO  - Medical physics
VL  - 52
IS  - 8
SN  - 0094-2405
CY  - Hoboken, NJ
PB  - Wiley
M1  - DKFZ-2025-01850
SP  - e18047
PY  - 2025
N1  - #EA:E025#LA:E025#
AB  - 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 
KW  - Tomography, X-Ray Computed: instrumentation
KW  - Tomography, X-Ray Computed: methods
KW  - Tomography, X-Ray Computed: adverse effects
KW  - Radiation Dosage
KW  - Humans
KW  - Monte Carlo Method
KW  - Signal-To-Noise Ratio
KW  - Risk
KW  - computed tomography (Other)
KW  - radiation risk (Other)
KW  - tube current modulation (Other)
KW  - tube voltage modulation (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:40903921
DO  - DOI:10.1002/mp.18047
UR  - https://inrepo02.dkfz.de/record/304437
ER  -