Low Radiation Dose Implications in Obese Abdominal Computed Tomography Imaging

The aim of this study was to evaluate the implications of low radiation dose in abdominal computed tomography (CT) when combined with noise reduction filters and to see if this approach can overcome the challenges that arise while scanning obese patients. Anthropomorphic phantoms layered with and without 3-cm-thick circumferential animal fat packs to simulate different sized patients were scanned using a 128-slice multidetector CT (MDCT) scanner. Abdominal protocols (n = 12) were applied using various tube currents (150, 200, 250, and 300 mA) and tube voltages (100, 120, and 140 kVp). MOSFET dosimeters measured the internal organ dose. All images were reconstructed with filtered back projection (FBP) and different iterative reconstruction (IR) strengths (SAFIRE 3, SAFIRE 4, and SAFIRE 5) techniques and objective noise was measured within three regions of interests (ROIs) at the level of L4–L5. Organ doses varied from 0.34–56.2 mGy; the colon received the highest doses for both phantom sizes. Compared to the normal-weighted phantom, the obese phantom was associated with an approximately 20% decrease in effective dose. The 100 kVp procedure resulted in a 40% lower effective dose (p < 0.05) compared to at 120 kVp and the associated noise increase was improved by increasing the IR (5) use, which resulted in a 60% noise reduction compared to when using FBP (p < 0.05). When combined with iterative reconstruction, the low-kVp approach is feasible for obese patients in order to optimize radiation dose and maintain objective image quality.