ArticleDiagnostics (Basel, Switzerland)2024
Optimizing Radiation Dose and Image Quality in Stroke CT Protocols: Proposed Diagnostic Reference Levels for Multiphase CT Angiography and Perfusion Imaging.
Article in Diagnostics (Basel, Switzerland), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Letter to the Editor: Cerebral CT perfusion dose: diagnostic reference levels should stimulate, not replace, optimization.Insights into imaging · 2026Article
- Real-world data on the impact of dose reduction measures on radiation exposure in CT perfusion of the brain.European journal of radiology open · 2026Article
- Balancing Radiation Dose and Image Quality: Protocol Optimization for Mobile Head CT in Neurointensive Care Unit Patients.Diagnostics (Basel, Switzerland) · 2026Article
- Optimization of Bolus-Tracking Thresholds levels in Cerebral CT Angiography: Influence of Patient Characteristics on contrast enhancement dynamics and radiation dose metrics.F1000Research · 2025Article
- Prognostic value of CT contrast staining after endovascular therapy in basilar artery occlusion stroke.Frontiers in neurologyArticle
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Authors and funding
9 authors.
Funding
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Abstract
objectiveIn suspected acute ischemic stroke, it is now reasonable to expand the conventional "stroke protocol" (non-contrast computed tomography (NCCT), arterial CT angiography (CTA), and optionally CT perfusion (CTP)) to early and late venous head scans yielding a multiphase CTA (MP-CTA) to increase diagnostic confidence. Diagnostic reference levels (DRLs) have been defined for neither MP-CTA nor CTP. We therefore present dosimetry data, while also considering image quality, for a large, unselected patient cohort.
methodsA retrospective single-center study of 1790 patients undergoing the extended stroke protocol with three scanners (2× dual-source, DSCT; 1× single-source, SSCT) between 07/21 and 12/23 was conducted. For each sequence, we analyzed the radiation dose (volumetric CT dose index (CTDIvol); dose length product; effective dose); objective image quality using manually placed regions of interest (contrast-to-noise ratio (CNR)); and subjective image quality (4-point scale: 1 = non-diagnostic, 4 = excellent). The DRL was defined as the 75% percentile of the CTDIvol distribution. The Kruskal-Wallis test was used initially to test for overall equality of median values in each data group. Single post-test comparisons were performed with Dunn's test, with an overall statistical significance level of 0.05.
resultsDosimetry values were significantly higher for SSCT (
conclusionsOur data imply that additive MP-CTA scans only yield a minor increase in radiation exposure, particularly when using DSCT. CTP should be limited to selected patients.
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