Comparison of effective doses for low-dose MDCT and radiographic examination of sinuses in children.

Abstract

Our objective was to show that in low-dose MDCT of the sinuses in children the effective dose can be lowered to a level comparable to that used for standard radiographic images, with resultant CT scans that are still of diagnostic image quality. In standard radiographic examinations of sinuses (anteroposterior and lateral views) with 75 kV, 20 mAs, and 3-mm aluminum filtration in 69 children (mean age, 4.2 years), the dose-area-product (DAP; mGy x cm2) was measured and converted to effective dose (mSv) according to coefficients published by the British National Radiological Protection Board. Another group of 125 children (mean age, 6.8 years) underwent low-dose MDCT of the sinuses with 6- or 16-MDCT in two phases and with different scanning protocols. An effective dose for MDCT was calculated from conversion of the dose-length-product (DLP, mGy xm) according to age. The mean effective dose (E) for standard radiography was 0.0528 mSv. The mean E value for low-dose MDCT was 0.096 mSv in the first phase of the study but could be lowered in the second phase to 0.0531 mSv by a combination of higher pitch and faster scan rotation time in our scan protocols, which results in diagnostic image quality at a very low dose. Statistical analysis showed no significant differences in effective dose between radiography and MDCT of the second phase. With modern MDCT technology, low-dose CT of the sinuses in children can yield diagnostic image quality using an effective dose comparable to that used for standard radiography.