The development of non-contrast CT brain techniques to reduce patient dose at Chaiyaphum Hospital

Abstract

 Introduction: While computed tomography (CT) scans are valuable tools for medical diagnosis, they expose patients to ionizing radiation. Chaiyaphum Hospital should implement advanced imaging techniques to minimize radiation dose and enhance diagnostic yield.

            Objectives: The primary objective of this study was to develop a new CT scanning protocol for non-contrast head CT to reduce radiation dose to patients and compare the radiation dose before and after the protocol modification.

            Methods: A retrospective study (Oct 2022-Sep 2023) and a prospective study (Aug-Sep 2023) were conducted on 130 patients. mAs values were adjusted between 300-400 to assess image quality (NI, SNR, CNR, HCSR, LCSR) and radiation dose. Independent t-tests were used for statistical analysis.  Results: Before protocol modification, the mean CTDI_vol was within the reference level (54.94 ± 2.35 mGy), but the mean DLP was higher than the reference level (1,065.17 ± 40.38 mGy.cm). Phantom studies showed that reducing mAs to 350 mAs resulted in a significant decrease in CTDI_vol to 47.39 ± 2.16 mGy and DLP to 933.15 ± 33.80 mGy.cm, while maintaining acceptable image quality. Comparison between before and after protocol modification revealed a significant decrease in CTDI_vol by 7.55 units (95% CI: 6.99, 8.10) and DLP by 132.02 units (95% CI: 122.93, 141.11).

            Conclusion: The modified CT protocol with reduced mAs for non-contrast head CT significantly reduced radiation dose to patients without compromising image quality. This study demonstrates the feasibility of implementing a low-dose CT protocol in a clinical setting and highlights the importance of ongoing efforts to optimize imaging protocols to minimize patient radiation exposure.