Investigation of the influence of image reconstruction filter and scan parameters on operation of automatic tube current modulation systems for different CT scanners.

Variation in the user selected CT scanning parameters under automatic tube current modulation (ATCM) between hospitals has a substantial influence on the radiation doses and image quality for patients. The aim of this study was to investigate the effect of changing image reconstruction filter and scan parameter settings on tube current, dose and image quality for various CT scanners operating under ATCM. The scan parameters varied were pitch factor, rotation time, collimator configuration, kVp, image thickness and image filter convolution (FC) used for reconstruction. The Toshiba scanner varies the tube current to achieve a set target noise. Changes in the FC setting and image thickness for the first reconstruction were the major factors affecting patient dose. A two-step change in FC from smoother to sharper filters doubles the dose, but is counterbalanced by an improvement in spatial resolution. In contrast, Philips and Siemens scanners maintained tube current values similar to those for a reference image and patient, and the tube current only varied slightly for changes in individual CT scan parameters. The selection of a sharp filter increased the image noise, while use of iDose iterative reconstruction reduced the noise. Since the principles used by CT manufacturers for ATCM vary, it is important that parameters which affect patient dose and image quality for each scanner are made clear to operator to aid in optimisation.