Size-dependent scanning parameters (kVp and mAs) for photon-counting spectral CT system in pediatric imaging: simulation study.

We are developing a photon-counting spectral CT detector with a small pixel size of [Formula: see text] mm(2), offering a potential advantage for better visualization of small structures in pediatric patients. The purpose of this study is to determine the patient size dependent scanning parameters (kVp and mAs) for pediatric CT in two imaging cases: adipose imaging and iodinated blood imaging. Cylindrical soft-tissue phantoms of diameters between 10-25 cm were used to mimic patients of different ages from 0 to 15 y. For adipose imaging, a 5 mm diameter adipose sphere was assumed as an imaging target, while in the case of iodinated imaging, an iodinated blood sphere of 1 mm in diameter was assumed. By applying the geometry of a commercial CT scanner (GE Lightspeed VCT), simulations were carried out to calculate the detectability index, [Formula: see text], with tube potentials varying from 40 to 140 kVp. The optimal kVp for each phantom in each imaging case was determined such that the dose-normalized detectability index, [Formula: see text]dose, is maximized. With the assumption that the detectability index in pediatric imaging is required the same as in typical adult imaging, the value of mAs at optimal kVp for each phantom was selected to achieve a reference detectability index that was obtained by scanning an adult phantom (30 cm in diameter) in a typical adult CT procedure (120 kVp and 200 mAs) using a modeled energy-integrating system. For adipose imaging, the optimal kVps are 50, 60, 80, and 120 kVp, respectively, for phantoms of 10, 15, 20, and 25 cm in diameter. The corresponding mAs values required to achieve the reference detectability index are only 9%, 23%, 24%, and 54% of the mAs that is used for adult patients at 120 kVp, for 10, 15, 20, and 25 cm diameter phantoms, respectively. In the case of iodinated imaging, a tube potential of 60 kVp was found optimal for all phantoms investigated, and the mAs values required to achieve the reference detectability index are 2%, 9%, 37%, and 109% of the adult mAs. The results also indicate that with the use of respective optimal kVps, the photon-counting spectral system offers up to 30% higher [Formula: see text]dose than the modeled energy-integrating system for adipose imaging, and 70% for iodinated imaging.