Automatic tube current modulation for whole-body polytrauma CT with immobilization devices: is there an increase in radiation dose and degradation of image quality?

The objective of this study was the assessment of the image quality and radiation dose in polytrauma CT using immobilization devices. An anthropomorphic whole body and a liver phantom were scanned on a 128-slice CT scanner with four different protocols using automatic tube current modulation (120 kVp, 150 ref. mAs; 120 kV, 200 ref. mAs; 140 kVp, 150 ref. mAs; and 140 kVp, 200 ref. mAs) and four different setups (no immobilization device (setup A), vacuum mattress 1 (setup B), vacuum mattress 2 (setup C), and spineboard (setup D)). Qualitative and quantitative image quality parameters and radiation dose were assessed. Image noise increased on average by 6.6, 11.2, and 9.4 %, and CNR decreased by 11.2, 13.9, and 6.5 for setups B, C, and D, respectively, compared with setup A. The CTDIvol increased up to 6 % using immobilization devices. Severe streak artifacts, provoked by the inflation valve of the mattresses were detected at the level of the head and shoulder. Applying immobilization devices for whole-body CT with automatic tube current modulation increases the radiation dose and decreases the quantitative image quality slightly. Severe artifacts, induced by the inflation valve of the mattress, can influence the diagnostic accuracy at the level of the head and shoulder.