Trends in radiation dose and image quality for pediatric patients with a multidetector CT and a third-generation dual-source dual-energy CT.

To provide an overview on dose reduction and image quality after the installation of a third-generation dual-source CT (dsCT) in a Pediatric Radiology Department. We included pediatric patients (< 20 years old) undergoing CT for oncological staging (neck, chest and abdomen) or low-dose chest CT for lung diseases. Each of these two groups were further divided in two age groups (≤ or > 10 years old) including patients scanned in the same period of two consecutive years, in 2017 with a 16-row LightSpeed CT (GE Healthcare) or in 2018 with a Somatom Force dsCT (Siemens Healthineers). Technical parameters such as kVp, mAs, slice thickness, exposure times and dose indicators were retrieved and compared. Image quality was evaluated in consensus by two radiologists on a five-point semiquantitative scale. Nonparametric tests were used. In oncological patients, significantly lower kVp and tube current with better image quality were achieved with the dsCT. Radiation dose (total DLP) was 5-6 times lower with dsCT, thanks also to virtual non-contrast images. In low-dose chest CT, the frequent use of tin filter required higher tube current; a total DLP 3 times lower was achieved with dsCT in patients ≤ 10 years old. The image quality was better with the dsCT in low-dose chest CT protocols. The third-generation dsCT provides high-quality images with reduced motion artifacts at lower dose.